Patriot Ledger Op-Ed: Gutting the Affordable Care Act will make fighting opioid epidemic much harder

Substance abuse is an epidemic plaguing far too many communities throughout Massachusetts. It's a public health emergency that requires a coordinated response between local, state, and federal officials in partnership with families, health care providers, and law enforcement.

There's plenty that both Massachusetts and Congress needs to do to address this crisis, but one thing is certain: our job will get a whole lot harder if Washington Republicans succeed in passing their proposed legislation to gut the Affordable Care Act .

After eight years of votes to repeal the ACA with no replacement in sight and weeks spent crafting a replacement plan in secret, the Republican leadership finally revealed its health care proposal last week. And now it's no wonder why they drafted it in the dark - because the plan is ugly.

The new Republican health care plan would rip insurance away from millions of Americans, including by putting an end to the Medicaid expansion that today covers 11 million adults. It would slash vital insurance subsidies and impose huge cuts on the Medicaid program- a program that provides health coverage for grandparents in nursing homes, individuals with disabilities, foster kids, children, and vulnerable patients.

And for states like Massachusetts that are working hard to help patients and families affected by the opioid crisis, the Republican health plan would undermine the progress we've made by slashing critical coverage and funding for substance use disorder and coverage for mental health.

Under the ACA, treatment for substance use disorders is an essential health benefit - meaning all plans must provide adequate coverage. The ACA also expanded Medicaid - meaning millions more Americans could access the coverage they need. Ending the Medicaid expansion will eliminate a key source of health coverage for individuals needing substance use disorder and mental health coverage.

The Republican repeal plan also removes protections in the ACA that required plans to keep out-of-pocket expenses low - and takes away funds used to help make insurance affordable. Under the Republican bill, even if plans technically cover behavioral health care, insurance companies can make these services so expensive that they remain out of reach. As a result, the more than 20 million Americans suffering from substance use disorder would lose their chance to get the care they so desperately need.

Repeal of the ACA would also hurt the groups across Massachusetts that work to provide quality, accessible care to everyone who needs it. These groups often rely on Medicaid dollars, and they are already strapped for funding. If they lose that funding, many of them may be forced to turn patients away or provide uncompensated care. Right now, only 10 percent of those who need specialty treatment for substance use disorder can get it-90 percent can't get help. The Republican plan would make sure even more people get turned away.

As I travel around the Commonwealth, I have been listening to families and health care providers about how the ACA has made a difference in their lives. Thousands of people rallied at Faneuil Hall in January in support of the ACA, including Janis McGrory of Harwich, who shared the story of the loss of her daughter, Liz LeFort, to an opioid overdose.

A week ago, I was at Lynn Community Health Center, where I heard about its behavioral health services, including an outpatient substance abuse clinic. Dedicated staffers talked about how the ACA helps them provide coordinated care to patients who are able to come through the door because they finally have health care coverage. These patients are able to receive substance abuse treatment, as well as other services like hepatitis C or HIV treatment, preventative services, and mental health treatment. They are making lives better, but they need resources to do their work.

Today, I'm attending a roundtable discussion at Manet Community Health Center to talk about Quincy's efforts to address the opioid epidemic. I'll hear from patients, providers, and local officials about the need to block the Republicans' efforts to cut off help. When I go back to Washington, I'll keep fighting. I'll keep fighting because of the tremendous impact that the ACA has had on Massachusetts - and, over the long run, I'll keep fighting to make the ACA better.

Read the op-ed on the Patiot Ledger's website here.

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