Medicaid and The Killer Drugs

 

Medicaid causes many problems, not to mention it provides second-class healthcare. In recent posts I have pointed to the negative impact of Medicaid on state budgets and education (Medicaid – The State Killer) and its negative impact on the defense of our nation (Medicaid – The Defense Killer.) Today we’ll talk about how Medicaid is contributing to the epidemic of opioid abuse that is killing people.

President Trump declared recently the opioid epidemic is a national emergency. The proof of this is irrefutable. According to The Wall Street Journal, drugs now rank as the leading cause of death for Americans under age 50. Think about that. That’s higher than auto accidents, higher than cancer, higher than diabetes or heart disease. It’s even higher than urban violence that is booming in big cities like St. Louis, Chicago, Detroit, and Baltimore.

Opioid overdoses have quadrupled since 1999, and fatalities are soaring. The number of overdoses in Ohio alone this year is projected to exceed the nationwide count in 1990. In the mostly rural state of New Hampshire, opioid abuse was a major issue in the 2016 presidential campaign.

Most opioid abuse and overdoses begin with prescription painkillers that lead to addiction. Although the majority of people prescribed these drugs never become addicted, a significant minority get hooked and then turn to street drugs to feed their addiction. These street drugs are usually laced with fentanyl and heroin, far stronger opioids with lethal side effects.

How does Medicaid impact this picture?

A recent study by Express Scripts Holding found that about a quarter of Medicaid patients were prescribed an opioid in 2015. Wisconsin Senator Ron Johnson has called attention to evidence that the Medicaid expansion under ObamaCare may be contributing to the rise in opioid abuse.

According to a federal Health and Human Services (HHS) analysis requested by Senator Johnson, overdose deaths per million residents rose twice as fast in the 29 Medicaid expansion states – those that increased eligibility to 138% from 100% of the federal poverty level (FPL), than in the 21 non-expansion states between 2013 and 2015.

It is especially alarming to note the marked disparities between neighboring states based on whether they opted into ObamaCare’s Medicaid expansion. Deaths increased twice as much in New Hampshire (108%) and Maryland (44%) – where Medicaid expanded – as in Maine (55%) and Virginia (22%). Drug fatalities skyrocketed by 41% in expansion Ohio while climbing only 3% in non-expansion Wisconsin.

Vast quantities of opioids can be obtained cheaply with Medicaid cards. A police detective in Wisconsin told Senator Johnson’s office that 240 oxycodone pills can be purchased with a Medicaid card for a $1 co-pay and resold for $4,000 on the street! A single Vicodin pill (hydrocodone) sells for as much as $50.

Senator Johnson says, “It appears that the program has created a perverse incentive for people to use opioids, sell them for large profits and stay hooked.” He is calling for the Inspector General of HHS to investigate Medicaid’s controls to prevent such abuses. Hopefully, President Trump’s emergency declaration will provide funding for expanded opioid treatment. But it is clear that reigning in the abuse of Medicaid is an important part of the solution.

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