There’s a long list of folks that the American Health Care Act (AHCA) would screw over. That includes thousands receiving treatment for substance use disorders, by endangering funding that subsidizes treatment centers like the Operation Parental Awareness and Responsibility (PAR) addiction treatment center in Largo. On Monday, May 8, House Representative Charlie Crist, a St. Petersburg Democrat, held a roundtable discussion at PAR to learn more about the folks working to overcome a problem that kills at least ten Floridians a day.
The meeting comes less than a week after Florida Governor Rick Scott declared a public health emergency to address Florida’s opioid epidemic, a step forward that was promptly followed by multiple steps backward as House Republicans voted to repeal Obamacare and implement the American Health Care Act.
Crist called the Republican healthcare bill a “disaster” that would terminate coverage for folks receiving mental health and addiction treatment that is currently mandatory under the Affordable Care Act. In spite of the consequences, Trump, who campaigned on the promise that no one would lose healthcare, has praised the bill as “a great plan.”
The AHCA still has to pass the Senate, which Crist says is unlikely given the bill’s unpopularity. “The Senate is not going to let that happen,” said Crist. “I’ve even heard Republicans say ‘I’m concerned.’” He pointed to warnings from Republican representatives like Senator Lindsey Graham (R-SC).
Graham took to Twitter to say he is “concerned with the process” and that the bill “should be viewed with caution” after the House rushed the bill through with little review and no report from the Congressional Budget Office.
Crist rebuked House Republicans who supported the bill, which would include an $880 billion cut to Medicaid, a vital source of coverage for low-income individuals receiving what is often lifesaving treatment for health conditions like addiction. “You’d have to have a heart of stone to want to do that for your fellow man or woman — the poor and disabled,” said Crist, in a refrain from a speech he gave at Saturday’s “Save Affordable Healthcare” rally in St. Petersburg.
Many of the folks at the roundtable were mothers in the midst of methadone treatment. PAR is one of few treatment centers that allows mothers to stay with their children while receiving methadone treatment. Holding her six-month-old baby, one of the mothers, whose name has been withheld for her privacy, told Crist that methadone has been crucial to her maintaining sobriety. “That keeps us from having that craving, that urge,” she said.
Mike Osborn, clinical director of medication assisted patient services at PAR, explained that medication like methadone “is such a long-acting medication that the withdrawals will be stronger than with a short-acting opiate," and termination midway through treatment could derail a patient’s progress to sobriety.
People in the middle of medication-assisted treatment, like methadone and buprenorphine regimens, stand to lose access to care if the bill passes. Many healthcare professionals consider medication-assisted treatment the most effective for opioid use disorder and say that abrupt termination of treatment could result in powerful withdrawals.
“If they cancel the essential health benefits it will not be covered,” said PAR CEO Dianne Clarke, PhD. Methadone treatment “is about a one-year process for people to get their brain chemistry restabilized [sic] and then be able to have their lives back in order and start to come off it. It’s a long-term medication. Ninety percent of people will relapse if they are not on methadone.”
Meanwhile, Scott has yet to respond to the GOP’s move. The bill was passed two days after Scott’s declaration, which gives state agencies expedited access to $27 million in funds from an Obama-era grant allocated for opioid treatment and research.
It’s unlikely that the funding would be enough to stem a multibillion-dollar epidemic, and under Trump’s proposed budget, states won’t receive much more help from federal agencies. In spite of Trump’s campaign promises to end the opioid epidemic, his so-called skinny budget would cut 95% of the funding for the Office of National Drug Control Policy, the agency leading the effort to stem opioid use disorder.