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Capitolworks: Just the Facts (and an opinion)…Opioids Silent Second Generation

As the health care debate wages on, we learn more about each Senators' agenda as they contemplate the Nation’s health care system and the overall well-being of their constituents. One of the strongest voices to emerge are those Senators focused on the opioid crisis. There is no doubt that our country is facing a public health epidemic that must be addressed in the same manner as previous epidemics such as polio, the flu, and HIV to name a few. One very revealing statistic regarding the extent of this crisis is the following: our nation lost 53,000 soldiers in Vietnam. In 2016 alone, 52,000 people died from an opioid overdose. The numbers are staggering and worthy of concern and consideration as lawmakers attempt to restructure the health care system. Within the health care discussions, consideration must be given to an additional often-overlooked population, children. Children and youth whose parents or caregivers are addicts are the silent second generation of the opioid epidemic.

Every day children and adolescents enter the foster care system because their parent(s) or guardians are unable to care for them because of their addictions. Abuse, neglect, or death of their parent or caregiver from opioids brings these kids into the system at an increasing and alarming rate. And, every day more and more infants of addicted mothers unable to care for them are entering the foster care system because of opioid exposure in utero. These are the innocent victims. And, if our lawmakers enact the sweeping changes to the Medicaid program that is currently under consideration, they will be further victimized.

Perhaps at this point, you are wondering how changes to the financing structure of the Medicaid program- NOT the expansion- would further victimize these children. When children are removed from their homes and placed in foster care, they become categorically eligible for Medicaid with some caveats and exceptions. Currently, the Medicaid program is responsible for providing these children with any and all medically necessary services including behavioral/mental health services. As you might imagine, children who have suffered from abuse, neglect, and loss often need more than physical health services. They need appropriate mental health services to help them cope with exposure to their adverse childhood experiences.

However, under both the House and Senate’s health care reform bill, the Medicaid program—again, not the expansion—would be reduced by billions of dollars which can only result in less coverage, less access to care, and less treatment for those enrolled in the program. And yet, this country is facing a public health crisis, and the number of children coming into the foster care system as a direct result of this crisis is increasing daily. Congress must, therefore, find a way to reconcile their desire to reduce federal spending on health care with the increasing health care needs of the foster care population. In a time of crisis, limiting access and coverage for those children and youth, who by no fault of their own, must rely upon Medicaid cannot be an option.

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