Our broken politics have been on full display this year. And nowhere has that been clearer than the fight over health care. I was a vocal critic of attempts to repeal the Affordable Care Act because the expansion of Medicaid and critical insurance reforms included in the law have helped expand access to treatment for substance use disorders. The law has actually saved lives.
Sadly, we know the opioid crisis is still getting worse. It has ravaged many hard-hit communities across the country where people are still struggling to find a job and stay sober. Even beyond the devastating loss of life, we have seen hard evidence that the opioid crisis is preventing people from getting jobs and hurting the economy.
I’ve recently commented on the White House analysis, which found that we lost more than $500 billion of economic growth in 2015 because of substance use disorders. It followed additional research earlier this year which found that employers were struggling to find qualified job applicants who aren’t addicted to opioids. With the CDC’s upcoming tally for 2016, we can expect that picture to get even worse.
Which is why I cannot understand the Center for Medicare & Medicaid Services’ (CMS) recent decision that could make it harder for people to get access to treatment.
The department recently announced new criteria that, for the first time, allows states to obtain wavers to “promote upward mobility.” In government speak, this means instituting work requirements for people to receive Medicaid. In practice, this really would allow states to deny coverage to people if they don’t have a job. Over the weekend it was reported that eight states (including Kentucky, Maine, New Hampshire and Indiana who have all been devastated by addiction) have already asked CMS for approval to institute these work requirements.
Now as a former CEO, I’m in favor of upward mobility and encouraging people to find a job. But we also must be realistic about the tremendous damage this national emergency is having on the day-to-day lives of thousands of Americans.
Requiring work as a pre-condition for receiving Medicaid coverage to treat addiction would likely only hurt those people who can’t work. If states go forward and implement these rules, you can almost guarantee that we’ll see a vicious cycle where people cannot get a job because of a substance use disorder — but then lose access to treatment through Medicaid. And all of this will ultimately lead to a greater loss of life.
We need to be smart about this. Taking away health care won’t improve the economy. It certainly won’t help reduce the amount of lives lost from the opioid crisis. If we really want to begin tackling the $500 billion anvil on the economy from the opioid crisis, we would start by increasing access to treatment. CMS should refocus on its mission to increase and strengthen coverage and quit playing politics with the survival of the people they are entrusted to help.