Trump lieutenant takes war on opiates to Maine, faces skepticism, protests

Posted May 10, 2017, at 11:33 a.m.
Last modified May 10, 2017, at 5:21 p.m.

AUGUSTA, Maine — Over a din from protesters, President Donald Trump’s top health care lieutenant told Maine reporters on Wednesday that the administration envisions a “seamless” transition for people getting treatment for opiate addiction, but experts are skeptical.

U.S. Health and Human Services Secretary Tom Price came to the State House on Wednesday alongside Kellyanne Conway, a senior adviser to the Republican president, for an opiate addiction roundtable hosted by Gov. Paul LePage.

Price called opiates a “scourge across this nation.” That is so in Maine, which had more than one drug overdose death per day in 2017 — a record high that was driven by increases in deaths attributed to fentanyl and heroin.

“The president has made one of his top priorities to make certain that we turn the tide on this,” Price said before the roundtable. “At this point, we have been losing the battle.”

The visit is part of a nationwide listening tour that Price kicked off last month after the Trump administration announced $485 million in grants to states and territories to increase prevention, treatment and recovery services, $2 million of which will go to Maine.

His visit also came at a crucial time for Trump and Republicans in their effort to repeal and replace the Affordable Care Act. Their American Health Care Act was passed by the House of Representatives last week and faces the prospect of major changes in the Senate.

That bill has sparked outrage from the left and a news conference with Price, LePage and Conway in the governor’s Cabinet room on the second floor of the State House was drowned out at times by progressives gathered in the Hall of Flags for the annual Women’s Day.

The Republican bill aims to replace subsidies in the Affordable Care Act with a system of tax credits. It used Maine’s 2011 health care reform law as a model for “high-risk pools” where people with pre-existing conditions are identified by insurers for government aid.

But a Congressional Budget Office estimate of an earlier version of the bill said 24 million would lose insurance by 2026, with average premiums decreasing starting in 2020. However, insurers would be able to charge more for older people in high-cost areas, which the Kaiser Family Foundation has estimated would negatively affect people in rural Maine.

Among the litany of complaints from Democrats and health policy experts is that while the bill is written in a way that says it would maintain protections for people with pre-existing conditions, states would be allowed to waive certain protections for Medicaid and private insurance plans and it would also phase out Medicaid expansion under the Affordable Care Act.

After being asked about how changes in the bill would affect people being treated for opiate addiction, Price said Trump is committed to a “seamless” transition for people who would move between programs.

“I think it’s important to … appreciate that the president’s commitment is to make certain that every single American has access to the kind of coverage they want for themselves,” he said, “not what the government forces them to buy.”

Maine is one of only a few states with its own laws protecting people with pre-existing conditions, but LePage has vetoed expansion five times because of concerns with cost and changes during his administration reduced Medicaid rolls by 67,000 between 2011 and 2015.

Mark Publicker, an addiction specialist in Portland, said in that environment, little can be done to expand treatment to many who need it, calling the current system “seamless” in its own way.

“If you don’t have have insurance now, you seamlessly won’t have insurance,” he said.

Gordon Smith, executive vice president of Maine Medical Association, which opposes the Republican bill and backs expansion, said “I haven’t seen anything in their proposal” that would allow for an easy transition, saying Medicaid changes would leave states “holding the bag” for costs.

U.S. Sen. Angus King, an independent who caucuses with Democrats, blasted the bill in a Wednesday floor speech, saying it would make it more difficult for people with a substance use disorder to get treatment and calling it “the most ill conceived, damaging and downright cruel piece of legislation I have ever seen any legislative body pass.”

Represented in Wednesday’s roundtable were doctors, rehabilitation specialists, law enforcement and people in recovery, including Liza Parker, 26, of Ellsworth, who said she’s been clean for more than a year.

But specialists outside the room questioned what it accomplished. Malory Otteson Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, said no one from her group or a number of other organizations was invited.

“Who are they listening to?” Shaughnessy said.

BDN writers Christopher Cousins and Nok-Noi Ricker contributed to this report.

 

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