Is Health Care Complicated? Yes. Sensitive? You Bet

By Lauren Flynn Kelly - June 29, 2017

In writing the latest issue of Medicare Advantage News, which was made more difficult by late-breaking developments in the Senate’s effort to repeal and replace the Affordable Care Act, I was struck by how sensitive the issue of delivering health care is. At the end of the day, it’s about meeting people’s needs. And sometimes, the people defending, making or proposing laws might not be comfortable with some of those needs.

On June 22 — the very same day that the “discussion draft” of the Better Care Reconciliation Act (BCRA) was introduced by the Senate — I attended a tremendously informative summit on the opioid crisis that centered around a subset of the Medicaid population: pregnant women and their babies. I don’t think there was a dry eye in the room when a young mother of three shared her story of struggling with addiction after she was prescribed opioids for pain from her second C-section. But physicians and addiction specialists on the panel explained that opioid-addicted pregnant women face barriers to receiving the care they need such as a lack of access to medication-assisted treatment (MAT) and a lack of physician experience with or understanding of opioid use disorder in pregnant women. Moreover, women in most states can be prosecuted for opioid misuse in pregnancy.

Just two levels down in the same Senate building, a group of disabled Americans was gathered outside the office of Senate Majority Leader Mitch McConnell (R-Ky.) chanting, “No cuts to Medicaid! No cuts to Medicaid!” around the same time he introduced a bill that would leave an estimated 15 million more Medicaid enrollees without insurance by 2026 than under current law. Some may have seen news footage that evening showing many of these people being removed from their wheelchairs and carried out by Senate police at the end of the day, while some very uncomfortable staffers looked the other way.

Just one of many reasons the BCRA was pulled this week from a vote is opioids. Senators Shelley Moore Capito (R-W. Va.) and Rob Portman (R-Ohio), both from states where the opioid crisis is particularly prevalent, had requested the inclusion of $45 billion in extra funding over 10 years for substance use disorder treatment. That $45 billion probably wouldn’t even come close to what’s actually needed to address the crisis and deliver MAT to patients like those pregnant women, yet the Senate bill as introduced earmarked only $2 billion in federal funds for such services.

What the brave woman and other patients who were present at the opioid summit, which was hosted by the Institute for Medicaid Innovation, and the people who protested outside McConnell’s office did was put faces to the debate over health care as a right vs. a privilege.

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