Doug Jones, the U.S. Senate’s newest member and the first Democrat to represent Alabama in the upper chamber in a generation, appears to be off to a running start. Since taking office a little more than two weeks ago, Jones has already co-sponsored a bill to fight the Trump administration's controversial reversal on net neutrality. On Wednesday he was notably one of only a few Democratic senators on hand to fight back against Republicans’ creeping assault on some of America’s most vulnerable patients.
Notably, it was Jones' surprise victory last month that effectively ended Republicans' hopes of killing Obamacare. (They settled instead on using the GOP tax bill to eliminate the law's individual mandate.)
After enduring a bruising and embarrassing failure to finally repeal the Affordable Care Act, Senate Majority Leader Mitch McConnell, R-Ky., conceded last year that it was "time to move on.” But the GOP’s crusade against Barack Obama’s signature domestic policy marches on into 2018. Democrats, however, seem to be several steps behind, as Republicans directly attack one of the most effective strategies for combating opioid abuse: Obamacare's expansion of Medicaid.
On Wednesday, Republicans held a pair of hearings in both the House and the Senate on the supposed connection between Medicaid and America’s drug crisis – part of a coordinated campaign against the federal health insurance program for low-income Americans that will likely only make the opioid crisis worse. Republicans on the House Ways and Means Oversight Subcommittee held an opioid-focused hearing about Medicaid on Wednesday. Under the chairmanship of Sen. Ron Johnson, R-Wis., the Senate Homeland Security and Governmental Affairs Committee also held a session titled "Unintended Consequences: Medicaid and the Opioid Epidemic."
“People may be scratching their heads saying, ‘Why is . . . Homeland Security holding a hearing on the opioid crisis and Medicaid?’” Johnson said at the outset of the hearing. He went on to explain that he asked his staff to file a report and schedule a hearing on the issue after reading an article in Commentary magazine, a conservative publication.
The theory promoted by Commentary is that Medicaid recipients are taking advantage of their free health care by selling their pain pills on the black market, expanding the market for opioids. This has gradually crept from right-wing media into the political mainstream. In March, Conn Carroll, a spokesman for Sen. Mike Lee, R-Utah, argued that “expanded coverage helped cause the opioid crisis. Free pills means more addicts.”
On Wednesday, Johnson released a report on behalf of the Senate committee's Republican staff titled, "Drugs for Dollars: How Medicaid Helps Fuel the Opioid Epidemic." The report asks, "What if one of the contributing causes is connected to federal spending itself?"
Johnson’s report concludes, "Medicaid has contributed to the nation’s opioid epidemic by establishing a series of incentives that make it enormously profitable to abuse and sell dangerous drugs."
Apparently not content with limiting poor peoples’ access to health insurance, it would seem that Republicans are now attempting to pathologize those on Medicaid as drug addled criminals.
“This is a government program-wide phenomenon where American taxpayers are providing well-intentioned funds into some of theses programs and those funds are being utilized to divert drugs, sell them on the open market," Johnson said during Wednesday’s hearing.
By this logic, the Department of Defense was responsible for the heroin epidemic among returning veterans following the Vietnam War. Cutting the defense budget, it would follow, would have ended that heroin crisis. The Veterans Health Administration still has a huge issue with opioid overprescription, addiction and drug diversion – but Republicans would never dare hold a hearing suggesting that increased funding of the VA is the root cause.
“Lawmakers never intended this, but I’m guessing there will be many who will not want to acknowledge it,” Johnson continued about Medicaid on Wednesday. “Why? Because Obamacare included a large-scale expansion of Medicaid. During the 2017 debate on repealing and replacing Obamacare, proponents of expansion cited its role in funding treatment for addiction.”
Of course, it must have been Obama's fault somehow, just as that hurricane that flooded New Orleans (three years before he was elected) was also Obama's fault. By this argument, Obamacare directly or indirectly contributed to the 63,632 overdose deaths caused by opioids in 2016. But Republicans' timeline doesn't work. Medicaid expansion under the Affordable Care Act took place in 2014 — nearly 20 years after overdose rates started creeping up. As Paige Winfield Cunningham of The Washington Post points out, Republicans could just as easily “use that same reasoning to oppose expansion of private health insurance.”
Instead, with a straight face, Republicans questioned their hand-picked experts – officials from GOP-led states, including an anti-Medicaid ideologue and two state prosecutors – and attempted to blame the opioid crisis on better access to the health care system for low-income Americans. No one at the hearing brought up the role of Big Pharma or doctors who are too willing to overprescribe, and Democrats barely put up a fight.
Jones and Sen. Gary Peters of Michigan were the only Democrats on hand for the opening testimonies from the hearing’s paneled experts. Along with Sen. Kamala Harris of California, they were the only Democrats who even bothered to ask a question or attempt any pushback against the right-wing misinformation at Wednesday’s Senate hearing.
The federal government is now on the brink of yet another shutdown, the Trump White House is providing a never-ending stream of controversy and the lives of hundreds of thousands of DACA recipients still hangs on the whims of Congress’ most hardline conservatives. Still, Wednesday’s events were among the most troubling indications that ludicrous conservative conspiracy theories have fully taken hold in the halls of Congress. With Republicans in complete control of the federal government for the rest of the year, Democrats must combat the further mainstreaming of such ideas if they have any hopes of crawling back to the majority in either chamber in 2019.
Democrats simply weren't there on Wednesday to point out that Medicaid-expansion states have reduced the unmet need for treatment of substance abuse disorders by 18 percent, according to the Center on Budget and Policy Priorities. The program, which provided coverage to 3 in 10 people dealing with opioid addiction in 2015, covers outpatient treatment and inpatient detoxification. Thankfully Jones, who represents a red state that did not expand Medicaid, was around to make the point that states with above average opioid-overdose death rates include both Medicaid expansion and non-expansion states.
Sen. Claire McCaskill of Missouri, the committee's ranking Democrat (who faces a tough re-election battle this year in a state easily won by Donald Trump) planned to push back hard at Wednesday's hearing, according to her office. But she was reportedly ill with the flu and stayed home.
"This idea that Medicaid expansion is fueling the rise in opioid deaths is total hogwash," McCaskill said in prepared remarks. "It is not supported by the facts. And I am concerned that this committee is using taxpayer dollars to push out this misinformation to advance a political agenda.”
She’s right, but Democrats must make a better effort to fight back against Republicans’ latest attack on health care for the poor. Obamacare has helped patients treat their addictions; deaths have declined. Eleven Medicaid-expansion states have implemented policies to encourage the use of alternative therapies to help manage pain and limit reliance on opioids, according to a 2016 survey by the National Academy for State Health Policy. Republicans' efforts to exploit this problem with outright lies, for political advantage, are at the very least disingenuous. Even in a time of plentiful chaos and outrage, they must not be overlooked.
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