In late February, the House of Representatives passed their budget resolution, clearing the first procedural hurdle in the process known as “Reconciliation.” This process is used often by incoming White House administrations with a friendly Congressional majority, in an attempt to cut spending in specific areas so that these funds may be used to advance the President’s policy agenda. A reconciliation bill must show that money is being saved, and it cannot be filibustered in the Senate. Because the Trump White House is seeking to enact tax policies that will deplete revenue, Congress must find hundreds of billions of dollars to offset this.
While it remains unclear where Congress will find offsets, a large majority in Washington believe that Medicaid is a program that may be severely impacted. Several hundred billion dollars for Medicaid are now at risk as Congress begins to look for programs to cut. While there may not be cuts to Medicaid’s overall budget per se, there remains the possibility that Congress will attempt to save money by adding either work requirements, or by capping the amount of Medicaid funds a state can receive from the federal government. According to the Kaiser Family Foundation, research findings show that state Medicaid expansions to low-income adults are associated with increased access to care, increased economic security, improved self-reported health status, and other outcomes including lower mortality rates for certain conditions, decreased maternal mortality, improved treatment management for conditions (e.g., diabetes, HIV), and improved outcomes related to substance use disorders. The impact of these cuts could be disastrous for those who provide recovery support services, especially in states where Medicaid has been expanded under the Affordable Care Act. It will be several months before the process is complete, and we will continue to keep you posted in this space as developments occur.
There is, fortunately, good news to share as well. New provisional data from CDC’s National Vital Statistics System predict a nearly 24% decline in drug overdose deaths in the United States for the 12 months ending in September 2024, compared to the previous year. This is the most recent national data available and shows a continued steep decline in overdose deaths. Provisional data shows about 87,000 drug overdose deaths from October 2023 to September 2024, down from around 114,000 the previous year. This is the fewest overdose deaths in any 12-month period since June 2020. While this national decline is encouraging news, overdose remains the leading cause of death for Americans aged 18-44, highlighting the importance of sustained efforts to ensure this progress continues. 45 states showed declines in overdose deaths, but five states—Alaska, Montana, Nevada, South Dakota, and Utah—still saw increases in overdose deaths, highlighting the continued need for rapid local data and tailored response.
