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  • Washington Highlights

    House and Senate Lawmakers Propose Solutions to the Opioid Epidemic

    Tannaz Rasouli, Sr. Director, Public Policy & Strategic Outreach
    Len Marquez, Senior Director, Government Relations

    House and Senate committees continued their focus on the opioid epidemic this week. Among the committees with opioid related activities were the House Ways and Means Committee, House Energy and Commerce Committee, and Senate Health, Education, Labor, and Pensions (HELP) Committee.

    House Ways and Means leadership, including Chair Kevin Brady (R-Texas), Ranking Member Richard Neal (D-Mass.), Health Subcommittee Chair Peter Roskam (R-Ill.), and Ranking Member Sandy Levin (D-Mich.), April 11 released a bipartisan white paper that offered solutions to address the opioid epidemic. According to the committee’s press release, the white paper is the result of stakeholder feedback the committee received following a Request for Information earlier this year. The AAMC’s recommendations are among the 110 responses cited in the document [see Washington Highlights, March 23].

    The white paper discusses several reoccurring themes that emerged from stakeholder comments, including better data tracking, increasing access to medication-assisted treatment, and limiting opioid prescriptions, among others. The committee plans to use the document to “develop and advance bipartisan policies that focus on improving Medicare’s response to the opioid epidemic.”

    Medicare was also among the topics of discussion during an April 11 House Energy and Commerce Health Subcommittee opioid hearing, which stretched over two days and reviewed 34 bills related to Medicare, Medicaid, and other related health programs. In total, the committee is considering 67 pieces of legislation aimed at addressing the opioid epidemic. This vast number paired with the speed at which the committee is considering the bills has sparked concern with Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-N.J.).

    In his opening statement, Ranking Member Pallone stated, “While I support addressing this crisis through a bipartisan process, I am concerned that the sheer quantity of bills before the Committee today and the Chairman’s extremely ambitious timeframe will not leave us much time to get these policies right,” pointing out that members of the committee have had “less than a week” to review the 34 bills discussed in the hearing.

    Of the bills covered during the hearing, members discussed a draft bill, the Medicaid Graduate Medical Education Transparency Act, which would require state Medicaid agencies to begin reporting detailed information regarding their Medicaid graduate medical education (GME) programs. In his opening remarks, Energy and Commerce Health Subcommittee Chair Michael Burgess, MD (R-Texas) said of the draft legislation, “One issue area that repeatedly comes up is our physician workforce. Congress can pass bills that increase access to evidence-based treatment, but if we do not have enough physicians equipped with proper tools and training, we will not have sufficient capacity to provide effective treatments for individuals suffering from substance use disorder. To this end, I have authored draft legislation that will provide Congress with more robust transparency about how graduate medical education dollars under current law are helping equip the next generation of doctors to better identify and treat patients with substance use disorder.”

    However, other members of the committee expressed skepticism that the legislation could accomplish that goal. Rep. Eliot Engle (D-N.Y.) specifically mentioned that stakeholders had contacted him with concerns about the legislation and stated, “In my opinion, the reporting required under this bill is overly prescriptive and burdensome and may take up limited resources states have for Medicaid GME ... We are facing a shortage of providers, but I don’t believe this bill would address that.”

    Meanwhile, the Senate HELP Committee April 11 held a full committee hearing to review its bipartisan discussion draft bill, the Opioid Crisis Response Act of 2018, released by Senate HELP Chair Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) on April 4. Chairman Alexander kicked off the hearing by describing the bipartisan discussion draft, which he stated includes 29 proposals from members of the Senate HELP Committee. He said the draft bill would be “the next step in helping end the national opioid crisis.”

    Chairman Alexander also said the bill includes a proposal to “spur development of a non-addictive painkiller by giving the National Institutes of Health additional flexibility,” referring to the ACE Research Act (S. 2406), which would allow the National Institutes of Health to use “other transactional authority” for research to respond to public health threats. He stated that the development of a non-addictive painkiller would be the “Holy Grail of solving the opioid crisis.”

    Ranking Member Murray praised the committee’s bipartisan efforts, saying the bill was “drafted with serious attention” to concerns the committee heard, later calling it a “major step” in responding to the opioid crisis. Of the provisions laid out in the committee’s summary, Sen. Murray highlighted a proposal in the bill that would authorize funding for programs that support areas with health provider shortages. Sen. Alexander announced during the Senate HELP hearing that his committee intends to mark up its opioid bill April 24

    Lawmakers continue to tee up additional responses to the opioid crisis. The Senate Finance Committee April 12 announced that it will hold a hearing on April 19 to discuss “how Medicare, Medicaid and human services programs can better address the opioid epidemic and substance abuse disorders.” House Energy and Commerce Committee Chair Greg Walden (R-Ore.) expressed his desire to advance an opioid package to the House floor prior to the Memorial Day recess.