ROBERT SIEGEL, HOST:
The latest version of the Senate GOP health care bill includes $45 billion to help fight the opioid crisis. A handful of Republican senators who represent states hit hard by the crisis pushed for the money because the bill dramatically decreases other spending. Ben Allen of member station WITF looks at the numbers.
BEN ALLEN, BYLINE: Forty-five billion dollars sounds like a lot of money.
RICHARD EDLEY: No one would laugh at $45 billion.
ALLEN: Richard Edley is the head of a group that represents some 170 substance abuse treatment providers in Pennsylvania. But Edley says he started to do the math and got really concerned. That's because the opioid grant is packaged with a cutback in federal Medicaid spending, which could mean many lose their insurance. Edley imagines having a conversation with someone fighting cancer.
EDLEY: Bad news is you've lost all your benefits, but the good news is we're going to do some grant funding to your state for cancer treatment, roughly about $900 a person for you. You'd look at them and say, that's no way to be doing health care. But that's exactly how we're treating substance use disorders.
ALLEN: Other back-of-the-envelope calculations show that amount might average to about $2,000 a person for about a hundred thousand people. But that still wouldn't be enough, he says. Last year through expanded Medicaid, 124,000 people in Pennsylvania got help for their drug addiction. Edley says Pennsylvania's share of that 45 billion would get eaten up quickly.
EDLEY: I think if this plan actually went into place the way it's designed, within six months or a year, we're going to be back at the drawing board realizing, all right, that didn't work. And there's too many people being hurt.
ALLEN: Treatment usually involves many steps and medication to manage cravings. Like any other chronic disease, it can take years to stabilize someone addicted to opioids. More than 50,000 people died from drug overdoses last year in the U.S. Pennsylvania's drug and alcohol acting secretary, Jennifer Smith, says the GOP plan would lead to those numbers growing even more.
JENNIFER SMITH: Doesn't even come close. And you know, we can piece together some solutions that might help get us a little closer to where we had been, but the end result is more people are going to die.
ALLEN: And Smith says there would be ripple effects - grandparents taking care of grandkids, bankruptcies because of treatment costs, more work for county children and youth services. Smith also worries less treatment means more people will be desperate to support their habit.
SMITH: And they end up with a criminal record. Nobody wants to hire them.
ALLEN: So they drop out of the workforce. Pennsylvania's Republican U.S. senator, Pat Toomey, supports cutting federal spending on Medicaid, arguing if states want to keep people covered, they should pay more of the bill. He also says fighting the opioid crisis is a top priority. His office didn't directly answer how the cuts line up with fighting the epidemic, but his office says current Medicaid spending is unsustainable. Smith says chopping at Medicaid won't solve any problems because people who can't get treatment often end up with other problems that require government help.
SMITH: There shouldn't be a price tag on it. The question should be, how much do you need, not, is 45 billion enough?
ALLEN: Democratic Governor Tom Wolfe says if the federal government reduces funding, the state wouldn't be able to make up most of that lost money. For NPR News, I'm Ben Allen in Harrisburg.
SIEGEL: And that story is part of a reporting partnership of NPR, WITF's Transforming Health project and Kaiser Health News.
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