Addiction Policy News

ASAM Opposes Grant Funding as Alternative to Medicaid in BCRA

June 29, 2017



Today it was reported that Senate negotiators working on the Better Care Reconciliation Act (BCRA) have added to the bill $45 billion in funding to combat our nation’s ongoing opioid overdose epidemic, which killed more than 33,000 Americans in 2015. The American Society of Addiction Medicine (ASAM) opposes this attempt to patch a fundamentally flawed health care bill, and calls on the Senate to reject grant funding as a means to finance health care.


“No amount of grant funding can provide the sustainable, predictable, and flexible funding that health insurance can, and addiction treatment providers cannot rely on uncertain appropriations to run their practices” said ASAM President Dr. Kelly Clark. “At a time when we are moving toward integration and care coordination, this approach moves us backward toward separate and unequal treatment systems for addiction and all other medical care.”


Grant funding targeted for the treatment of opioid addiction ignores the biology of the underlying disease and the high prevalence of co-occurring mental illness and other medical conditions among persons with opioid use disorder. According to the 2015 National Survey on Drug Use and Health (NSDUH) issued by the Substance Abuse and Mental Health Services Administration (SAMHSA), of the 19.6 million adults with a past year substance use disorder, 8.1 million (41.2 percent) also had a mental illness.


“Opioid addiction cannot be treated in isolation, and funding only addiction treatment when patients have other chronic and complex medical needs is likely to be ineffective,” said Dr. Corey Waller, Chair of ASAM’s Legislative Advocacy Committee. “This approach just doesn’t make any clinical or economic sense.”


The Congressional Budget Office (CBO) estimated that the latest draft of the BCRA would cut $772 billion from Medicaid, which is the largest and most significant source of coverage and funding for addiction treatment in the country, and cause 15 million Americans currently covered by Medicaid to lose coverage. Medicaid also pays for an estimated 45-50% of medication treatment for opioid addiction in states like Ohio and West Virginia that have been hit the hardest by the opioid epidemic.