American Bridge Vice President Shripal Shah released the following statement on Donald Trump’s vacation meeting about the opioid epidemic:
“More than 2,700 Americans are expected to die from opioid overdoses during Donald Trump’s 17-day vacation and a meeting at his golf course today will be of little comfort to the families and friends of the victims. The administration’s actions speak louder than his words: since taking office, Trump has backed $800 billion in cuts to the largest payer of opioid treatment and his sham commission has twice failed to produce any strategy to combat this epidemic. What more does he need to hear about this crisis before he puts the golf clubs away and does his job?”
Trump’s Budget Included $800 Billion In Medicaid Cuts, The Largest Payer For Opioid Treatment
Medicaid Is The Largest Payer For Behavioral Health Treatment, Including Opioid Treatment, In The Nation. [United States Government Accountability Office, 2015]
Trump’s Budget Proposal Cut Over $800 Billion From Medicaid Over 10 Years. According to The New York Times, “President Trump plans to unveil on Tuesday a $4.1 trillion budget for 2018 that would cut deeply into programs for the poor, from health care and food stamps to student loans and disability payments, laying out an austere vision for reordering the nation’s priorities. […] Over the next decade, it calls for slashing more than $800 billion from Medicaid, the federal health program for the poor, while slicing $192 billion from nutritional assistance and $272 billion over all from welfare programs.” [New York Times, 5/22/17]
Trump’s Budget Called for An Additional $610 Billion In Medicaid Cuts On Top Of The AHCA Cuts
The Budget Called For An Additional $610 Billion In Medicaid Cuts Over The $880 Included In The AHCA. According to CNN Money, “The budget outline assumes that the American Health Care Act, the Republican replacement for the Affordable Care Act, will take effect in its current form. That’s far from assured, but if it does, Medicaid funding will be slashed by more than $880 billion over the next decade, as payments to the states would be capped and eligibility would be narrowed.(For more on the AHCA Medicaid cuts, read MONEY’s primer on the bill.) But the budget proposal—which Congress still has to approve—assumes an additional $610 billion in Medicaid cuts because it allows states to restructure their Medicaid programs, by switching to per capita caps (a set amount of money per enrollee per year) or block grants (a set amount of money each state would receive from the federal government each year).” [CNN Money, 5/23/17]
The Cuts Would Come From Rolling Back The Affordable Care Act’s Medicaid Expansion And Allowing States To Opt For Per-Capita Or Block Grants
The AHCA’s Medicaid Cuts Would Come From Rolling Back The Affordable Care Act’s Medicaid Expansion And Implementing Per-Capita Spending Caps. According to The Washington Post, “Republicans’ Obamacare replacement plan would cut spending by $1.2 trillion over the coming decade and save the government $337 billion, according to an analysis released Monday by the nonpartisan Congressional Budget Office. To find those savings, Republicans are proposing cuts to programs designed to help the poor and the working class. Here’s where the GOP found the money: Medicaid: The most significant provision, in dollar terms, of the Republican bill would reduce spending on Medicaid — the government’s health insurance program for the poor — by $880 billion. Republicans would roll back the Medicaid expansion instituted under Obamacare (officially known as the Affordable Care Act). The GOP plan also would place a limit on how much states could spend on care for each Medicaid beneficiary, indexing it to inflation and to the prices of health-care services. Proponents of the measure say it would offer states more flexibility to administer the program in the hope that they would find more effective ways to spend their resources.” [Washington Post, 3/13/17]
TIME: The Additional $660 Billion In Cuts Are Because The Budget “Allows States To Restructure Their Medicaid Programs, By Switching To Per Capita Caps […] Or Block Grants.” According to TIME, “The budget outline assumes that the American Health Care Act, the Republican replacement for the Affordable Care Act, will take effect in its current form. That’s far from assured, but if it does, Medicaid funding will be slashed by more than $880 billion over the next decade, as payments to the states would be capped and eligibility would be narrowed.(For more on the AHCA Medicaid cuts, read MONEY’s primer on the bill.) But the budget proposal—which Congress still has to approve—assumes an additional $610 billion in Medicaid cuts because it allows states to restructure their Medicaid programs, by switching to per capita caps (a set amount of money per enrollee per year) or block grants (a set amount of money each state would receive from the federal government each year).” [TIME, 5/23/17]
The CBO Estimated the AHCA Cuts Alone Would Result In 14 Million Fewer Medicaid Enrollees By 2026
