Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and to include extraneous material on the bill, H.R. 5797. Mr. Chairman, I yield myself such time as I may consume. Mr.…
Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days to revise and extend their remarks and to include extraneous material on the bill, H.R. 5797.
Mr. Chairman, I yield myself such time as I may consume.
Mr. Chairman, the opioid epidemic is ravaging this Nation. Families have been torn apart; lives have been destroyed; and communities are endangered.
This crisis does not discriminate. Americans from all walks of life in all 50 States are being held hostage by the scourge of opioids.
Tragically, the opioid epidemic claims the lives of 115 Americans on average each day. In my home of Orange County, California, 361 people died from opioid overdoses in 2015. That accounts for a 50 percent increase in overdose deaths since 2006.
According to the OC Health Care Agency's 2017 ``Opioid Overdose and Death in Orange County'' report, the rate of opioid-related emergency room visits increased by more than 140 percent since 2005. Between 2011 and 2015, Orange County emergency rooms treated nearly 7,500 opioid overdose and abuse cases.
We can put an end to these tragic statistics by providing full access to various treatment options to those seeking help with their addictions. While many of these patients may benefit from outpatient help, others need highly specialized inpatient treatment to ensure they are receiving the most clinically appropriate care.
The IMD CARE Act will increase access to care for certain Medicaid beneficiaries with opioid use disorder who need the most intensive care possible: inpatient care.
Current law prohibits the Federal Government from providing Federal Medicaid matching funds to States to provide mental disease care to Medicaid-eligible patients aged 21 to 64 in facilities defined as institutes of mental diseases, commonly known as IMDs. This IMD exclusion means that Federal dollars may not be provided for the care of Medicaid-eligible patients in this age group for substance use disorder treatments at hospitals, nursing facilities, or other institutions with more than 16 beds.
It is time to repeal the IMD exclusion and remove this outdated barrier to inpatient treatment. The IMD CARE Act would allow States to repeal for 5 years the IMD exclusion for adult Medicaid beneficiaries who have an opioid use disorder, which includes heroin and fentanyl.
These beneficiaries would receive treatment in an IMD for up to 30 days over a 12-month period, during which time the beneficiary would be regularly assessed to ensure their treatment and health needs require inpatient care. The bill would also require the IMD to develop an outpatient plan for the individual's ongoing treatment upon discharge.
Throughout the Energy and Commerce Committee's work on the opioid crisis, the IMD exclusion is consistently identified as a significant barrier to care for Medicaid patients. Not every patient needs treatment in an IMD, but those who do are often among the most vulnerable. What once was a well-intended exclusion on Federal Medicaid spending has since prevented individuals from seeking treatment.
In the light of the opioid epidemic, I believe my legislation strikes the right balance. I know some have suggested States continue to seek CMS waivers to allow Medicaid to pay for IMD care. Waivers can be a good option for some States, but not all States want a waiver. In fact, less than half of the States have applied for a waiver. Additionally, a waiver can take a substantial amount of time to develop, review, and approve.
We are losing too many friends and family members to force States to navigate a lengthy and uncertain waiver process. The IMD CARE Act allows
States to act now to ensure patients who are suffering from addiction get the care they need.
The National Governors Association and the American Hospital Association have endorsed this legislation. Other organizations, such as the National Association of State Medicaid Directors and the National Association of State Mental Health Directors, have supported the idea of Congress addressing the IMD.
While the repeal of the IMD exclusion would increase mandatory outlays and add costs to the Medicaid system, the IMD CARE Act is fully paid for by curbing unnecessary Federal and State Medicaid outlays.
I want to thank Chairman Walden and my colleagues on the House Energy and Commerce Committee for their support of this bill, which will provide much needed care to Americans suffering from opioid use disorder. Through the IMD CARE Act, Congress has a unique opportunity to remove a barrier to care and bring specialized treatment to Medicaid patients who desperately need it.
Mr. Chairman, I urge all Members to support this important bill today, and I reserve the balance of my time.
Mr. Chairman, I yield 3 minutes to the gentleman from Texas (Mr. Burgess).
Mr. Chair, I yield 5 minutes to the gentleman from Oregon (Mr. Walden), chairman of the Committee on Energy and Commerce.
Mr. Chair, I yield myself the balance of my time.
Mr. Chair, the opioid crisis requires us to act now. The IMD exclusion is consistently identified as a significant barrier to care by State Medicaid directors and numerous other stakeholder groups. We need to pass this bill in order to increase access to acute, short-term inpatient treatment. I urge my colleagues to support this bill and help individuals suffering with opioid addiction.
Mr. Chair, I yield back the balance of my time.
Mr. Chairman, I claim the time in opposition, but I am not opposed to the amendment.
Mr. Chairman, I yield myself such time as I may consume.
Mr. Chairman, I thank the gentleman from Michigan (Mr. Kildee), my colleague, for offering this amendment to H.R. 5797.
This amendment seeks to add several components to a State report that is included in H.R. 5797. I appreciate Mr. Kildee's work on this amendment. I think that this information would be valuable, and I am happy to accept the amendment. However, I want to note that we will need to talk to States about the information this amendment would have, and then report. Changes may have to be made, depending on that feedback.
I am committed to working out the technical details of the amendment as we move into conference.
Mr. Chairman, I yield to the gentleman from New Jersey (Mr. Pallone).
Mr. Chairman, I yield back the balance of my time.
Mr. Speaker, I withdraw my point of order.
Mr. Speaker, I claim the time in opposition to the motion.
Mr. Speaker, the Energy and Commerce Committee has worked hard to make this monumental first step in removing a decades-old barrier.
Currently the law prohibits Medicaid beneficiaries aged 21 to 64 from receiving care in an institution for mental disease, or IMD. This prohibition was set into law in the 1960s, long before the opioid crisis, and the time to repeal it in a targeted manner is now.
Now is the time, because 115 Americans are dying each day from opioid-related deaths. Now is the time, because
on average, 1,000 people are treated in emergency rooms for opioid misuse.
I am happy to work with my colleagues on expanding addiction treatment services, but that should not distract from what we are considering today: increasing access to specialized inpatient treatment for the most vulnerable in society who are struggling with an opioid addiction.
We are helping to ensure that people get the care they need in the midst of this crisis, and most importantly, it will save lives.
A recent MACPAC report clearly stated that the Medicaid IMD exclusion acts as a barrier for individuals with an opioid use disorder and is one of the few instances in Medicaid where Federal financial participation cannot be used for medically necessary and otherwise covered services for a specific Medicaid enrollee population receiving treatment in a specific setting.
The IMD CARE Act is vital to helping our communities end the opioid epidemic by removing that barrier. This bill provides for a targeted repeal of the IMD prohibition. The bill gives States a quicker alternative than Medicaid waivers to provide this much needed care. This bill was carefully crafted to ensure that patients are not being held in IMDs for longer than necessary and the bill also includes an offset.
For these reasons, the National Governors Association and the American Hospital Association support the bill.
Numerous stakeholder groups have identified the IMD exclusion repeal as one of the most significant reforms we can make to end the opioid crisis.
This is such a critical first step.
Mr. Speaker, I urge my colleagues to oppose this motion to recommit and to vote ``yes'' on final passage.
Mr. Speaker, I yield back the balance of my time.