North Carolina among hardest hit by opioid crisis, would face $9 billion federal Medicaid cut

RALEIGH (April 11, 2017) — North Carolina’s opioid crisis, already responsible for one of the highest incidents of drug-related deaths in the nation, could be further exacerbated under the House plan to repeal the Affordable Care Act (ACA). According to new estimates released today by the Washington, DC-based Center on Budget and Policy Priorities, the House ACA repeal bill would cut North Carolina’s Medicaid funding by more than $9 billion over the next 10 years, jeopardizing North Carolina’s ability to provide adequate coverage for substance use disorder (SUD) treatment to all eligible residents.

Despite the bill’s failure to even reach the House floor for a vote, Republicans are reportedly continuing negotiations to try and revive it or may pursue other ways to severely cut and cap funding for the Medicaid program – a move that could disproportionately affect millions of people with SUDs.

The ACA’s expansion of Medicaid to low-income adults has allowed millions of people with SUDs to get health coverage and access to SUD treatment services, according to a comprehensive report last year from the U.S. Surgeon General. In addition, because the ACA deemed it an essential health benefit, millions of people who bought coverage in the individual and small-group markets, including those getting coverage through the health reform’s marketplaces, have also gained coverage for SUD treatment.

“With one of the highest rates of drug-related deaths in the country, the last thing North Carolina needs is to reduce access to life-saving treatment,” said Nicole Dozier, Director of NC Justice Center’s Health Advocacy Project. “But the House Republican health bill would do just that.”

The ACA repeal bill, the American Health Care Act, would have threatened the gains in coverage for SUD by effectively ending the Medicaid expansion and capping and cutting Medicaid funding, in addition to other provisions that would have weakened individual and small-group market coverage and affordability. The bill would have left 24 million more people uninsured and shifted hundreds of millions in costs to states, including those that have been hit disproportionately by the opioid epidemic.

Rather than cutting access to SUD treatment, policymakers in Washington and here in the state should take steps to build on the success of the ACA to increase insurance eligibility and coverage for people with SUDs. These steps include expanding Medicaid to low-income adults. North Carolina has not yet expanded, despite the federal government picking up at least 90 percent of the cost and it being particularly beneficial in states hit hardest by the opioid epidemic. In West Virginia, the state with the highest drug overdose death rate in 2015, the share of people with substance use or mental health disorders who were hospitalized but uninsured fell from 23 percent in 2013 to 5 percent in 2014. Nationwide, the share of people with substance use or mental health disorders who were hospitalized but uninsured fell from about 20 percent in 2013 to 5 percent by mid-2015.

To learn more about how the House Republican plan would jeopardize substance abuse treatment coverage for thousands of Americans, please visit:

FOR MORE INFORMATION, CONTACT Ciara Zachary,, 919.856.2568; Julia Hawes,, 919.863.2406.