CBO: The Cuts Would Result In 14 Million Fewer Medicaid Enrollees By 2026, A Reduction Of Nearly A Fifth Of Enrollees. According to the Congressional Budget Office, “CBO estimates that several major provisions affecting Medicaid would decrease direct spending by $880 billion over the 2017-2026 period. That reduction would stem primarily from lower enrollment throughout the period, culminating in 14 million fewer Medicaid enrollees by 2026, a reduction of about 17 percent relative to the number under current law.” [Congressional Budget Office, American Healthcare Act Cost Estimate, 3/13/17]
March 2017: Trump Issued An Executive Order Creating A New National Opioid Commission To Be Led By Chris Christie
March 2017: Trump Issued An Executive Order Creating A New National Opioid Commission To Be Led By Chris Christie. According to PBS, “New Jersey Gov. Chris Christie will lead a new national opioid commission created Wednesday by an executive order from President Donald Trump that also maps out his administration’s latest strategy to combat the public health crisis. The fight against the opioid epidemic is ‘one that’s incredibly important to every family in every corner of this country,’ Christie said Wednesday in an interview with The Today Show, adding he and Trump ‘both care passionately about this issue and we want to save lives.’” [PBS, 3/29/17]
The Commission Was To Submit An Interim Report To Trump With Its Findings After 90 Days, And Submit A Final Report By October 2017 Unless More Time Was Needed. According to PBS, “According to Trump’s signed order, the commission is designed to: Identify existing federal dollars to combat drug addiction, including opioids; Assess availability and access to addiction treatment centers and overdose reversal and identify underserved areas; Measure the effectiveness of state prescription drug monitoring programs; Evaluate public messaging campaigns about prescription and illegal opioids, and identify best practices for drug prevention. In 90 days, the commission will submit an interim report to Trump with its findings. It will submit a final report by Oct. 1, unless more time is needed, according to the executive order. The commission will dissolve a month later.” [PBS, 3/29/17]
Critics Panned The New Commission As Redundant And A Waste Of Precious Time In The Fight Against Opioid Addiction, Has Twice Failed To Deliver Promised Report
CBS: White House Opioid Commission To Miss Deadline For Second Time. According to CBS News, “President Trump’s commission to fight the opioid epidemic will miss a deadline to file an interim report on the crisis for a second time, according to a notice set to be released Friday.” [CBS, 7/13/2017]
Politico: Public Health Advocates Said Trump’s Plan For “Yet Another Big Presidential Commission” Would, At Best, Duplicate Those Of The Obama White House And, At Worst, Set Back Efforts To Combat The Opioid Epidemic. According to Politico, “Trump won many of those communities — often overwhelmingly. But as president, he’s proposing deep cuts to research and treatment in favor of funding a border wall to stop drug traffic, while hinting at bringing back policies like criminalization of drug misuse — and announcing Wednesday yet another big presidential commission to study the problem. Public health advocates say those plans at best duplicate those of the Obama White House and at worst could set back efforts to tackle a problem that contributes to more than 47,000 deaths per year.” [Politico, 3/29/17]
Baltimore Health Commissioner Dr. Leana Wen: “We Do Not Have The Luxury Of Giving This Commission Months To Rehash Facts That Experts, Including The Surgeon General And Coalitions Of Doctors And Public Health Experts, Already Agree Upon.” According to an opinion by Baltimore health commissioner Dr. Leana S. Wen for CNN, “Little is known about the Trump administration’s plan to end this public health epidemic of opioid abuse, apart from the creation of a Commission on Combating Drug Addiction and the Opioid Crisis. So far, the White House has only said that the commission will produce a report and look for federal funding mechanisms. But that is not nearly enough. At a time when opioid overdose deaths kill tens of thousands of Americans every year — including more than 33,000 in 2015 — we do not have the luxury of giving this commission months to rehash facts that experts, including the surgeon general and coalitions of doctors and public health experts, already agree upon.” [Dr. Leana Wen – CNN, 4/12/17]
A Former Obama Administration Official Who Worked To Address The Opioid Crisis: “These People Don’t Need Another Damn Commission.” According to Politico, “Public health experts question the value of the commission. It was just last November when Surgeon General Vivek Murthy released his office’s first-ever report on opioids and addiction, which included tools and recommendations collected from more than a year of research. The CDC also released prescribing guidelines after thorough study. ‘These people don’t need another damn commission,’ said a former Obama administration official who worked to address the opioid crisis and asked not to be named. ‘We know what we need to do. … It’s not rocket science.’” [Politico, 3/29/17]
Longtime Drug Policy Official: “You Know What’s Redundant And A Waste Of Time, Effort And Money? The Commission.” According to Politico, “Another said that the office would be redundant, given the new White House opioids commission. ‘You know what’s redundant and a waste of time, effort and money?’ a longtime drug policy official countered. ‘The commission.’” [Politico, 5/5/17]
