Senate health care bill contains $2 billion to address opioid crisis, a fraction of what some had hoped

The U.S. Senate's health care bill contains $2 billion to help fight the opioid crisis gripping the nation, far less than some Republican senators had initially hoped. 

The bill includes $2 billion for fiscal year 2018 to provide grants to states for treatment and recovery services for people with mental or substance abuse disorders.

► Related:Senate Republicans unveil health care bill that slashes taxes, rolls back Medicaid

► Related:How the opioid crisis is impacting Tennessee

► Related:Read the full Senate bill

This amount would fall short of the $45 billion some Republicans senators had sought over 10 years, according to reports in The Washington Post and The Hill. 

But Sen. Lamar Alexander, R-Tenn., said the bill increases resources to fight the opioid crisis and that some senators are likely to lobby for additional funding when the legislation goes to the Senate floor next week.

"It’s by far the largest amount Congress has ever appropriated in one year for opioids,” Alexander said in an interview.

The 21st Century Cures Act, which Alexander ushered through Congress last year, included $1 billion in grants to states. But that money was spread over two years.

U.S. Rep. Marsha Blackburn, R-Brentwood, said the funding in the Senate version would build upon what Congress previously approved.

“As the Senate continues working on their bill, it is important to keep in mind that any funding for the opioid crisis works to build on the $1 billion we included to combat the epidemic in the bipartisan and bicameral 21st Century Cures Act which became law last year," she said in a statement. "Moreover, as the ACA marketplace continues to fail across the country, any funding we put forward in our health care package is funding that wouldn’t exist under current law.”

In Tennessee, the opioid crisis has hit hard.

A report released earlier this year detailed a surge of deaths between 2012 and 2015. In 2015, at least 1,451 Tennesseans died from drug overdoses. That's 22 drug overdose deaths for every 100,000 Tennesseans.

Democrats slam Senate proposal

Tennessee Democrats have offered fiery critiques of the plan and the GOP's decisions "made behind closed doors."

Gloria Johnson, a former Democratic state representative, was among advocates who held a “die-in” protesting the proposed GOP health care bill Wednesday night in Knoxville’s Market Square.

Johnson said the $2 billion the Senate bill allocates to states to fight the opioid epidemic in 2018 “falls far short of what is required to fight the opioid epidemic in our country,” especially in hard-hit Appalachia.

“Coupled with the massive cuts to Medicaid and loss of protections for 10 essential health benefits, which includes mental health, in the Senate bill, we will be taking steps backward in fighting addiction and getting people the access to the care they need for recovery,” Johnson said. “We need public hearings with experts to determine exactly how much damage this bill will cause.”

 U.S. Rep. Jim Cooper, D-Tenn., said called the bill "more of the same."

"Brutal cuts, fewer covered, worse care," he said. "No wonder Senate Republicans worked so hard to keep this bill a secret. But beware of last-minute deals that lead to sudden passage.”

U.S. Rep. Steve Cohen, D-Tenn, said Senate health care included "tragically" and "fatally" deep cuts.

He said the bill provides "woefully inadequate funding to fight the opioid epidemic."

Opioid addiction a national crisis

According to data compiled by the Associated Press, the Affordable Care Act’s Medicaid expansion allowed states to help address the opioid crisis. That expansion accounted for 61 percent of total Medicaid spending on substance abuse treatment in Kentucky, 47 percent in West Virginia, 56 percent in Michigan, 59 percent in Maryland, and 31 percent in Rhode Island.

In Ohio, the expansion accounted for 43 percent of Medicaid spending in 2016 on behavioral health, a category that includes mental health and substance abuse.

Tennessee did not expand Medicaid under the Affordable Care Act. 

Those states that accepted Medicaid expansion funds represent a cross-section of places hardest hit by the nation's drug-overdose epidemic, which claimed more than 52,000 lives in 2015.

Of the deaths, more than six in 10 were due to opioids, from prescription pain relievers like oxycodone to street drugs like heroin and an elephant tranquilizer, the Associated Press reported.

At a recent budget hearing, Health and Human Services Secretary Tom Price defended the Trump administration and raised questions about how much difference Medicaid actually makes.

Nancy Carter Daniels, founder of Tennessee Overdose Prevention, is worried there won’t be enough funding to go around to buy more of the opioid antidote naloxone.

“The United States and Tennessee have made significant progress in the last year in funding, but we need to increase this funding — not decrease it — so that more people have a chance to live," she said.

The HHS budget for the opioid crisis is more than three times as great as two years ago, $811 million versus $245 million, Price said. That reflects increases approved by Congress beyond what Medicaid spends.

The Senate's 142-page bill to repeal the Affordable Care Act contained a single mention of the opioid crisis on page 133.

Michael Collins, Kristi L. Nelson and the Associated Press contributed to this report.

Reporter Jordan Buie can be reached at 615-726-5970 or by email at jbuie@tennessean.com. Follow him on Twitter @jordanbuie.