What Will the Trump Presidency Mean for Addiction Treatment?

Donald Trump

While the new Trump administration is beginning to take shape, political observers and addiction professionals have been trying to gauge what the healthcare sector can expect from the new federal government.

With Georgia Representative Tom Price, “President-elect Donald Trump has chosen as his secretary of health and human services a man intent on systematically weakening, if not demolishing, the nation’s health care safety net,” the New York Times commented.


In Congress, Price has been one of the most fervent opponents of the Affordable Care Act (ACA), commonly known as “Obamacare.” During the campaign, Trump had repeatedly vowed to repeal the ACA and Price would like to replace it with his own “Empowering Patients” plan.


That plan would allow insurers to charge sick people more if they lapse in coverage—up to 150 percent of the standard premium. Unless modified, it also would repeal the expansion of Medicaid, a program that provided more than 12 million low-income Americans with coverage, and replace it with basically nothing.


This is not good news for people who need addiction treatment. Medicaid is the single largest payer for mental health services in the United States and is increasingly playing a larger role in the reimbursement of substance use disorder services. Nearly 12 percent of Medicaid beneficiaries over 18 have a substance use disorder.


According to the New York Times, the Price plan would no longer require insurance companies to cover addiction treatment, birth control, maternity care, prescription drugs and other medical services.


It is too early to tell what kind of kind of healthcare legislation the Trump administration will actually be able or willing to implement.


During his campaign, Trump outlined plans that focus on cutting off the supply of drugs crossing into the United States as well as tougher prosecution of drug traffickers which sounds a lot like the failed strategy of the War on Drugs in the 20th century. “There’s no doubt that can help, but it’s only a small part of a comprehensive solution,” writes addiction activist Gary Mendell in The Hill. “That’s why Trump must follow through on his promises regarding prevention and treatment.”


But those promises were fairly vague and a comprehensive solution requires extensive funding instead of downsizing.


“All the plans in the world won’t make a difference unless Washington puts some money behind them. It’s not enough to pass hollow laws,” writes Mendell who lost his son Brian to addiction.  


Advocates like Mendell hope to get the Comprehensive Addiction and Recovery Act (CARA) that Congress passed earlier this year fully funded as soon as possible. So far, lawmakers have allocated very little money for implementation and whether that will change during the lame-duck session in Washington is anybody’s guess.

There is some hope the incoming president will take the addiction crisis ravaging America seriously but for many people his emphasis on building a wall on the border with Mexico as a solution is troubling.