In Missouri, The Easiest Way To Get Drug Treatment 'Is To Get Pregnant'

By McCarton Ackerman 06/15/16

The GOP's rejection of federal aid to expand Medicaid availability has left thousands of low-income people unable to receive help to fight addiction.

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In Missouri, The Easiest Way To Get Drug Treatment 'Is To Get Pregnant'

Opposition to the Affordable Care Act (ACA) from lawmakers in some red states has made it difficult for residents to get the drug treatment they need.

The Los Angeles Times reported that 19 states, all of which have Republican governors or legislatures, have rejected federal aid to expand Medicaid availability under the ACA. Because of this, thousands of low-income people are unable to receive medicine to help fight addiction, or they remain on waiting lists for recovery programs. In these states, rejecting Medicaid expansion has essentially made coverage available for only poor children, seniors and pregnant women. 

“The best way to get treatment if you’re addicted to drugs in Missouri is to get pregnant,” said Dr. Joe Parks, the director of Missouri's Medicaid program, which has not been expanded.

Federal data shows that opioids (pain pills and heroin) were responsible for almost 29,000 overdose deaths in 2014. A recent analysis by the nonprofit Kaiser Family Foundation showed that Missouri had the 16th highest rate of opioid overdose deaths in 2014, but without Medicaid expansion, state officials say Missouri has been forced to scrape together federal grants and state tax revenues to create addiction recovery programs that are meager in comparison to residents' needs.

Many people in these states—another example is Nebraska—have to drop out of treatment because they can’t afford the cost on their own. A 30-day supply of Suboxone costs about $353, while a year of treatment (including medications) can cost $10,000 even with significant discounts. Federal data suggests that as many as several hundred thousand poor, uninsured Americans in these 19 states could qualify for Medicaid coverage if the states expanded Medicaid eligibility through the ACA, which is also known as Obamacare.

Expanding Medicaid isn't a cure-all, though. The Times noted that in some states that did expand Medicaid, the programs still don't cover all medication treatments, and addiction services are sometimes poorly coordinated. However, the increased access has given patients more treatment options.

Senior lawmakers from both the House and Senate are currently working on federal legislation that would expand addiction treatment across the country, but Republican lawmakers championing these efforts haven’t said anything about expanding Medicaid coverage, according to the Times. Most GOP lawmakers have vowed to roll it back in an effort to repeal Obamacare.

“In states that have expanded Medicaid, this legislation is going to be very helpful,” Dr. R. Corey Waller, a Michigan addition specialist and senior official at the American Society of Addiction Medicine, told the Times. “Everywhere else, it’s just window dressing.”

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.