ICYMI: At Hearing, Warren Warns Republican Cuts to Medicaid Would Harm Millions of Americans Struggling with Opioid Addiction
One study found that the health care and criminal justice systems save up to $100,000 over the course of a person's life when they are treated with medication for opioid addiction.
“If Republicans really wanted to save money, they'd be expanding treatment to folks they claim they want to represent here, rather than ripping it away so that we can bankroll tax cuts for billionaires.”
Washington, D.C. – At a hearing of the Senate Committee on Aging, U.S. Senator Elizabeth Warren (D-Mass.) slammed Republican proposals to cut Medicaid, which would harm the millions of Americans struggling with opioid addiction who rely on Medicaid to receive treatment. Medicaid is the single largest payer of substance use disorder services in the entire country.
Republicans’ plan would pay for more tax cuts for billionaires by slashing Medicaid funding by over $800 billion.
Dr. Malik Burnett, Assistant Professor in Addiction Medicine at the University of Maryland Midtown Campus, testified that capping Medicaid funding would limit patients’ options for addiction treatment. It would also reduce access to in-network providers for Medicaid patients as more providers would disenroll from the Medicaid network, denying patients the ability to access treatment close to where they live.
Dr. Burnett also testified that receiving opioid addiction treatment allows people to return to work sooner and become productive members of society, ultimately reducing strain on the social safety net. As a result, cutting Medicaid funding would actually force states to spend more.
Senator Warren called on Republicans in Congress to deliver real solutions to the constituents they represent instead of pushing for tax cuts for billionaires and large corporations while ripping away people’s health care.
Transcript: Hearing to Examine Combating the Opioid Epidemic
U.S. Senate Committee On Aging
February 26, 2025
Senator Elizabeth Warren: Thank you, Mr. Chairman, and thank you and Ranking Member Gillibrand for holding this hearing today. It's a really important topic, and I appreciate the care with which you treat this issue.
Since 2017, the opioid epidemic has taken the lives of nearly half a million Americans. Their families—and so many more—need Congress to come up with real solutions. For example, I know Chairman Scott and I agree on the need to close a trade loophole that lets China ship fentanyl precursors into the country uninspected, and it’s time to put a stop to that.
But, as we sit here today, President Trump and Congressional Republicans are working hard to advance budget legislation that would make the opioid epidemic worse, not better. They have proposals to cut over $800 billion from Medicaid, which is the largest single payer of substance use disorder services in the entire country. Why? So they can fund tax cuts for billionaires.
Let's be clear about this: slashing Medicaid funding either through per capita caps or back door cuts like work requirements in an area that already has work requirements would mean ripping away health care from millions of vulnerable Americans, including about a million people right now, who are getting treatment for their opioid addiction.
Dr. Burnett, you've worked on the front lines of the opioid crisis. You have helped countless people overcome addiction. I want to thank you for your work and express my admiration for that, but tell me, in this budget space, what percentage of your patients rely on Medicaid for their treatment?
Dr. Malik Burnett, Assistant Professor in Addiction Medicine at the University of Maryland Midtown Campus: I would say, currently, about 80% of our patients rely on Medicaid for treatment.
Senator Warren: Wow. So, in other words, Medicaid, as I understand it, is not just one option for how people get treatment. It is the backbone of the entire system for treating opioid addiction. Is that fair?
Dr. Burnett: That's a fair comment.
Senator Warren: All right, and yet, Republicans are talking about gutting that system to the tune of nearly a trillion dollars. So, I'd like to look at just a little deeper level about what those cuts would actually mean for our country's battle against the opioid crisis. Two of the policies proposed by House Republicans are capping Medicaid payments to states and imposing red tape like additional work requirements.
Dr. Burnett, can you just talk for a minute about how those changes would affect access to treatment if they were put into law?
Dr. Burnett: Absolutely. I think one, there was a recent Kaiser Family Foundation study that talks about the work requirements issue, and that actually almost 92% of people on Medicaid already are either working or involved in some sort of part-time or full-time work. So, the work requirements situation would just really add a lot of administrative burdens, ultimately resulting in people getting kicked off of Medicaid.
Senator Warren: So I just want to make sure we say that again: what proportion of people are now already subject to work requirements?
Dr. Burnett: 92%
Senator Warren: 92%. All right, so adding more work requirements on top of this has what impact?
Dr. Burnett: It would certainly increase the administrative burdens of keeping people on Medicaid.
Senator Warren: That's right. And what's the consequence of increasing those administrative burdens?
Dr. Burnett: They would lose access to their addiction.
Senator Warren: That's right. So, people just can't get the paperwork filled out. More people fall by the wayside. I think that was the Arkansas experiment, as I recall.
Dr. Burnett: That's correct.
Senator Warren: Yeah. But there's another part to this as well. What about capping the funding?
Dr. Burnett: Yeah, capping the funding would create two problems. One, it would definitely curtail the amount of choice that patients have relative to the types of addiction treatment that they would have, and then capping the funding would also create a network adequacy problem because more providers would disenroll from accepting patients on Medicaid, so patients would not have the ability to access treatment close to where they live.
Senator Warren: Yeah, in fact, we don't have to speculate on what the consequences would be. In states expanding Medicaid treatment for opioid addiction, it increased over four times faster than in states that refused the expansion. Meanwhile, Republican states that imposed so-called work requirements did not actually increase employment, because that was never the point. Instead, opioid overdoses went up and access to treatment actually went down. So look, there is no denying the critical role that Medicaid plays in fighting the opioid epidemic. Cutting that program is not just cruel, it's totally backwards in what we're trying to accomplish.
Might I ask one more question, Mr. Chairman? Thank you.
Dr. Burnett, I want to ask about something you've done some scholarly work on and you've published. You've written extensively about the positive effects of investing in treatment and how that ultimately lowers costs down the line, so that if you cut the investments for treatment like cutting Medicaid, the question is, is that really going to save any money?
Dr. Burnett: No, I think, as I said in my testimony, people who experience treatment are much faster to return to work, be productive members of society, and ultimately not be a burden on the social safety net. So it would actually be more detrimental to cut Medicaid funding in terms of the amount of expenditure that states and public dollars would be needing to use.
Senator Warren: So, this treatment gets people back to work, fewer trips to the emergency room?
Dr. Burnett: Totally.
Senator Warren: The long-term cost is that we save money by making these investments. One study found that for every patient treated with medication for opioid addiction, the government saves up to $100,000 over the course of that person's lifetime. Let's be clear: the budget cuts the Republicans are proposing are not about saving money. If Republicans really wanted to save money, they'd be expanding treatment to folks they claim they want to represent here, rather than ripping it away so that we can bankroll tax cuts for billionaires.
Families and communities across this country are counting on us to deliver real solutions to the opioid epidemic, not play politics, and I won't stop fighting for that. Thank you very much. Thank you all for being here. Thank you, Mr. Chairman.
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