Federal funding for government programs is not comparable to getting a raise at work. Increases in Medicaid spending over time do not amount to more money per enrollee; rather, the increases are necessary to maintain the current level of service provision. For all government programs, including Medicaid, funding increases are set to account for population size, new enrollees, inflation, and projected levels of service utilization, staffing needs, etc. The Congressional Budget Office estimates that the funding levels stipulated in the Senate bill (which has already been rejected by the same party who wrote it) would result in a nearly $800 million shortfall in Medicaid funding. You don’t have to call it a cut, but the outcome is the same: Medicaid funding would be insufficient and the budget would be smaller relative to its current size. As a result, many people who would qualify for Medicaid today would not qualify in the future, and many of the services provided by Medicaid today could not be provided in the future. For opioid addiction, this is particularly problematic, given that the opioid crisis is rapidly growing in size and severity. Thus, as the need for services is increasing, the ability to provide those services would decrease, resulting in an even greater gap between treatment needs and treatment provision. Without prompt and comprehensive addiction treatment, rates of untreated Hepatitis, HIV, tuberculosis, and other blood borne diseases would increase, leading to a spiral of rising costs — and a smaller relative budget to deal with the public health crisis.
