West Virginia Sen. Shelley Moore Capito is asking for more funds to address the opioid crisis — but that’s not all.
No health care bill is passing the Senate without Sen. Shelley Moore Capito (R-WV) . But she’s making herself tough to get these days. Capito has been asking for $45 billion in federal funding to address the opioid crisis and less severe spending caps for Medicaid. Her state has been devastated by the opioid crisis, now killing 30,000 American annually, and a third of its families Medicaid. She finally got the first condition Wednesday night, when Politico that Senate Majority Leader Mitch McConnell would increase the bill’s funding for the opioid crisis from $2 billion to $45 billion. But a couple of days ago, Capito told me that wouldn’ t be enough. She also wants a more generous spending cap for Medicaid — which, to be clear, still fundamentally changes the program from an open-ended entitlement. Right now the Senate spending caps are even harsher than the House’s were. The CBO the Senate bill would reduce Medicaid spending by $772 billion over 10 years, versus current law, and lead to 15 million fewer Americans being enrolled in the program. It also eventually ends the generous federal funding for Obamacare’s Medicaid expansion; Capito has okayed that provision, though she has pushed for the phaseout to be more gradual. “More opioid funding would be very good, very beneficial, but the core for me is the Medicaid provisions, ” Capito said then. “You can grant the state more money for treatment, but if you can’ t access the treatment, it’s not going to do you any good.” What about now that a big chunk of change — $45 billion — has officially been added to the bill? “I’ m optimistic on the opioid funding, but I haven’ t had anything finalized yet, ” she told me. Does she still need Medicaid changes to support the bill? “I’ m still looking at it, ” she said. “I’ m not convinced I’ m there. I’ m not there yet, I know that.” I observed she seemed more optimistic than she had earlier in the week. “I wouldn’ t characterize it like that, ” she said, with a bit of a smile. People who advocate for more opioid addiction treatment and funding in Washington are watching Capito and her compatriot, Sen. Rob Portman of Ohio, closely. They want more funding for state programs, sure — though they wonder if any money added to the Senate health care bill would be mandatory spending — but they are primarily concerned with Medicaid. Medicaid is the largest payer of addiction treatment in the country, and Capito and Portman’s request for $45 billion was based on the expected Medicaid cuts. But even members of President Trump’s own commission on opioids said that wasn’t enough money. Outside estimates think a number closer to $200 billion over 10 years would be needed, Politico. So addiction recovery advocates in Washington are urging Capito and Portman to hold their ground and press for less steep Medicaid cuts. The medical treatment that people in recovery need goes beyond addiction services. «With the proposed cuts to Medicaid in this bill, even if there were $50 billion included for [recovery] services, consumers would still be at risk because of problems that accompany addiction such as hepatitis, HIV, and endocarditis, » Andrew Kessler, who focuses on these issues at Slingshot Solutions, told me recently. «To say nothing of the mental health disorders that can often accompany addiction.» «So whether McConnell is trying to buy a couple of votes for either $2 billion or $50 billion, » he continued, «in the end, we hope that senators who have long supported the [recovery] community won’t sell their votes for 30 pieces of silver.» Nationwide, 22 mothers out of every 100,000 live births died during childbirth in 2013.California has found a way to buck that trend.. Are you an Obamacare enrollee interested in what happens next? Join our for conversation and updates.
