Congress set to tackle opioid legislation

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Congress is set to move forward on multiple pieces of opioid-related legislation as lawmakers return from a two-week recess.

On April 11, U.S. Senate lawmakers on the Health, Education, Labor and Pensions (HELP) Committee will consider a discussion draft of the Opioid Crisis Response Act of 2018, which contains wide-ranging measures that would help federal agencies address the crisis by improving access to telemedicine, increasing treatment services in areas with health provider shortages and establishing prescription limits on opioids.

Some of the proposals contained in the legislation follow up on programs originally outlined as part of the Comprehensive Addiction and Recovery Act of 2016 (P.L. 114-198), known as CARA, which passed into law with NACo’s support.

On April 11 and 12, the U.S. House of Representatives Energy and Commerce Committee will hold a two-day hearing focused on the opioid epidemic. During the hearing, members on the committee will also consider a total of 34 legislative proposals to combat the crisis via changes to Medicaid and Medicare. Many of these proposals focus on expanding patients’ access to Medicaid and Medicare-eligible addiction and recovery services.

NACo has endorsed two bills set for consideration by the Energy and Commerce Committee. The first piece of legislation, H.R. 4005, the Medicaid Reentry Act, would allow justice-involved individuals to receive federal Medicaid benefits for the 30-day period prior to their release, rather than being disenrolled from the program while they are in jail. The second bill, H.R. 1925, the At-Risk Youth Medicaid Protection Act, would allow for more timely provision of addiction treatment services for juveniles released from county correctional facilities, thereby reducing the risk of overdose death. These measures would help counties provide effective treatment and care coordination services pre-and post-release, allowing for smoother transitions to community care.

The bundle of proposals also contains a measure that would ease the Institutions for Mental Disease (IMD) exclusion barring treatment facilities with more than 16 beds from receiving Medicaid funds. NACo has long supported and prioritized federal legislative or regulatory changes that would alleviate the IMD exclusion.

It remains unclear whether the House will combine the separate bills into a broader legislative package or consider proposals individually. Energy and Commerce Committee Chairman Greg Walden (R-Ore.) indicated the House would attempt to pass opioid-related legislation by late May.

Congress’ consideration of opioid legislation this week comes shortly after lawmakers authorized approximately $6 billion in funds to address the opioid epidemic over two years as part of the budget agreement approved in February 2018. The FY 2018 omnibus bill, which passed in March 2018, specifically allocated opioid funding across multiple federal agencies and programs and contained a $2 billion increase in federal funds to combat the epidemic above FY 2017 levels.  

NACo will continue to engage with Congress and the administration to ensure county priorities are represented in legislation addressing the opioid crisis. On April 11, NACo sent two letters to Congress supporting bills that would help local health and social services providers, law enforcement and coroners meet the needs of communities impacted by the epidemic. Both letters can be found below. 

For more NACo resources on the opioid epidemic, please see the following:

NACo Letter to Congress on the Comprehensive Addiction Resources Emergency (CARE) Act

NACo Letter to Congress on the Medicaid Reentry Act and the At-Risk Youth Medicaid Protection Act

NACo Legislative Brief: Highlights of the FY 2018 Omnibus Federal Spending Package for Counties

County News: White House unveils strategy to fight opioid abuse

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