The House passed a bill on Wednesday allowing the Medicaid program to pay for opioid and cocaine addiction treatment in certain inpatient facilities, despite opposition from many Democrats.
The bill passed in a 261-155 vote. It is part of the House’s two-week effort to pass more than 50 bills aimed at addressing the opioid epidemic, which is contributing to an estimated 115 American deaths per day.
Most of the legislation has been bipartisan, but Rep. Mimi Walters’s (R-Calif.) bill on expanding Medicaid funding for certain treatment drew rebukes from some Democrats.
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Rep. Frank Pallone Jr. (N.J.), the top Democrat on the House Energy and Commerce Committee, argued that the bill’s focus on just two drug addictions was too narrow.
He also noted that it doesn’t tie federal dollars to improving community-based services, which he says is an important part of ensuring that people continue to receive the help they need.
“Without that connection, states simply will not pursue these needed improvements,” Pallone said on the House floor Wednesday.
“And, without incentives to improve access to treatment more broadly, repealing the IMD exclusion to only a narrow population … through legislation may simply encourage greater use of expensive inpatient treatment, including for people for whom it may not be the best option.”
For five years, the bill would provide greater access to beds in certain inpatient treatment facilities for those on Medicaid and who have an opioid addiction. An amendment from Rep. Bobby Rush (D-Ill.) expanded the legislation to include those with a cocaine addiction and was adopted by voice vote.
The legislation partly lifts a decades-old rule preventing Medicaid from paying for care at treatment facilities with more than 16 beds, known as the Institutions for Mental Diseases (IMD) exclusion. The restriction was meant to prevent the warehousing of people with mental health disorders in large institutions.
“We are helping to ensure that people get the care that they need in the midst of this crisis, and most importantly, it will save lives,” Walters said on the House floor, adding that the IMD exclusion acts as a barrier to treatment.
During Wednesday’s debate on the bill, Democrats argued that the Department of Health and Human Services (HHS) is already allowing states to request waivers from the IMD rule. But Republicans countered that the waiver process takes time and is filled with uncertainty.
According to a Congressional Budget Office analysis, the bill would cost the federal government an estimated $991 million. The addition of the Rush amendment increases the price tag by about $130 million, according to a Democratic committee aide. The bill is fully paid for, Walters said.