Senate leaders support expanding Medicaid coverage for addiction treatment

Tens of thousands of Medicaid beneficiaries would have more substance abuse treatment options under bipartisan legislation recently introduced in the Senate to help combat the heroin and prescription drug epidemic.

U.S. Sens. Shelley Moore Capito (R-WV), Susan Collins (R-ME) and Rob Portman (R-OH) introduced the Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act, which would modify a Medicaid Institutions for Mental Disease (IMD) exclusion that limits addiction treatment coverage.

The exclusion, which has been in place since 1965, restricts coverage of addiction treatment at facilities with more than 16 beds. The original intent of the IMD exclusion was to prevent providers from “warehousing” mentally ill patients.

“Our nation’s opioid and heroin epidemic has devastated countless families and communities across the country and has hit Maine particularly hard,” Collins said. “As we look for ways to address this burgeoning public health crisis, we must identify and correct outdated policies like the IMD exclusion that unintentionally block access to lifesaving substance abuse treatment. By improving access to treatment opportunities, our legislation will help provide hope and healing to those struggling with addiction.”

The Medicaid CARE Act would adjust the IMD exclusion to cover substance abuse treatment at accredited “residential addiction treatment facilities” with up to 40 beds. Adults with substance abuse disorders could receive treatment for up to 60 consecutive days.

The measure would also give more flexibility to pregnant and postpartum women seeking treatment, and it would create a $50 million grant program to support youth inpatient addiction treatment at facilities that serve at-risk Medicaid beneficiaries younger than 21.

U.S. Sens. Angus King (I-ME) and Dick Durbin (D-IL) joined the senators in introducing the bill.