The most comprehensive legislation to date aimed at combating the country's opioid addiction epidemic passed overwhelmingly in the House on Friday, despite threats by Democratic lawmakers that they would not support the measure because it lacked sufficient funding.
Lawmakers voted 407-5 in favor of the Comprehensive Addiction and Recovery Act (PDF). The tally included “yes” votes from 174 Democrats. Anti-addiction advocacy groups have worked for three years to push the legislation through Congress.
The fate of the bill was uncertain leading up to Friday's vote. On Tuesday Democratic members of the congressional conference committee negotiating the final version of the bill sent a letter (PDF) to committee Chair Rep. Fred Upton (R-Mich.) threatening to vote against the legislation if it didn't include another $900 million in funding.
On Wednesday the conference committee approved the bill without the support of any of the panel's Democrats after they failed to attach amendments giving states more funding for additional treatment and prevention. Earlier versions of the legislation won bipartisan support in both the House and Senate.
It was unclear Friday whether the bill would attract the 60 votes necessary in the Senate.
Aside from funding, a number of contentious issues could halt the bill's progress. For example, the final version of the bill eliminated a provision that would have required doctors to consult databases maintained by drug monitoring programs before prescribing opioids to patients.
The prescription drug monitoring programs "are important because they help doctors spot early signs of addiction, such as doctor-shopping,” Gary Mendell, founder and CEO of the anti-addiction advocacy group Shatterproof, wrote in a blog post published in the Huffington Post on Tuesday. “They also prevent physicians from accidentally prescribing a drug that could be lethal in combination with another the patient is taking.”
A less-talked-about provision would exempt manufacturers of opioid pain relievers from requirements to charge lower prices to the Medicaid program if they have new abuse-deterrent formulations. The Congressional Budget Office has estimated the measure would cost Medicaid $75 million over the next 10 years.
“That industry needs no further incentive, financial or other, to produce opioid products including abuse-deterrent products,” said Dr. Michael Carome, director of the Health Research Group for the patient advocacy organization Public Citizen. “This is really just completely unnecessary.”
The measure now moves to the Senate where a vote may occur as early as next week.
The National Council for Behavioral Health said in a statement Friday that it was disappointed that the final bill doesn't include more funding but also praised lawmakers for passing the legislation. “This bill is the result of many years of tireless advocacy and represents an important, bipartisan step forward in efforts to address the nation's opioid use and abuse epidemic," the advocacy group said. "The final report prioritizes prevention, treatment and recovery support services for those living with and in recovery from addiction."