WASHINGTON – U.S. Senator Chris Murphy (D-Conn.), a member of the U.S. Senate Appropriations Committee, on Thursday pressed U.S. Secretary of Health and Human Services Alex Azar during a U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies hearing about the department’s budget request for Fiscal Year 2020 that proposes cutting $1.5 billion from the Medicaid program, including eliminating the Medicaid expansion. Many people dealing with opioid addiction rely on Medicaid, and if this budget is approved, won’t be able to afford treatment. 

“4 out of 10 non-elderly adults that are dealing with opioid addiction today are on Medicaid and so when you put $5 billion in essentially flat funding for specific opioid treatment next to $1.5 trillion in cuts to the insurance program that actually allows states to pay for treatment, the result is a devastating net negative,” said Murphy.

“…Connecticut will try to scramble to come up with the money when we lose 100,000 people off of the roles of our Medicaid program. Other states may not be able to come up with those dollars. So I just want to ask you that. Isn't this what we are doing? Aren't we just asking states to essentially pick up the burden of the opioid epidemic, given the comparison of the Medicaid cuts in this bill, to the $5 billion in specific opioid funding?” Murphy added.

A complete transcript of Murphy’s exchange with Secretary Azar is below:

MURPHY: Thank you very much Mr. Chairman. Thank you Mr. Secretary for being here today. I want to thank the chairman and the ranking member for acknowledging at the outset what is the reality here. This budget is not going to be reflected in the one that Congress ultimately passes. We would never support the kind of draconian cuts that are in it to people in need, to very sick people, to very vulnerable populations. And so I understand that we are going to work together, Republicans and Democrats, to make sure this budget never ever sees the light of day. But I think for the good of the order it makes sense to repeat why this budget is so offensive to many of us. It’s not just the cuts, it’s that they stand in contrast to a giant gift-wrapped present that this Congress gave to the very, very wealthy in this country about a year ago. A $2 trillion unpaid for tax cut that was promised to increase wages by $4,000 per person that simply has not done that. It, when fully implemented, will deliver 80% of the benefits to the top 1% of income earners and now we are seeing who is being asked to pay for it. Frail seniors in Connecticut who are going to have their heating shut off in the winter because the Trump budget doesn’t fund the Low-Income Heating Assistance Program. So I think that’s at the heart of our frustration. It’s not just that this budget doesn’t reflect our values. It’s that it stands in contrast with a tax cut that is not going to deliver results for the majority of Americans.

Mr. Secretary, I want to talk to you about the effect of this budget on the opioid epidemic. In your testimony you point to about $5 billion in funding that is directly dedicated to the opioid epidemic that is largely money that was already in the budget. But it stands in contrast to $1.5 trillion in Medicaid cuts in this budget including the wholesale elimination of the Medicaid expansion. 4 out of 10 non-elderly adults that are dealing with opioid addiction today are on Medicaid and so when you put $5 billion in essentially flat funding for specific opioid treatment next to $1.5 trillion in cuts to the insurance program that actually allows states to pay for treatment, the result is a devastating net negative. A dramatic contraction of federal dollars out of the opioid treatment systems. And I guess I just wanted to be honest what we are doing here. I know you may say, well we are still going to spend more money in real dollars, but this is a $1.5 trillion cut compared to what we expected states to spend. And I feel like we should just be honest that what this budget asks is for states to pick up a much bigger share of the burden for caring for people with addiction. And that this national emergency we declared comes with it an expectation that the federal government would do less and states will do more. Connecticut would try to scramble to come up with the money when we lose 100,000 people off of the roles of our Medicaid program. Other states may not be able to come up with those dollars. So I just want to ask you that. Isn't this what we are doing? Aren't we just asking states to essentially pick up the burden of the opioid epidemic, given the comparison of the Medicaid cuts in this bill, to the $5 billion in specific opioid funding?

AZAR: I don't think so. While we have a 1.5 trillion dollar reduction that's in the budget for the Medicaid expansions and Affordable Care Act exchange subsidies. We add back a $1.2 trillion program that would be state based flexibility. My hope is that it would actually correct - one of the things I worry about with the opioid crisis and many other public health issues we deal with is that the Medicaid expansion focused on able-bodied adults has taken us away from our - it's actually incentivized coverage there away from the aged, disabled children, pregnant mothers. Those, for instance, opioid addicted that are part of core Medicaid. And my hope is that with the $1.2 trillion program and complete flexibility for the states on that money, that they would actually focus that in the areas like you just talked about where the needs are greatest and really prioritize in those areas and it might actually enhance coverage and access for those individuals that we all care so much about. 

MURPHY: Yeah we've heard this for a long time. That flexibility will allow states to enhance and greater focus their coverage, but in the end it's a whole lot less money than they were getting today and states are begging for additional dollars to care for people with opioid epidemic, asking them to just focus better with less money, I just think ignores that feedback that all of us are getting - Republicans and Democrats - about the realities on the ground. Thank you, Mr. Chairman.  

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