Pubdate: Fri, 13 Jan 2017
Source: Morning Call (Allentown, PA)
Copyright: 2017 The Morning Call Inc.


House Speaker Paul Ryan, R-Wis., told reporters Thursday that
Congressional Republicans are on a "rescue" mission to repeal and replace
the Affordable Care Act and that he and President-elect Donald Trump are
in perfect sync with the process of replacing Obamacare. (CHIP

Funding for mental illness and opioid addiction treatment in Pennsylvania
will take a big hit if the Affordable Care Act is repealed, according to
research published this week by Harvard Medical School.

More than 181,000 Pennsylvania residents with mental and substance abuse
disorders will lose access to services made available under the ACA,
concluded Harvard health economics professor Richard G. Frank and New York
University public service dean Sherry Glied.

Nationwide, repeal would cut at least $5.5 billion in federal funding that
helps more than 1 million people with serious mental disorders and nearly
3 million with substance use disorders -- of whom more than 200,000 are
opioid-addicted, the researchers found.

The 21st Century Cures Act, which Congress passed last month with the
support of overwhelming bipartisan majorities, authorized a $1 billion
increase in treatment over two years, Frank and Glied noted in an article
in The Hill newspaper in Washington, D.C.

"It would be a cruel sham for Congress to take an important, but modest,
step forward in investing in treatment capacity, while withdrawing funds
from the enormous recent progress made in addressing the needs for care of
those with mental health and addictive illness," they wrote.

The ACA is credited with extending health insurance to 20 million people.
To its opponents, however, it is the ultimate symbol of government
overreach -- an ill-fitting bureaucratic response to problems the
marketplace is better suited to resolve on its own.

Republicans, including President-elect Donald Trump and GOP leaders of
both the Senate and the House, have promised to undo Obamacare, as the law
is widely known. Though they've said they'll replace it with something
better, they've yet to put forth specifics.

As the country grapples with how to reverse an alarming trend in heroin
overdoses, The Morning Call is taking a deeper look at how opioid
addiction is affecting families and communities in the Lehigh Valley in
this occasional series of stories.

On Thursday, Senate Republicans took their first major step toward repeal,
voting 51-48 along party lines for a budget blueprint that would allow
them to gut the health care law without the threat of a Democratic

Of the Pennsylvanians with mental and substance abuse disorders who stand
to lose services, nearly 100,000 are covered through ACA marketplace
insurance, Frank and Glied found. The remaining 81,000 residents receive
coverage through an ACA-authorized expansion of Medicaid.

Particularly threatened is "medication assisted treatment" for opioid
addiction. Medicaid, the authors reported, contributes 29 percent of
Pennsylvania's funding for such treatment using buprenorphine, which
reduces painful withdrawal symptoms.

"This report makes clear that repealing the ACA without a plan to replace
it will deal a devastating blow to efforts to combat the opioid epidemic,"
U.S. Sen. Bob Casey, D-Pa., said. "The Republican obsession with repealing
the Affordable Care Act without a replacement plan is deeply irresponsible
and this report confirms that the consequences for those struggling with
opioid addiction are deadly serious."

U.S. Sen. Pat Toomey, R-Pa., who voted for repeal Thursday, was not
available for comment Thursday afternoon.

But U.S. Rep. Charlie Dent, R-15th District, who has voted for repeal in
the past, said, "The impact of repealing the healthcare law without a
pathway for reform or replacement on populations such as those suffering
from substance abuse or mental health issues is one of the reasons I have
urged my colleagues to not rush forward in initiating the repeal efforts.

"We did a lot of important work last Congress from providing better
resources to combat opioid abuse to enacting landmark mental health
reforms," he said. "I think it is critical that Congress and the President
proceed in a deliberative manner to ensure people do not suffer and that
the gains we made last Congress are not impeded."

ACA repeal could result in a number of unexpected consequences, the
nonprofit Kaiser Health News reported Thursday. For example, families with
autistic children could lose insurance coverage for therapy. Also in
jeopardy: Workplace breast-feeding rooms and restaurant calorie counts.

But the loss of funds for substance abuse treatment would come amid what
politicians on both sides of the aisle refer to as an opioid crisis.

Nearly 1 in 2 Lehigh Valley residents has a direct connection to the
crisis, with 43 percent saying they "personally know" someone who has been
addicted to heroin or another opiate, according to a Morning
Call/Muhlenberg College poll in June.

Evidence of an epidemic -- fueled by cheap and easy access to powerful
drugs, including painkillers prescribed by doctors -- is evident
throughout the Lehigh Valley.

Fifty-nine people died of accidental overdoses involving heroin or other
opiates in Northampton County in 2014 and 2015, coroner records show.

In Lehigh County, 40 people died over the same time period. Another 76
died from overdoses that were tied to multiple drugs.

Those who overdosed were as young as 15 and as old as 63, and their
average age was 38. Seventy-one percent were men, and 8 in 10 were white.
They lost their lives in the cities, in the suburbs, and in the
countryside, and in at least 18 of Northampton County's 38 municipalities
and 13 of Lehigh's 25 municipalities.

According to their obituaries, the victims included high school dropouts
and graduates, college students and college grads, an ironworker, a
retired chemist, a pharmacy technician, truck drivers, factory hands,
contractors and barbers.
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