To address opioid crisis, expand Medicaid (Capitol Updates)

I recently read a piece by Tulsa University President Dr. Gerry Clancy advocating for full Medicaid expansion in Oklahoma. Dr. Clancy had visited New Mexico to learn from national experts about new research in the treatment of opioid addiction. New Mexico has become a national leader in reversing opioid overdose deaths. In 2014 it was second only to West Virginia in opioid deaths per capita, but during the next four years New Mexico dropped its death rate while much of the country was still experiencing increases.
 
As Dr. Clancy described it, “New Mexico has done many of the same things we have done in Oklahoma to combat opioid overdose deaths such as the development of closer tracking of opioid prescriptions before physicians write another prescription, intervening when physicians are overprescribing opioids and the use of Narcan by first responders to prevent a death when there is an opioid overdose.”
But when he asked what has made the difference in New Mexico’s recent improvements in opioid overdose deaths, “the uniform answer from the physicians I met – full Medicaid expansion.”
Clancy says New Mexico used full Medicaid expansion to provide coverage to uninsured adults, including those with addiction and mental illnesses. It provided Medicaid coverage for the newest medication assisted treatments resulting in a 60% improvement rate in opioid addiction recovery. The state provided coverage to begin these modern medication treatments for opioid withdrawal and stabilization in the emergency room and allowed physicians with 8 hours of advanced training to prescribe these advanced medications without prior authorization from the outside Medicaid reviewer.
 
In 2017, 388 Oklahomans, 32 per month, died of unintentional opioid overdoses. Thousands more are living with addiction. It seems a shame that we in Oklahoma seem to be still hung up over things like work requirements and changes of address, even in traditional Medicaid coverage, when so much could be done to save and improve lives with Medicaid expansion. We’ve lost nearly a decade of available federal treatment dollars because “the base” doesn’t like something called “Obamacare.” It’s likely that many in that same “base” are suffering pain and loss of life in their own families because of addiction, but they fail to connect the dots.
 
In another recent piece advocating Medicaid expansion, Dr. Donald E. Loveless, Jr., section chief of obstetrics and gynecology at St. Francis Hospital in Tulsa, said, “I see the face of Medicaid every day in my practice. These people aren’t looking for a handout; they’re looking for help and healing. They are young adults, single mothers and fathers, veterans and seniors. Medicaid expansion should not be a political issue – it is a moral issue, a social justice issue and an economic issue … and for me, it is a patient care issue.” Who could say it any better? C’mon state leaders-friends in the legislature and governor. As Bob Stoops likes to say, “No excuses!”

ABOUT THE AUTHOR

Steve Lewis served as Speaker of the Oklahoma House of Representatives from 1989-1991. He currently practices law in Tulsa and represents clients at the Capitol.

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