Trump’s Budget Could Accelerate the Opioid Crisis

Candidate Donald Trump tapped into the angst and fear gripping rural America. He promised out-of-work coal miners he’d get them their old jobs back, even if that’s likely impossible; told seniors and poor people he was the only candidate who wouldn’t touch their Social Security or Medicaid, even as his party actively tried to overhaul those programs; and told the nation he’d end the opioid epidemic ripping through communities across America – a promise he’s now also turning his back on.

The president’s budget released this week proposes slashing Medicaid by between $610 billion and $1.4 trillion. (The budget is so shoddily produced that budget experts and the administration have failed to agree on the actual amount of the proposed cuts.) This could be devastating for all 50 states.

The Kaiser Family Foundation reports that about 30 percent of the roughly two million people who are struggling with opioid and heroin addiction in the U.S. receive treatment from Medicaid or the Children’s Health Insurance Program, known as CHIP. The treatment comes in the form of inpatient detox programs, hospitalization, outpatient programs and continuous case management so people don’t relapse. But Medicaid is largely free, or at least low-cost, for patients, and that has Republicans up in arms.

“We have two groups of people: those Americans who believe in more freedom, and … those Americans who believe in more free stuff,” Republican Sen. John Kennedy says at Thursday’s budget hearing, at which Office of Management and Budget Director Mick Mulvaney was testifying.

Mulvaney, a former South Carolina congressman, echoes Kennedy, saying Trump’s budget tries to keep “free stuff” out of the hands of the nation’s undeserving, like addicts, poor people and the elderly. He says the budget is aimed at restoring confidence in other taxpayers.

“What this budget does is looks them in the eye and says, ‘We’re not going to allow that anymore, and if we are wasting your money we are going to stop.’ If it’s going to somebody who shouldn’t get it, we’re going to stop. And we’re going to respect your money as much as you do,” Mulvaney testifies.

That response comes across as tone deaf to lawmakers representing the states most affected by the opioid epidemic, like Ohio – where some 200,000 people were put on Medicaid because of the Affordable Care Act, which the GOP is desperately trying to scrap.

“These families, you would hope, are on their way back, and then you’re going to rip this insurance away?” Democratic Sen. Sherrod Brown tells Rolling Stone. “It just strikes me as almost criminal that a bunch of elected officials that have government-paid insurance would yank it away from families – many of whom have full-time jobs and just don’t have insurance.”

The president’s budget would also roll back investments in other programs that have propped up the Heartland, like cuts to rural business programs, hospital funding, and housing and infrastructure programs. Altogether, slashing that federal support would hit rural America disproportionately hard.

“These cuts would be devastating if they take effect,” Democratic Sen. Amy Klobuchar says on the Senate floor Thursday. “Altogether these cuts not only threaten the progress we’ve made to fight against the opioid crisis, but they also threaten the prosperity of the rural communities that have been hardest hit.”

The president is also calling for cutting funding for the Department of Health and Human Services by 16 percent, which Democrats say is misguided. Coupled with the Medicaid cuts, they argue the GOP is just playing budget gimmicks that don’t help solve any of the nation’s problems.

“It’s not just the treatment for opioid addiction, but it’s also the fact that when you have fewer people insured, more people show up uninsured at the hospital, and those costs are passed on to everybody who has insurance,” Democratic Sen. Claire McCaskill tells Rolling Stone. “So it’s just saying we’re going to cut Medicaid to raise everybody else’s premiums.”

After receiving near universal pushback on Capitol Hill, the White House did reverse its proposal to cut the budget of the Office of National Drug Control Policy by about 95 percent, which would have basically killed the office of the drug czar. That was a win for lawmakers who have been trying to address the opioid crisis. But they’re not satisfied yet – they want more investment in Medicaid, HHS and the local health centers and hospitals that are on the front lines of the battle.

“We’ve got to invest in our people, and that means you’ve got to invest in treatment and helping people overcome that demon,” Democratic Rep. Keith Ellison tells Rolling Stone. The deputy chairman of the DNC says President Trump is abandoning the rural Americans who propelled him into the Oval Office. “Basically what he’s saying [is], ‘I’ve got a choice to make between my friend’s tax cut and your health. I want my friends to have the money and not you.'”