Opioid Bill Passes Final Congress Vote, Now Goes to President
By: Stephen Koff, The Plain Dealer
July 13, 2016
WASHINGTON, D.C. -- Congress took the final step Wednesday to approve spending millions of dollars to fight the heroin and opioid epidemic claiming thousands of lives across America.
The Comprehensive Addiction and Recovery Act, calling for $181 million a year in new spending for addiction and recovery programs, was steered through Congress with heavy lifting by Ohio Republican U.S. Sen. Rob Portman. It now goes to President Barack Obama for his signature.
But funding fights lie ahead, and the White House said that without more money, the bill falls short.
Portman called the bill's passage "a historic moment, the first time in decades that Congress has passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery."
But Obama and congressional Democrats had hoped the bill would provide even more money, and the president's 2017 budget proposal sought $1.1 billion for anti-opioid spending over the next two years.
"The Administration has consistently said that turning the tide of the prescription opioid and heroin epidemic requires real resources to help those Americans seeking treatment get the care that they need," the White House said in a statement. "We continue to believe this bill falls far short... While the President will sign this bill once it reaches his desk because some action is better than none, he won't stop fighting to secure the resources this public health crisis demands."
Seventy-eight Americans die each day from opioid overdoses, the White House added.
The bill was able to secure overwhelming congressional support, despite misgivings, after a conference of House and Senate members in recent weeks pushed up the bill's authorized spending levels more than $100 million higher than the previous $78 million annual proposal.
The House voted 407-5 on July 8 to pass this final version of the bill, and the Senate followed today, voting 92-2.
This doesn't guarantee that even these sums will actually go out. But it gives the strongest signal possible of Congress's intent, following a three-year effort. We'll explain.
What's the bill do?
The bill authorizes more spending by the Justice Department and Department of Health and Human Services on grants to help state and local agencies deal with addiction and recovery in the epidemic, which Portman says kills 2,000 Ohioans a year.
In Akron this month, first responders treated 17 opiate overdose patients, one of whom died, in a 24-hour period.
Some examples:
- Emergency responders will be able to get more access to powerful drugs used to reverse opioid overdoses.
- States and local agencies will have more federal grant money available for programs that help recovering users kick their addictions.
- Specialized attention will go to students, veterans, pregnant women and families, to deal with their particular addiction issues.
- Police will have more options to send certain drug users to treatment and recovery programs rather than jail.
- The Controlled Substances Act will be amended to expand the use of buprenorphine in treatment. Buprenorphine is itself an opioid, but one that authorities say has been proven to cut addiction under proper supervision. If you have heard Portman talk about "evidence-based" treatment, this is partly what he meant.
What about the money?
We won't get into the weeds. But it's important to know this: The bill that passed today says the government is authorized to do all of the things mentioned above and more, at a cost of $181 million a year over the next five years.
It doesn't actually provide the money.
Think of this as congressional authorization, which is exactly what this bill is -- an authorization bill -- versus congressional appropriations or spending bills, nearly all of which are still to come.
Democrats tried earlier this year to get an immediate $600 million in emergency funding attached to the opioid bill, and Portman joined them. But they could not overcome objections from a majority of Republicans who cited increases in drug-prevention and treatment funding already passed over the last two years, though those were not near the levels Democrats wanted.
You can read some of the previous proposals for anti-opioid authorization here:
So you're saying there's another spending battle ahead?
At least one, if not for each of the next five years. The Substance Abuse and Mental Health Services Administration confirmed to cleveland.com that before it can solicit grant applications from states and local agencies for this bill's programs, it needs to be sure that Congress will actually appropriate the money for the applicable fiscal year, which starts each Oct. 1.
You might say fine, it's only July. But Congress later this week will take a break until just after Labor Day, which will only give it a few weeks to deal with spending bills before the 2017 fiscal year begins.
Congress will probably pass a continuing resolution instead of rushing when it returns. That would keep spending at today's levels. As for new levels -- levels that take into account the authorization bill passed today -- Congress will put off those decisions.
The only real debate right now is whether Congress will put off decisions until after the November elections, or January or even later, depending on whether there's a shift in political power.
"The bipartisan passage of CARA is certainly a positive step," said U.S. Rep. Marcy Kaptur, a Toledo Democrat who voted for it but has concerns about its funding. "But let's not oversell it as a panacea. It is not.
"Unlike other legislative responses to similar national emergencies, CARA contains no emergency funds, which can be spent right away. That delays funding for months, perhaps years."
U.S. Sen Sherrod Brown Brown, a Democrat, agreed. While he praised the measure, he added that "this bill alone is not enough. We must recognize the opioid epidemic for what it is – a public health emergency – and invest the real dollars it takes to combat it."
This, by the way, has little to do with underlying sentiment about the opioid bill. It has everything to do with partisan divisions over spending.
But didn't Portman already get some money for this year?
He did -- about $80 million, appropriated through a last-minute spending bill last December. That money is now out in communities but mostly unspent, Portman says, so he says it can go to addiction and recovery programs right away.
But this is a trick question, because Democrats note that Portman actually voted against this very spending, despite his role in making sure it got in the last-minute 2016 omnibus bill.
You can decide which side has more legitimacy; it's a bit of a political game we've been over before and it's bound to keep playing out now. Read about it here:
Today's passage is nevertheless a big deal for Portman. He didn't get this bill passed alone; fellow Republican Sen. Kelly Ayotte of New Hampshire and Democratic Sens. Sheldon Whitehouse of Rhode Island and Amy Klobuchar of Minnesota also played leading roles.
Yet no other bill in his five-plus years in the Senate has received this level of personal passion from Portman. He talked about it almost nonstop.
Passage marks "the first time that we've treated addiction like the disease that it is, which will help put an end to the stigma that has surrounded addiction for too long," Portman said today.
This "will help save lives, and help more Americans achieve their God-given potential."