House approves massive opioids legislation

The House of Representatives on Friday passed the most expansive legislation Congress has taken to date to address the opioid crisis, approving a bipartisan package that combines 58 bills passed in the last two weeks.

Provisions in the final package address a wide range of issues related to the crisis that is wreaking havoc across the country, such as expanding access to treatment and recovery services, coming up with opioid alternatives for pain treatment, intercepting illegal opioids at mail facilities and combating use of fentanyl. In a time of sharp partisan divides and vitriol, the 396-14 bipartisan vote underscored the reach and scope of the crisis on Capitol Hill, where lawmakers and staff say the issue has become one of, if not the, top issues they hear about from constituents in their states and districts.

With the crisis continuing to see widespread deaths, opioids are an issue that has touched most, if not all, in the states, cities and towns represented on Capitol Hill. During 2016, there were more than 63,600 overdose deaths in the United States, including 42,249 that involved an opioid, according to the Centers for Disease Control. That’s an average of 115 opioid overdose deaths each day.

The bill, titled the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, builds onto other efforts by Congress in recent years to tackle the epidemic, including $4 billion in funding earlier this year in a large spending bill. In 2016, the House passed the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act.

All told, Rep. Greg Walden — chairman of the Energy and Commerce Committee, one of the committees that dealt with opioids legislation — described the combination of bills as “one of the most significant congressional efforts against a drug crisis in our nation’s history.”

“But we must continue to continue to legislate, evaluate, conduct oversight and work together to provide new solutions … so that we can rise to this ever challenging situation,” he said Friday on the House floor.

A key provision in the bill would allow Medicaid to pay for treatment in certain inpatient facilities that treat mental illness — rolling back a federal prohibition in order to target opioid addiction — for up to 30 days. The provision was initially tailored only for opioid treatment, drawing criticism from Democrats for focusing on too small a population. An agreement between Walden and Rep. Bobby Rush, an Illinois Democrat, which was approved earlier in the week by voice vote, broadened the provision to expand its reach to crack cocaine as well.

Also folded into the bill was a measure known as Jessie’s Law, which requires the government to come up with guidelines for doctors and hospitals on how to best display a patient’s addiction history to prevent relapse.

Republicans have led a concerted messaging effort to focus on opioids the past two weeks and used the vast majority of floor time on the issue, though an unrelated intra-party battle on immigration captured most of the spotlight.

While the latest package passed with bipartisan support, there was some criticism by Democrats who felt it didn’t go far enough. Rep. Frank Pallone, the top Democrat on the House Energy and Commerce Committee, ultimately supported the final package but said more can be done.

“This bill makes incremental changes to support those affected by the opioid crisis, but is far from perfect,” he said in a statement. Many Democrats have repeatedly knocked Republicans for repealing parts of the Affordable Care Act.

The legislation next heads to the Senate, where multiple committees are working on their own package of bills to address the crisis. Aides in both chambers say they expect to reconcile the bills and get something to the President’s desk to be signed into law before the end of the year.

A spokesman for Senate Majority Leader Mitch McConnell said the bipartisan bills reported out of the four committees are “priorities for the Majority Leader.”

“The chairmen and ranking members of those committees (Commerce, Finance, HELP and Judiciary) are now working on an agreement for floor consideration of the package of bills,” Don Stewart said. “Once the Senate completes work on this opioids package, we’ll work quickly with the House to get a final bill to the President for his signature.”