mobanmarketSen. Amy Klobuchar is tackling drug addiction and mental health services in her newest policy proposal released Friday, a deeply personal one for the presidential contender, whose father struggled with alcoholism.
What would the plan do?
The Minnesota Democrat’s plan aims to prevent and treat addiction, particularly to opioids. It commits to improving access to care and mental health facilities, including in-patient programs, as well as funding more research.
But the plan doesn’t include specifics about expanding access to treatment for people addicted to opioids, and the price tag would likely spark opposition from fiscal conservatives.
How would it work?
The proposal addresses three phases of substance abuse: prevention, treatment and recovery.
On prevention, Klobuchar said her administration would increase resources to early drug intervention and detection programs, as well as mental health programs, in schools and in health care facilities. The plan would also curtail “doctor shopping,” in line with a Klobuchar Senate bill that would require doctors to use monitoring programs that flag patients at risk of misusing drugs. She would also incentivize states to enact ignition interlock laws to prevent repeat drunk driving offenses and invest in suicide prevention programs, especially those focused on certain higher-risk groups, like veterans and Native American tribes.
On treatment, Klobuchar wants to fund more research and more access to care. Klobuchar said she would “add beds” to health, alcohol and drug treatment facilities, “as an estimated 21 million people needed substance use treatment, but fewer than 20 percent were able to access it,” the proposal said, though it lacked specifics about the cost and scope of that expansion.
On recovery, Klobuchar, the former Hennepin County Attorney, calls for the criminal justice system to prioritize mental health and substance abuse treatment over jail time for nonviolent offenders. She also wants resources to train law enforcement to deal with Americans with mental illness and expand housing access for in-treatment recovery programs.
What are the weaknesses in the proposal?
Klobuchar includes a number of ideas that have previously failed to gain support in Congress, like having the government negotiate the price of naloxone, a lifesaving drug that can reverse an overdose, in order to make it more affordable. Most Republicans oppose the idea.
Another part of her plan — allowing Medicaid to reimburse for inpatient mental health and addiction care at certain facilities — has historically been seen as an expensive nonstarter on Capitol Hill. The Congressional Budget Office previously estimated its price tag at between $40 billion and $60 billion. Some mental health experts argue the plan isn’t necessary because states can already get Medicaid reimbursements for these services with a federal waiver.
Klobuchar’s proposal also does not specify how she would hold insurers accountable for discriminating against mental health or addiction coverage.
How much would it cost?
$100 billion
Klobuchar said she would raise the money for the plan by enacting a 2-cent tax on each milligram of active opioid ingredient in a prescription, paid for by drug manufacturers or importers. It’s unclear whether there will be appetite on Capitol Hill, particularly among Republicans, to impose a new tax on drugmakers. A similar tax approved last year by New York state lawmakers raised concerns among patient advocates that the added costs may get passed onto consumers instead.
What have other Democrats proposed?
Last year, Sen. Elizabeth Warren proposed a $100 billion plan to address the opioid crisis that would provide that funding over 10 years for states, territories, tribal communities and cities hit hard by addiction.
Former Rep. John Delaney of Maryland released a plan Thursday to increase access to mental health services. Though details were scarce, his proposal shared similarities with Klobuchar’s, including increasing access to care in schools and the criminal justice system.
Other candidates’ health care policies also touch on addressing the opioid crisis and access to mental health care.
Who would it help?
Klobuchar’s plan touches on nearly all aspects of behavioral health issues, which affect millions of Americans every day. Roughly 1 in 5 adults in the U.S. have a mental illness, according to the National Institute on Mental Health, and more than 27 million Americans report using illicit drugs or misusing prescription painkillers. The Centers for Disease Control and Prevention estimates that nearly 130 Americans fatally overdose on opioids every day, and an estimated 88,000 people suffer alcohol-related deaths every year, according to federal figures.
Who opposes it?
So far, no Democrats have expressed opposition to this kind of plan.