Senate Passes Sweeping Bipartisan Opioid Bill

Senate Passes Sweeping Bipartisan Opioid Bill

In a strongly bipartisan 98-1 vote, the Senate has approved massive new legislation aimed at combating the opioid epidemic, and sent it on to the White House for President Trump's signature. Only Sen. Mike Lee (R-Utah) opposed it, and Sen. Ted Cruz, (R-Texas), chose not to vote.

The landmark bill reconciles the Senate's own bill, "The Opioid Crisis Response Act of 2018," passed a week earlier by the Senate, and the "Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act," the House bill passed just days earlier.

The opioid legislation, currently designated House Resolution 6 (H.R. 6), is being called "sweeping" and "wide-ranging" because it brings together dozens of individual proposals from both sides of the House that affect every federal agency that has a role in addressing the opioid crisis, from law enforcement, educational and preventive measures to treatment, recovery and beyond.

Fentanyl and the Post Office

Notable provisions in the bill include orders that the U.S. Postal Service ramp up its screening for fentanyl in all packages from overseas, especially China. As we've reported numerous times, many forms of fentanyl are finding their way into the country from China. When added to fake pills and heroin, fentanyl additives are responsible for doubling overdose deaths in at least 10 states over the past couple of years. Along with prescription narcotics and other psychoactive pharmaceuticals, overdose deaths involving fentanyl claimed over 72,000 American lives last year.

"I will say getting that passed, to me, is just common sense. I think it's overdue. I'm disappointed it took us this long," said Sen. Rob Portman (R-Ohio), who was one of the first lawmakers to raise an alarm about opioid addiction back in 2014. "How many people had to die before Congress stood up and did the right thing with regard to telling our own post office you have to provide better screening?"

Increased attention to treatment

As reported in the Washington Post, public-health advocates "laud the bill's increased attention to treatment" which all agree is "key component to overcoming addiction."

The bill includes grants for "recovery centers" that would include housing, mental and physical health care and even job training. It also lifts the old "16-bed" Medicare rule prohibiting Medicare coverage for opioid treatment in facilities with more than 16 beds. The bill allows for 30 days of Medicare residential treatment coverage in larger facilities.

Another provision, praised by the American Cancer Society, encourages increased innovative research into pain treatment and the development of non-opioid medications. It also approved a proposed requirement that the HHS and the DOJ conduct studies "on the effects of federal and state opioid prescribing limits on patients" - currently a contentious subject among chronic pain patients.

Summary runs 27 pages

The section-by-section summary (PDF) of the roughly 660-page bill covers 27 pages, and lists hundreds of provisions for Medicaid, Medicare, FDA, Law Enforcement, Public Health, and five pages of provisions just called Miscellaneous. It really needs to be perused to get an idea of how truly comprehensive this bill is.

Congress approved $8.5 billion earlier this year to address the opioid epidemic. This is the figure most referred to as the suggested budget for this bill. Moreover, the President signed a separate spending bill in late September that includes an additional $6.7 billion for substance abuse treatment and prevention. There have been other allocations in recent months as well, earmarked for the opioid epidemic.

However, Sen. Elizabeth Warren (D-Mass.) and Rep. Elijah E. Cummings (D-Md.) have repeatedly pointed out that there's no funding guaranteed for subsequent years. Their proposal that Congress commit at least $100 billion over 10 years to combat opioids has been met with less than enthusiastic reactions in Washington.

Historic H.R. 6 journey

The history of America's historic new opioid legislation, involving both chambers of government, goes something like this:

  • On June 22, 2018, the House passes H.R. 6 by a vote of 396 to 14.
  • On September 17, the Senate passes its own amended H.R. 6 by a vote of 99-1.
  • On September 28, the House passes its final bicameral agreement on H.R. 6 by a vote of 393 to 8 – close to the original House vote in June.
  • This final version of H.R.6 moves on to the Senate for reconciliation, which passes the final draft.
  • H.R. 6 is sent to the president's desk for approval.

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