With Trumpcare stalled, the backroom dealing has begun.Senate Majority Leader Mitch McConnell has a new carrot to lure GOP senators to support the plan to repeal and replace Obamacare: a $45 billion fund dedicated to America’s escalating opioid crisis.The fund, which was just $2 billion in the original bill, is aimed at winning back senators from the Rust Belt and New England who are currently opposed to the bill in part because of concerns that slashing Medicaid will exacerbate the opioid epidemic.“I think we’re going to pass this,” one administration official told Axios. “I really think they’ll bribe off the moderates with opioid money and then actually move policy to shore up Mike Lee and Ted Cruz.”Rob Portman of Ohio, Shelley Moore Capito of West Virginia, and Susan Collins of Maine are some of the no votes that McConnell is targeting with the $45 billion appropriation.But Capito almost immediately threw cold water on the proposal, telling CNN that the opioid crisis can’t be solved without access to health insurance. “You won’t access the treatment without the coverage, whether from the exchanges or Medicaid,” she said Wednesday.Capito and Portman issued a June 27 joint statement that said they oppose the current Republican plan because it would cut $772 billion worth of Medicaid funding over the next 10 years. “I continue to have real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic,” Portman said.Without “yes” votes from both Capito and Portman, the first signature piece of legislation of Trump’s presidency is likely doomed to fail.Ohio’s Republican Gov. John Kasich also pointed out that the $45 billion wouldn’t be enough to offset the deep Medicaid cuts. “That’s like spitting in the ocean,” Kasich told Politico on Thursday.Medical experts have agreed with Kasich’s assessment. Vivek Murphy, the U.S. surgeon general from 2014 until this past April, said earlier this week that cutting Medicaid while giving states money to throw at the opioid crisis “ignores a fundamental reality that addiction is rarely an isolated condition. Many people living with substance use disorders need comprehensive insurance to treat related health conditions like chronic pain, anxiety, and depression.”Seemingly every week, new studies confirm the severity of the crisis. The Blue Cross Blue Shield Association reported Thursday that opioid-use disorder diagnoses rose nearly 500 percent from 2010-2016. Overdose deaths have quadrupled since 1999, according to the CDC, and preliminary data indicates that more than 59,000 people died from opioids in 2016.While Medicaid cuts extend well beyond 2026, the proposed $45 billion opioid fund is just a one-time appropriation. That means the fund would be a temporary salve on a deep and festering wound — and that McConnell and the Trump administration will almost certainly need to offer a bigger bribe.Follow Alex on Twitter @AlxThomp
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