The Trump Administration Proposed A 95% Cut To The Office Of National Drug Control Policy
Trump’s Fiscal 2018 Budget Included Cuts Of About 95% Of Funding For The Office Of National Drug Control Policy. According to Politico, “President Donald Trump’s fiscal 2018 budget would cut about 95 percent of funding for the Office of National Drug Control Policy, effectively ending its mission as the lead agency in charge of combating the opioid crisis and other drug epidemics, according to an internal office email and two sources who spoke with Politico.” [Politico, 5/5/17]
The Office Of National Drug Control Policy Received $388 Million In Federal Funding In Fiscal 2017, But The White House Budget Proposal Only Allotted $24 Million For The Agency. According to Politico, “President Donald Trump’s fiscal 2018 budget would cut about 95 percent of funding for the Office of National Drug Control Policy, effectively ending its mission as the lead agency in charge of combating the opioid crisis and other drug epidemics, according to an internal office email and two sources who spoke with POLITICO. The office, which received $388 million in federal funding in fiscal 2017, would only receive $24 million in fiscal 2018, according to the White House budget proposal. The agency’s high-intensity drug-trafficking program, which received $254 million in federal funding in 2017, and its drug-free communities support program, which received $100 million, would be completely zeroed out under Trump’s proposal.” [Politico, 5/5/17]
Trump’s Budget Cut Would Cut ONDCP’s Staff Roughly In Half
Trump’s Budget Would Cut Almost $7 Million In Salaries From The ONDCP, A Cut Projected To Reduce The Office’s Staff By About Half. According to Politico, “President Donald Trump’s fiscal 2018 budget would cut about 95 percent of funding for the Office of National Drug Control Policy, effectively ending its mission as the lead agency in charge of combating the opioid crisis and other drug epidemics, according to an internal office email and two sources who spoke with POLITICO. […] The budget also seeks to cut almost $7 million in salaries, leading to projected cuts of as many as 33 full-time equivalents. About 70 people currently work at the drug control office.” [Politico, 5/5/17]
Acting Director Rich Baum, In An Internal Email To Staff: “These Drastic Proposed Cuts Are Frankly Heartbreaking And, If Carried Out, Would Cause Us To Lose Many Good People Who Contribute Greatly To ONDCP’s Mission And Core Activities.” According to Politico, “‘These drastic proposed cuts are frankly heartbreaking and, if carried out, would cause us to lose many good people who contribute greatly to ONDCP’s mission and core activities,’ acting Director Rich Baum wrote in an internal email to staff that was shared with POLITICO.” [Politico, 5/5/17]
Baum Was A Former Hill GOP Staffer Picked By The Trump White House To Lead The Office Of Drug Control Policy. According to Politico, “The White House on Tuesday also shuffled the leadership at the Office of Drug Control Policy, replacing acting head Kemp Chester — a compromise pick between the outgoing Obama and incoming Trump administrations — with acting head Rich Baum, a former Hill GOP staffer who’s been critical of legalizing marijuana and wants to tackle drug cartels abroad. Baum specializes in what’s called the ‘supply side’ of drug policy — cracking down on the flow of illegal drugs — as opposed to ‘the demand side,’ or treating the end user. Baum is close to GOP policy experts who worked to enact the ‘war on drugs’ tactics under previous Republican presidents, several sources told POLITICO.” [Politico, 3/29/17]
Trump’s Budget Would Totally Defund The High-Intensity Drug-Trafficking Program
ONDCP’s High-Intensity Drug-Trafficking Program Received $254 Million In Federal Funding In 2017 But Would Receive No Funding At All Under Trump’s Budget. According to Politico, “President Donald Trump’s fiscal 2018 budget would cut about 95 percent of funding for the Office of National Drug Control Policy, effectively ending its mission as the lead agency in charge of combating the opioid crisis and other drug epidemics, according to an internal office email and two sources who spoke with POLITICO. […] The agency’s high-intensity drug-trafficking program, which received $254 million in federal funding in 2017, and its drug-free communities support program, which received $100 million, would be completely zeroed out under Trump’s proposal.” [Politico, 5/5/17]
The HIDTA Program Is A Coordinated Effort Between Federal, State, And Local Law Enforcement To Address Drug Trafficking In Specific Areas. According to congressional testimony by Office of National Drug Control Policy Director Michael P. Botticelli in Congressional Quarterly, “The HIDTA Program was created as part of ONDCP’s original authorization to reduce drug trafficking and production in the United States by facilitating cooperation among Federal, state, local, and tribal law enforcement agencies. The HIDTA Program is a locally-based program that responds to the drug trafficking issues facing specific areas of the country. Law enforcement agencies at all levels of government share information and implement coordinated enforcement activities; enhance intelligence sharing among Federal, state, local, and tribal law enforcement agencies; provide reliable intelligence to law enforcement agencies to develop effective enforcement strategies and operations; and support coordinated law enforcement strategies to maximize available resources and reduce the supply of illegal drugs in designated areas.” [CQ Congressional Testimony, 12/2/15]
