West Virginia has been called “ground zero” of the opioid epidemic that is ripping across the nation. Every day, 144 Americans die from an opioid overdose. Here in West Virginia, 818 died in 2016 from drug overdoses, the highest death rate in the nation.
It is hard to imagine that it could get worse. But it could and it will, if the U.S. Senate’s proposed health repeal bill is enacted. The Senate version of the American Health Care Act would cripple our efforts to combat the opioid epidemic by ending the Medicaid expansion, cutting hundreds of billions of dollars in federal Medicaid funds and radically changing the structure of the program through federal funding caps.
These changes would be particularly devastating in West Virginia, which currently receives 78 percent of funding for the state’s Medicaid program from the federal government.
Based on a report by the nonpartisan Congressional Budget Office about the House version of the bill, West Virginia would lose over $4 billion in Medicaid funding over the next decade. Early analysis indicates that the loss of funding could be even greater under the Senate’s plan.
Vital programming reliant on federal Medicaid dollars, including school-based community health clinics that are a lifeline in our rural communities, would likely be unable to continue. With nearly 30 percent of West Virginians receiving health coverage through Medicaid and CHIP, the loss of this funding would mean significant reductions in the number of people and the scope of services eligible for coverage.
In West Virginia, federal funds provided through Medicaid expansion offset $43 million in state behavioral-health program funding in 2015 alone.
Not only are more West Virginians able to access life-saving addiction treatment, but the state also saves money that it is now able to reinvest in the well-being of our communities.
But the impact would extend beyond Medicaid coverage and funding. According to the CBO report on the House version of health care repeal, which is the basis for the Senate’s proposal, 23 million more Americans would be uninsured. Since West Virginia’s uninsured population dropped from 14 percent in 2013 to 6 percent in 2016 — the lowest it has ever been — we can expect to see the state’s uninsured rate shoot back up if the health bill is passed in its current form.
A recent report by the Center on Budget and Policy Priorities reveals that 214,500 West Virginians with mental-health and substance-use disorders are covered through state exchanges and Medicaid expansion. Prior to the requirement in the Affordable Care Act that all insurers must cover mental-health and addiction treatment as part of their essential health benefits, many health plans excluded this coverage.
Under the version of the AHCA which the Senate is now considering, this coverage would be significantly weakened or altogether stripped away, taking us back to the time when insurers could discriminate against people based on their medical histories. This would hit West Virginians especially hard, as the state has the highest share of people with declinable pre-existing medical conditions in the country.
As we continue to witness the escalating devastation of the opioid epidemic in West Virginia, we simply cannot afford to strip addiction coverage from young people and adults who need prevention, treatment and recovery supports. We simply cannot afford to bear the full burden of the cost to combat this crisis on state budgets alone.
Sen. Capito and Sen. Manchin have an obligation to ensure that health reform includes provisions that expand access to addiction prevention, treatment and recovery services. They must vote no on the Senate version of the AHCA. The health of West Virginians and the economic well-being of the state depend on it.
Paul Samuels is president of the Legal Action Center, a national nonprofit organization with a mission to fight discrimination against people with addiction, HIV/AIDS and criminal records. Chantal Centofanti-Fields is executive director of West Virginians for Affordable Health Care.
