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Congressman Richard Neal

Representing the 1st District of Massachusetts

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Neal Opening Statement at Markup of Bills to Combat the Opioid Crisis

May 16, 2018
Press Release

Mr. Chairman, I am pleased you are holding this markup today and that it has been carried out in a bipartisan manner. The opioid crisis is not a Democrat or Republican issue—it is a health, safety, family, community, and economic issue. Everyone in this room has a family member or knows someone close to them directly connected to the opioid crisis.

In 2016, there were 2,083 confirmed cases of opioid-related overdose deaths in Massachusetts. That is a 26% increase from 2015 and a 54% increase from 2014. In 2017 there was a small decrease, but clearly there is still a strong need to address this devastating trend.

Opioid use disorders are rapidly growing among Medicare beneficiaries. Medicare Part D spending on opioids far outpaces enrollment, growing 165% from 2006 to 2015. And this map (*hold up map*) illustrates the highest rate of inpatient admissions related to opioid use in the over 65 population. People think opioid use disorders are a problem impacting young people, but this chart clearly shows Medicare beneficiaries are at risk.

That is why the legislation that I introduced with Mr. Holding is so critically important. This bill adds Opioid Treatment Programs (OTPs) as a covered benefit under Medicare. Currently Medicare does not cover this sort of treatment. This would give Medicare beneficiaries access to a range of medication and behavioral treatment options leading to more hope for long-term recovery.

The Republicans have gone to great lengths to sabotage one of the best substance use and mental health treatment programs: the Affordable Care Act (ACA). Thanks to the ACA, millions of previously uninsured adults now have access to health insurance. It guarantees parity and non-discrimination for people who need substance use and mental health treatment. The ACA also expands Medicaid which is now the biggest payer for substance use disorder treatment. But instead of strengthening and ensuring a sustainable future for the measure, Republicans are using it pay for their $2.3 trillion tax plan. Like I have said before, this is ultimately about affordability. If these critical benefits on which the middle class rely are taken away, it would be a double whammy. It would not only reverse any progress to curb the opioid crisis but also increase health care costs and lower coverage and quality. That’s simply irresponsible.

Today’s markup covers four opioid policy areas: prevention, provider education, beneficiary education, and treatment options. All would make important contributions to the fight.

I’m also pleased that we’re considering the Securing the International Mail Against Opioids Act. This legislation stems from the STOP Act, a bill on which I worked closely with Representative Tiberi before his retirement. I commend the work done by Trade Subcommittee Ranking Member Pascrell on this bill, which enjoys bipartisan support and would help stop the flow of opioids coming into the United States.

Although we are taking steps today to address opioid use disorders, it is also important to remember there are many other families devastated by addiction to other substances like crack, cocaine, heroin, and alcohol. And I want to make sure we do not lose sight of how people of color continue to serve a disproportionate amount of time in prison for drug offenses. African Americans and whites use drugs at similar rates, but the imprisonment rate of African Americans for drug charges is almost 6 times that of whites. Prison is not a treatment system.

And the impact of the opioid crisis on the labor participation rate is just as concerning. According to a recent report, the economic burden from opioids was estimated to be $95 billion.

I want to take a moment to thank the staff on both sides of the aisle for their weeks of hard work to bring these bills to fruition. This effort exemplifies what has become an all-too-rare occurrence in Congress--bipartisan cooperation. In particular, thanks to House Legislative Counsel, CMS Office of Legislation and the staff at the Congressional Budget Office. Thank you for the significant time you have invested to get us to today. 

This is a complicated issue and one markup is not going to solve this public health epidemic or its impact on our society but this is a good first step. Mr. Chairman, I encourage you to continue this discussion so we can identify other Medicare policies to further promote access to treatment. Thank you