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Ranking Member Neal Opening Statement at Ways and Means Oversight Subcommittee Hearing

January 17, 2018
Press Release

Madam Chairwoman, I am glad that the Oversight Subcommittee is holding a hearing on the opioid issue as it relates to Medicare. Although overdose rates are highest for people 25 to 54, this public health emergency also affects Medicare beneficiaries. 

Everyone in this room has a family member or knows someone directly impacted by the opioid epidemic. In my home state of Massachusetts, there were 2,094 confirmed opioid-related overdose deaths in 2016.

Although overdose rates are highest for people 25 to 54, this public health emergency also affects Medicare beneficiaries. 

According to an Altarum November 2017 report, the economic burden from opioids was estimated to be $95 billion in 2016, $21.4 billion of which was attributed to health care services (direct and indirect costs) and $55.6 billion to lost earnings and productivity.

The statistics are shocking. In 2016, one-third of Medicare Part D beneficiaries filled a prescription opioid. One third of beneficiaries. This number is too high--we need to explore better ways to manage chronic pain. More alarming is that nearly 70,000 beneficiaries received “extreme” amounts of opioids that year. Whether that is due to abuse, misuse, or addiction, we need to get a handle on what is happening. In my home state of Massachusetts, there were 2,094 confirmed opioid-related overdose deaths in 2016.

Our witnesses today have a number of recommendations for ways Medicare can better monitor and prevent abuse. I hope that we can work in a bipartisan manner to urge the Centers for Medicare & Medicaid (CMS) to move quickly to implement them.

Congress and the Administration simply are not doing enough to help Americans access necessary treatment for opioid use disorders. President Trump declared the opioid epidemic a public health emergency in October – and the only thing his Administration and Congress have to show for it is a report, no action. The emergency declaration expires next week, but nothing has progressed. Yet another missed opportunity for positive action.

The most significant step that has been taken in recent years to stem the tide of the opioid crisis has been to expand Medicaid under the Affordable Care Act to low-income working Americans who previously could not afford insurance. The Medicaid expansion has provided millions of previously uninsured adults with access to health insurance which includes coverage for substance abuse and mental health services. In addition, other essential health coverage benefits have enabled them to seek screening and treatment services that previously were prohibitively costly. 

Last year, my Republican colleagues tried to enact $800 billion in cuts to Medicaid, eliminating the coverage that millions recently gained. And the Trump Administration is working to make coverage significantly more difficult. Another attempt to keep Americans from the treatment they need. This is an ill-advised course of action, and will exacerbate the challenges those in need of treatment are facing.

For Medicare – the specific topic of today’s hearing - we need to look to beneficiaries’ ability to access treatment, as oftentimes providers (or treatment options) aren’t available to meet the need. We know that there are significant gaps in coverage and access under Medicare. For example, Medicare does not cover Outpatient Treatment Programs (OTP) that provide comprehensive opioid addiction treatments nor does Medicare cover methadone for addiction, which is often the treatment of choice for longer-term addicts.

We clearly have work to do this year. We must stop undermining the programs that provide coverage and treatment for those who need it and instead strengthen and improve access to care and coverage.

Our witnesses today will provide suggestions for items that may help at the margins, which we should wholeheartedly embrace. However we must not lose sight of the bigger picture as well. Thank you. 

 

Watch the statement here.

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