Senate Republicans unveiled their version of the reconciliation bill which includes President Trump’s tax cut extensions. To offset the cost of those extensions it also includes reductions in numerous federal programs and proposes deep cuts to Medicaid.

Though the bill text released by the Senate Finance Committee is similar to the package passed by a narrow 215-214 vote in the House last month, it contains enough changes to virtually ensure an intra-party battle as they struggle to pass a final bill. So far, enough Republican Senators have indicated they are opposed to the latest version to prevent passage as currently drafted.

Once it passes the Senate, it must pass the House again, since there are anticipated changes to the version they approved. Many Representatives have already indicated their opposition to the Senate language.

Of major concern to the substance use disorder field are the massive cuts to Medicaid. The Senate proposal imposes far deeper cuts to the program than House Republicans could agree on for their bill. The House measure included a new work requirement to Medicaid for childless adults. The Congressional Budget Office has estimated that change would cause about 5.2 million adults to lose their Medicaid coverage over the next decade.

The Senate plan would expand the work requirement to the parents of children aged 14 and over, requiring them to work or volunteer at least 80 hours a month to qualify for the insurance program. The Senate proposal also makes it more difficult for states that have expanded their Medicaid programs by taxing certain health care providers and then using the expanded matching federal money to keep rural hospitals afloat.

If either the Senate or House version of the bill passes, the Medicare cuts will eliminate access to substance use disorder care for millions of Americans. Medicare is the largest payor of substance use disorder and mental health care in the country. It will also seriously disrupt the health care system.

Please consider calling your United States Senator and ask them to oppose the Medicaid cuts in the reconciliation bill. You may find your Senator here.

The Administration is pushing Congress to pass the bill in the next few weeks. Your voice could make a huge difference. NAATP will continue to advocate for access to care for everyone in need.