Approximately 60% Of Americans Live In High-Intensity Drug-Trafficking Areas
The Nation’s 28 High-Intensity Drug-Trafficking Areas Cover About 17% Of U.S. Counties And About 60% Of The Population. According to The Washington Post, “By comparison, the $2.5 million being committed to the latest program by the White House Office of National Drug Control Policy is a small investment, but a senior law enforcement official involved in developing the new strategy said the pairing of public health workers and police is a key step toward ‘both reducing crime and reducing the number of people who end up in emergency rooms.’ The new money will pay for hiring ‘a cop and a health data analyst’ in 15 of the nation’s 28 High Intensity Drug Trafficking Areas, which cover about 17 percent of U.S. counties and about 60 percent of the population, the official said.” [Washington Post, 8/16/15]
Trump’s Budget Would Totally Defund The Drug-Free Communities Support Program
The ONDCP’s Drug-Free Communities Support Program Received $100 Million In Federal Funding In 2017, But Would Receive No Funding At All Under Trump’s Proposal. According to Politico, “President Donald Trump’s fiscal 2018 budget would cut about 95 percent of funding for the Office of National Drug Control Policy, effectively ending its mission as the lead agency in charge of combating the opioid crisis and other drug epidemics, according to an internal office email and two sources who spoke with POLITICO. […] The agency’s high-intensity drug-trafficking program, which received $254 million in federal funding in 2017, and its drug-free communities support program, which received $100 million, would be completely zeroed out under Trump’s proposal.” [Politico, 5/5/17]
The Drug-Free Communities Support Program Was The Nation’s Leading Effort To Mobilize Communities To Prevent Youth Drug Use. According to congressional testimony by Office of National Drug Control Policy Director Michael P. Botticelli in Congressional Quarterly, “The DFC Support Program, created by the Drug Free Communities Act of 1997, serves as the Nation’s leading effort to mobilize communities to prevent youth drug use. Directed by ONDCP in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services, the DFC Program provides grants to local drug-free community coalitions, enabling them to increase collaboration among community partners and to prevent and reduce youth substance use. ONDCP provides oversight of the DFC Support Program to include final award determination, program regulation, policy, and its national evaluation.” [CQ Congressional Testimony, 12/2/15]
The Drug-Free Communities Support Program At Least Doubled The Financial Resources Available To Implement And Enhance Community Substance Use Prevention Activities Through Matching Federal Funds. According to the Drug-Free Communities Support Program 2014 National Evaluation Report by ICF International, “From the beginning of the DFC Support Program to the awarding of Fiscal Year (FY) 2013 DFC grants, ONDCP has awarded over 2,000 DFC grants to community coalitions across the nation. DFC grantees have included community coalitions in all 50 states, the District of Columbia, the Virgin Islands, American Samoa, Puerto Rico, Guam, Micronesia, and Palau. They represent rural, urban, suburban, and tribal communities. DFC grantees receive awards of up to $125,000 per year for up to five years per award, with a maximum of 10 award years. DFC grantees are required to match Federal funds, thus at a minimum doubling the financial resources available to implement and enhance community substance use prevention activities and resources.” [Drug-Free Communities Support Program 2014 National Evaluation Report – ICF International, August 2015]
A Group Of Over 200 Medical And Drug Policy Organizations Wrote To OMB Director Mick Mulvaney In Defense Of The Program
Group Of 200+ Medical And Drug Policy Organizations: The Drug Free Communities Program Was “Critically Important” And “Proven To Effectively Reduce Alcohol, Tobacco, Marijuana And Prescription Drug Misuse Among Middle And High School-Aged Children.” According to a letter to Office of Management and Budget director Mick Mulvaney from over 200 medical and drug policy organizations, “The critically important Drug Free Communities (DFC) program, which provides funding directly to communities to prevent drug use. DFC-funded coalitions are proven to effectively reduce alcohol, tobacco, marijuana and prescription drug misuse among middle and high school-aged children.” [Letter from the American Public Health Association, Drug Free Schools Coalition, Johns Hopkins Bloomberg School of Public Health and others to Mick Mulvaney, 2/23/17]