Cuts to Medicaid will make fentanyl fight harder
By Ronald Brownstein
President Donald Trump says the opioid epidemic is such a clear and present danger that it justifies extraordinary actions against the foreign nations he accuses of facilitating the flow of fentanyl into the U.S. Meanwhile, his Republican allies in Congress are about to hobble the federal government’s most important domestic tool for fighting opioid addiction: the Medicaid program.
The result is that, just as Trump is demanding that other countries do more to fight the opioid epidemic, Congress is poised to do less.
Trump has portrayed drug smuggling as “a national emergency” and “public health crisis” to justify his initial round of tariffs on China, Mexico and (implausibly) Canada. Congressional Republicans, by contrast, appear willing to treat the opioid struggle as collateral damage as they seek spending cuts to offset the cost of extending (and enlarging) Trump’s 2017 tax cuts. Though Trump has sent conflicting signals on what he would accept, the House Energy and Commerce Committee voted Tuesday afternoon on a plan to cut about $700 billion from Medicaid over the next decade.
A scholar at the Brookings Institution estimates that Medicaid accounts for about $29 billion of the roughly $33 billion the federal government spent to treat opioid addiction in 2023. Medicaid funds opioid addiction treatment for more than 1.8 million people, federal figures show. Lisa Clemans-Cope, a senior research fellow at the Urban Institute, estimates that’s about half of all Americans receiving such treatment.
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