While the House is in recess this month, Senate leaders are moving quickly to schedule floor votes on a series of bills to address the national opioid overdose epidemic. The Senate Finance Committee, Senate Judiciary Committee, and Senate Committee on Health, Education, Labor, and Pensions (HELP), have each advanced their own package of bills on a largely bipartisan basis to mitigate the impact of the crisis and deliver much-needed resources to Tribes, states and other localities. These bills are aimed at expanding access to treatment and recovery; increasing investments in prevention and surveillance; improving law enforcement and interdiction efforts; financing research into new medicines to treat addiction; and eliminating regulatory barriers to substance use disorder (SUD) treatment under Medicare and Medicaid.
Summary of Senate Opioid Bills:
In June, 2018, the Senate Finance Committee advanced S.3120 – HEAL Act of 2018. This legislation includes largely non-controversial regulatory fixes to Medicare and Medicaid. These changes include expanding the use of electronic prescribing of controlled substances, standardizing prior authorization requirements, raising Medicare and Medicaid provider accountability, and authorizing Medicaid payments for pregnant and postpartum women receiving SUD services outside of Institutions for Mental Diseases (IMDs). Similarly, the Senate Judiciary Committee advanced five bills that largely focus on law enforcement and interdiction needs within the Departments of Justice and the Drug Enforcement Agency.
NIHB has largely focused its advocacy and outreach efforts on S.2680 – Opioid Crisis Response Act (OCRA) – advanced by the Senate HELP Committee, as these have included the most provisions for Tribes.
Some of the significant provisions for Tribes include a 5% set aside under a two-year reauthorization of the opioid response grants, amounting to $50 million in direct Tribal opioid funding per year. In addition, OCRA includes up to a 3% set aside for Tribes under Plans of Safe Care to address maternal and child opioid addiction, and establishes parity between Tribes and states under a number of other funding provisions that address workforce development, youth treatment and recovery, and public health surveillance. The bill also establishes a federal interagency task force on trauma that includes the Indian Health Service and the Bureau of Indian Affairs as members.
Status of Floor Votes on Senate Opioid Bills:
Senate leaders have noted that the HELP Committee bill package, S.2680, is most likely the vehicle by which the Senate will advance their final opioid package. NIHB has been informed that the Senate may schedule a floor vote on OCRA before the end of the month. NIHB is still working to ensure that S.2545 – the Native Behavioral Health Access Improvement Act of 2018 – is included as part of OCRA. Introduced by Senator Tina Smith (D-MN), S.2545 is modeled off of the highly successful Special Diabetes Program for Indians and would provide $150 million in funding to Tribes to address behavioral health priorities through 2022.
There are notable differences between opioid legislation In the House and the Senate, so it is unclear how the two chambers will reconcile the legislation together. NIHB continues to meet with Senate leaders from both parties to ensure that the Tribally-specific provisions are advanced in the final bill package.
For more information about opioid legislation, contact NIHB Director of Congressional Relations, Caitrin McCarron Shuy, at cshuy@nihb.org.
