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Another Voice: Cuts to Medicaid will make opioid epidemic worse

By Emma Fabian

Proposed cuts to Medicaid that will be voted on this month by our elected representatives contradict what we know about public health and curbing epidemics. We are plagued by an opioid overdose epidemic in this country that is particularly catastrophic in Western New York. It would only be made worse by cutting the means our residents use to obtain care for themselves and their families.

There is no shortage of data at our fingertips regarding the Medicaid system and this current drug overdose crisis. About 6 million people statewide and over 30 percent of Erie County residents receive their health care through Medicaid. Those figures have risen since the rollout of the Affordable Care Act. Furthermore, those figures only represent residents who are registered for Medicaid, not those who are eligible.

Last year in Erie County, over 300 people died from fatal opioid overdoses. Opioid overdose is now the leading cause of unintentional death in the United States. Rates of hepatitis C, the potentially lethal viral disease widespread among the injection drug using community, have also skyrocketed, especially in Western New York.

At both local community and federal levels, we have made significant strides to increase access to care for substance users. Erie County has a continuum of care for people who use substances, including several new programs, recognizing that there is no one-size-fits-all solution for substance use. Many of these services, including medical care, counseling and inpatient treatment, require some type of insurance coverage. Across the country, all Medicaid and other insurance plans are required to provide access to some type of treatment for substance use disorder and cannot limit that treatment any more than they would for other conditions. The recent advancements are far from perfect, but they are on the right path.

Now the cuts to health coverage proposed by our federal administration would eliminate the aforementioned improvements and leave a significant number of residents in communities such as Erie County without coverage altogether. If these cuts pass, the community will see greater rates of hepatitis C and fatal overdoses by denying access to treatment to many of our most vulnerable.
Instead of using what we know about ending epidemics (through prevention and access to care), funding cuts to Medicaid threaten to make the current epidemics worse.

In my role as director of some substance use programs and policy work, I am constantly asked: “What caused this epidemic?” “Why did my son/daughter become addicted?” “How can we get people help?”

Some of the people asking these questions are elected representatives. I hope they know the answers do not include cutting access to health care. And if they disregard the real facts and choose to leave our already struggling community members without coverage, we will not let them forget it.

Emma Fabian, M.S.W., is director of substance user health policy at Evergreen Health in Buffalo.

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