Editorial: Expand Medicaid coverage to include heroin treatment

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Chicago and Illinois have a shameful record when it comes to heroin addiction. Our city leads the nation in heroin-related emergency room visits, yet our state is among the very worst in funding addiction treatment programs.

No one should be surprised, then, as Cook County Sheriff Tom Dart often says, that our jails and prisons are full of people who committed crimes to feed their drug habits.

As early as Wednesday, the Illinois General Assembly can do something about that. The House, followed by the Senate, can vote to extend Medicaid coverage to pay for federally-approved medications and therapy to treat heroin addiction. A bill with this provision sailed last spring through both the House and Senate, with overwhelming bipartisan support, but Gov. Rauner, in an amendatory veto, struck the provision. An override of the governor’s veto is called for.

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We can appreciate the governor’s reasoning. Illinois is broke and “facing unprecedented fiscal difficulties,” as he says, and the bill’s chief sponsor, Rep. Lou Lang, D-Skokie, estimates the cost of expanded Medicaid coverage would be $25 million a year. Skeptics claim the cost would be even higher.

But there is also a cost to doing nothing. The Illinois Alcoholism and Drug Dependence Association estimates that for every dollar spent on treatment, $4.87 is saved in corresponding healthcare costs, creating a net benefit of tens of millions.

Chicago is first in the nation for emergency-room visits related to heroin use, according to a report released last month by the Illinois Consortium on Drug Policy at Roosevelt University, and suburban and rural areas have seen a spike in overdoses as well. But, according to the report, Illinois is third worst in public funding for treatment, ahead of only Texas and Tennessee. Illinois used to be in the middle of the pack, but the state decreased general revenue funding by nearly 30 percent from 2007 to 2012. And more cuts are in store under the governor’s proposed budget.

Nationally, heroin-related deaths from overdoses nearly doubled between 2011 and 2013, with more than 8,200 dying in 2013, according to the Centers for Disease Control and Prevention. In Illinois, there were at least 681 heroin overdoses in 2014, an increase from 583 in 2013, according to the Illinois Department of Public Health.

A recommendation for states from the CDC calls for Medicaid coverage to include Medication-Assisted Treatment, known as MAT, that combines use of medications such as methadone, buprenorphine or naltrexone with counseling and behavioral therapies.

Wealthy people and most of the middle class have insurance that covers such treatments. For the poor there is only Medicaid.

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