Washington, D.C. — As the Trump administration continues to threaten Americans’ health care in the federal courts and propose deep cuts to Medicaid, Medicare, and Social Security, the Center for American Progress Action Fund is releasing a new video as part of a social media campaign to educate Americans on what’s at stake.
The campaign will tell stories of Americans such as Dr. Larry Greenblatt, a hospital medical director from Durham, North Carolina, who specializes in treating patients battling opioid addiction. In North Carolina, the opioid crisis has been particularly devastating. Four North Carolina cities—Wilmington, Hickory, Jacksonville, and Fayetteville—are among the 25 U.S. cities with the highest rates of opioid use disorder (OUD). As Dr. Greenblatt says in the video, the Trump administration’s threats to programs such as Medicaid would significantly diminish efforts to fight against the ongoing crisis in the state.
“North Carolina has had ongoing increases in our opioid overdose deaths,” says Dr. Greenblatt. “We’re seeing a lot of families being disrupted. This is a huge public health problem, but there really haven’t been a lot of details from President Trump about this.”
Despite President Trump’s central promise not to cut the programs “like every other Republican,” his administration’s budget proposal cuts $1.5 trillion from Medicaid, $25 billion from Social Security, and $845 billion from Medicare over the course of the next decade. Moreover, the administration’s proposal to block grant the Medicaid program would fundamentally undercut how Medicaid currently works. Under the current system, as public health crises—such as the opioid crisis—emerge, federal funding automatically increases to meet growing demand. Under a block grant system, however, states such as North Carolina would absorb responsibility for financing the full cost of rising needs that stem from these public health emergencies.
According to the Kaiser Family Foundation, Medicaid expansion under the Affordable Care Act (ACA) has played a critical role in addressing the opioid epidemic by giving states the resources to provide coverage to nearly 4 in 10 nonelderly adults battling OUD. Medicaid expansion has also been instrumental in providing early interventions for patients as well as measures to reduce opioid prescribing—all things that could be made impossible to sustain with the budget cuts proposed by the Trump administration.
More than 20 million Americans have been able to obtain health coverage thanks to the ACA, and 135 million people receive protections for preexisting conditions through the law. Unfortunately, despite the law’s many benefits, including expanded services to populations without access to OUD treatment, the Trump administration has focused on undoing it—either through congressional action or by toppling the law in the courts. Trump also promised to come up with a replacement plan if the ACA were repealed or overturned, but his administration has failed to create an alternative plan. The Republican majority in the North Carolina Legislature has also blocked efforts to enact comprehensive Medicaid expansion, as is allowed under the ACA.
“We don’t have Medicaid expansion in North Carolina, though we have many, many people who would benefit—and Medicaid can make a big difference in making treatment available,” Dr. Greenblatt says. “When people are ready to get off opioids, we need to be able to meet them where they’re at, offer them effective medication, and help them get their life back. Donald Trump needs to make this a priority. People can make a path to recovery, and we need to find ways to help people get there.”
After multiple attempts by the Trump administration to repeal the ACA in Congress, the U.S. Department of Justice joined a health care repeal lawsuit seeking to overturn the law in full. In July, the U.S. Court of Appeals for the 5th Circuit heard oral arguments in the case, putting health care coverage for 20 million Americans and preexisting condition protections for tens of millions more at risk. A ruling in the appeal could come any day now.
“There are about 2 million people in this country that have opioid use disorder, and about 20 percent of them are currently in treatment,” says Dr. Greenblatt. “It’s all kinds of people. It’s folks that are college educated. It’s people that are low income. It’s all different races, even different ages. But they all have something in common, and that’s they’ve become addicted to opioids.”
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