Democrats Hone in on Opioid Crisis in Bashing Proposed Medicaid Cuts

• Not just Zika: Other mosquito-borne viruses may cause birth defects, study suggests
• STAT Plus: European Union moves toward a formal policy for reviewing new medicines
• STAT Plus: Show me the data: Docs remain squeamish about Merck lung cancer drug as first-line treatment
• CDC Director Brenda Fitzgerald resigns after report she invested in tobacco stocks
• STAT Plus: Pharmalittle: Moody’s cautions on Sanofi deals; Pfizer vows to invest in the U.S.

Health and Human Services Secretary Tom Price defended the White House’s proposed cuts to Medicaid in its 2018 budget blueprint before a pair of congressional committees on Thursday, parrying blows from Democrats furious over spending reductions they say President Trump pledged on the campaign trail never to approve.

“What kind of voodoo math are you using to justify your statements claiming to help Americans?” Rep. Linda Sanchez of California, a Democrat, asked Price at a hearing before the House Committee on Ways and Means, “when you’re taking over a trillion dollars out of the system to pay for tax cuts for the rich?”

Price maintained that the 2018 budget blueprint is not a cut to Medicaid. The allocation proposed for Medicaid is indeed an increase over the previous fiscal year. But in 2018 and in future years, the pace of increases is slowed such that Medicaid expenditures would drop by 25 percent over the next decade as compared with current law.

The secretary also repeatedly countered with an argument often made by White House Budget Director Mick Mulvaney: The success of federal programs should not be measured by the size of their budget, he said, because if they were, HHS would be by consensus the most effective federal department.

Democratic lawmakers on Thursday also coalesced around one issue as a line of attack against the cuts: the opioid crisis.
“How do you plan to increase access to treatment when you cut the single biggest source of funding for treatment by $600 billion in your budget,” asked Sen. Sherrod Brown of Ohio, a Democrat, pointing out that nearly two-thirds of the money his state spent on drug abuse issues last year came through Medicaid. “How does that possibly add up in the Trump-Price math of 2017?”

As of 2014, Medicaid picked up the tab for 21 percent of substance-abuse treatment spending and covered roughly one-quarter of medication-assisted treatments. Democrats have said that Medicaid rollbacks that would follow a partial repeal of the Affordable Care Act could strip access to services that patients use to combat drug addiction.

Republicans remain vocal on the issue as well. On Thursday morning, Sen. Orrin Hatch of Utah, the Republican who chairs the Senate Finance Committee, asked Price how he planned to tackle the crisis, which he had listed at the beginning of the hearing as one of three major HHS priorities for the coming year.

“We’re identifying the kinds of treatment and recovery efforts that work,” Price said, citing public health, law enforcement, and new treatment aspects of the opioid fight that his department was pursuing. “Assisting in the states — we want to make sure we have overdose-reversing drugs available wherever they need to be available.”

While there is bipartisan agreement about the urgency and severity of the opioid crisis, Democrats remained incredulous that Medicaid recipients who use the program to pay for drug abuse treatment would not be left hanging.

“The House-passed health care bill slashed Medicaid funding by $1.4 trillion,” Rep. Richard Neal of Massachusetts, the ranking Democrat on the House Ways and Means Committee, told Price.

The legislation, he said, “would lead to cuts in substance disorder treatment coverage for Americans suffering from substance abuse disorders, including opioid addiction. The budget compounds the problem by also eliminating billions of dollars in Social Services Block Grant funding dedicated to substance abuse treatment. I would urge you to reconsider these cuts.”

Democrats, most vocally Sen. Claire McCaskill of Missouri, also repeatedly pressed Price on whether HHS would continue to fund cost-sharing reduction payments to insurers thought to be key in maintaining stable ACA markets. Price, citing his status as the defendant in a legal case filed by Congress during the Obama administration, said only that the 2018 budget accounts for the payments’ continuation.