Addiction treatment coverage is slashed in the Republican proposal to replace the Affordable Care Act, which will strip away what advocates say is essential coverage for drug addiction treatment. This reduction in coverage is being proposed even as the number of people dying from opiate overdoses has continue to climb nationwide. Beginning in 2020, the bill will also leave basic mental-health treatment in the hands of the states under Medicaid.

The proposal will also roll back Medicaid expansion under the act, an essential component of treatment coverage for many struggling addicts. While its unknown what Congressional motivation is — whether it’s merely saving money or satisfying insurers — the action will directly affect states bearing the most damage from the opiate crisis. Under the ACA, Ohio, Kentucky and West Virginia expanded Medicaid, as well as thirty-one states and the District of Columbia. This coverage will be lost under the AHCA measure.Even more frustrating for many advocates was the closed-door session in which the proposal was created, leaving even Republican addiction advocates in the dark about how decisions were made.

Without Medicaid, many of the addicts finding recovery after a life-changing event, such as the death of a friend or their own overdose, will not be able to afford treatment and the burden will fall back on the individual or the state. Opiate addiction is particularly difficult for addicts to quit using on their own, often coming with horrible withdrawal effects such as burning stomach and leg cramps. Without a detox facility to pay for treatment, the opiate crisis is sure to have more casualties.

Treatment professionals warn that mental-health disorders often help feed addictive tendencies, and those with mental illnesses that go untreated are often left to their own devices, including self-medication. Currently, almost 1.3 million people receive treatment for mental-health and substance abuse disorders under the Medicaid expansion, according to research from health-care economists Richard Frank of the Harvard Medical School and Sherry Glied of New York University. Those who are currently benefiting from addiction treatment coverage may be the last addicts to benefit under the current Congress and administration.

Last week, House Republicans confirmed the cuts during a meeting of the House Energy and Commerce Committee, argueing that by dropping the requirement, states will gain additional flexibility in coverage decisions. Not all committee members, however, were on board with the change. Rep. Joe Kennedy (D-Mass.) said and Rep. Peter Welch (D-Vt.) tried to introduce an amendment during the committee meeting to include mandates for substance abuse and mental-health coverage. The amendment was quickly struck down¬† but it was along party lines. A few Republican senators, with constituents in the heart of the opiate crisis, expressed worry over removing the benefits. Sens. Rob Portman from Ohio, Shelley Moore Capito, from West Virginia, and Cory Gardner, from Colorado, with Lisa Murkowski, Alaska, sent a letter to Senate Majority Leader Mitch McConnell, R-Ky. They argued that the plan does not “provide stability and certainty” for individuals and families enrolled in Medicaid expansion programs or flexibility for states.

The AHCA bill is allegedly only in its first phases. Before the bill is finalized, Republicans are expected to repeal the Affordable Care Act in its entirety. The Intercept has also obtained documents that show a rollback of maternity benefits is planned for the next phase of the healthcare overhaul.

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