Congress tackles SUPPORT Act and Medicaid cuts

Congress returned from a two-week recess last week. Here’s what they worked on…

SUPPORT Act

• The House Energy and Commerce Committee voted 36-13 to advance a reauthorization of the 2018 SUPPORT Act, which funds treatment and recovery programs for opioid use disorder and expands access to medications for opioid use disorder.
• Reminder: The committee approved the same bill unanimously in 2023. It was part of a bipartisan, bicameral health care package lawmakers intended to pass with funding legislation in December, but it was ultimately left out of the funding bill.
• But: Last week, a majority of Democrats on the committee opposed it, underscoring how their frustration over Department of Government Efficiency (DOGE) cuts is undermining the few remaining areas of bipartisan agreement.
• The context: Half of employees at the Substance Abuse and Mental Health Services Administration (SAMHSA), which is responsible for grant-making under the law, were let go last month, and several amendments that sought to restore grant funding for mental health and addiction programs were rejected.
• The response: Rep. DeGette, the top Democrat on E&C’s Health Subcommittee, said, “I am confused [that] we are working on the SUPPORT Act while [the] administration is working independent of Congress to undermine its aims.”

Medicaid:

• New proposal: House Republicans discussed a new, controversial proposal to cut Medicaid. It would place per capita caps on Medicaid funding for certain beneficiaries in states that have expanded Medicaid under the Affordable Care Act. Per capita caps and reducing the federal share of payments (another proposal) would have similar impacts – shifting more costs to the states and causing coverage losses. But a cap could help skirt trigger laws in many states that would end expansion if the federal share of payments is lowered. The cap would still effectively lower the federal share of payments, but it would occur more slowly than directly reducing the federal share.
• New date: House leaders are pushing the Energy and Commerce Committee’s bill markup another week as they try to resolve differences over Medicaid. The panel will now likely hold its markup the week of May 12 and will hold a series of member meetings this week.