Bipartisan group wants to lift Medicaid restriction on substance abuse treatment

A bipartisan group of senators want Congress’ final opioids package to lift a decades-old restriction on Medicaid funding for substance abuse treatment.

Sens. Rob Portman (R-Ohio), Ben Cardin (D-Md.), Dick Durbin (D-Ill.) and Sherrod Brown (D-Ohio) introduced a proposal Tuesday to allow states to use Medicaid money to pay for coverage at addiction treatment facilities for people with diagnosed substance use disorders for up to 90 consecutive days — something prohibited under federal Medicaid law.

“This new legislation represents a thoughtful, bipartisan solution that will expand access to treatment while targeting the cost, and we will push for its inclusion in the final House-Senate opioid package,” Portman said in a statement.

The House and Senate are resolving the differences between their two opioid packages before holding a vote on the new bill and sending it to the president.

Lifting these funding restrictions is a contentious issue for Congress as it deals with the nation’s growing opioid crisis.

Supporters say it would expand access to treatment for those with substance use disorders – many of whom use Medicaid.

But opponents worry about the cost, and say the money could used more wisely in other ways that address the epidemic.

Current federal law bans the use of Medicaid funding for inpatient, residential treatment facilities with more than 16 beds. This provision was included in the law when Medicaid was passed in 1965 and was aimed at preventing the warehousing of mentally ill people in large institutions.

But the science of addiction treatment has improved over the past decade, and now the restrictions pose a barrier to people who need inpatient services, advocates argue.

Portman’s bill would “tear down the walls keeping people from recovery,” said Dr. Kelly Clark with the American Society of Addiction Medicine.

“It’s letting us practice addiction medicine the way we know is appropriate.”

The opioids packaged passed by the House earlier this summer partially repeals these restrictions for fiscal years 2019 through 2023 for Medicaid beneficiaries aged 21 to 64 with opioid use disorders.

The Senate package passed Tuesday didn’t include a repeal of the restrictions.

But Portman said he will push to have his bill included in the final bill that comes out of the conference with the House.