Locals fear Medicaid cuts would hurt opioid fight

Reductions in Medicaid spending at the state or federal level would negatively impact local efforts to curtail drug addiction at a time with a record number of deaths related to the epidemic in Trumbull County, local officials say.

“It will definitely have a negative impact on anybody trying to get addiction and mental health treatment, people who became qualified for treatment under the expansion,” said April Caraway, executive director of the Trumbull County Mental Health and Recovery Board.

About 80 percent of the people served by local treatment agencies receive Medicaid insurance, Caraway said.

The Medicaid expansion helped 3,840 Trumbull County residents receive $9.4 million in treatment services in 2016, Caraway said.

“Medicaid expansion has enabled thousands of Trumbull County residents to get mental health and addiction treatment. Anything you can do to keep Medicaid expansion is necessary, as it will save lives,” Caraway said.

Federal lawmakers are working on a bill to repeal and replace the Affordable Care Act, which expanded Medicaid services to millions of low-income residents. The U.S. Senate is working on the bill; a version the U.S. House passed threatens cuts to services to millions.

Both bills essentially roll back the Medicaid expansion enacted in the ACA that has benefited more than 10 million Americans. Both significantly reduce funding for the entire Medicaid program that currently benefits 75 million Americans.

If these bills become law, more than 20 million Americans would lose coverage over the next 10 years, according to estimates from the nonpartisan Congressional Budget Office.

“If there is a freeze, we don’t know where the funding will come from to treat these people. More will die, and that is sad, because treatment works and people do recover,” Caraway said.

Republicans in the Ohio House and Senate argue the state’s budget includes nearly $180 million in funding to combat the opioid crisis, “on top of the nearly $1 billion already spent by the state annually on drug abuse and addiction.”

“Included is $60 million in funding for child protective services and programs to support children in drug-affected families; an additional $2 million dollars over the biennium to support county coroners and criminal and forensic labs who are facing case overload issues; maintaining $20 million capital commitment for the expansion of treatment and recovery housing; funding critical upgrades to the Ohio Automated Rx Reporting System (OARRS) system, a statewide effort to track prescriptions and combat prescription abuse, and adding a $5 million investment to help counties establish drug abuse response teams, among other initiatives,” according to a statement from the Ohio Senate Majority Caucus.

Frank Migliozzi, commissioner of the Trumbull County Combined Health District, said he worries about cuts to research and prevention dollars, as well as the long-term effect on society.

“The thing is, when it comes to public health, people don’t immediately see the positive effects of research and prevention, because it takes time,” Migliozzi said. “But in the long-term, those efforts prevent the spread of disease and saves the cost of caring for people who would have needed treatment.”

If those dollars are eliminated or reduced, prevention efforts may not materialize into the results society needs to progress, as well as coming or present public health concerns — like the opioid crisis, Migliozzi said.

More people have died from drug overdoses in Trumbull County each year since 2013, when 39 died, according to data from the Trumbull County Coroner’s Office. The county is on track to surpass the record-breaking number of 106 accidental overdose deaths it set in 2016. Halfway through this year, 40 people are confirmed to have died from overdoses, with 18 more suspected.

If cuts were to come to Ohio’s Medicaid expansion program, Caraway wondered if county mental health and recovery boards like hers would receive an influx of funding, because the boards’ budgets were cut to help pay for the expansion.

“I don’t hear anyone discussing giving more allocations to us to pay for the treatment if the expansion is done away with,” Caraway said.

The Associated Press contributed to this report.


By the numbers:

Medicaid expansion

500 — number of Trumbull County residents who have overdosed so far this year.

460 — number of Trumbull County residents saved from an accidental overdose so far this year

3,840 — number of Trumbull County residents receiving benefits through the expansion of Medicaid

$9,354,545 — value of services Trumbull County Medicaid expansion enrollees received in 2016

SOURCE: Trumbull County Mental Health

and Recovery Board