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Stephanie Pellitt

, National Council for Behavioral Health

Trump Talks ACA, Drug Prices and Opioids During SOTU

February 1, 2018 | ACA | Opioid and Heroin Epidemic | Comments
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Tuesday evening, President Donald Trump used his first State of the Union address to tout repeal of the Affordable Care Act’s (ACA) individual mandate, reiterate his promise to reduce prescription drug prices and vow to address the opioid epidemic with an enhanced focus on criminal justice. Although the speech lacked health care specifics, the address did serve to highlight President Trump’s most pressing health care priorities heading into his second year as Commander-In-Chief.

Here are the key health care takeaways from the State of the Union:

ACA Repeal

President Trump praised Congress’ recent repeal of the ACA’s individual mandate, saying “We repealed the core of disastrous Obamacare — the individual mandate is now gone.” While the repeal of mandate for all Americans to have health insurance is not effective until 2019, the latest projections from the Congressional Budget Office estimate this provision resulting in 13 million fewer people having health insurance.

Drug Prices

During his speech, President Trump cited reducing prescription drug prices as one of his administration’s greatest priorities. He explained, “In many other countries, these drugs cost far less than what we pay in the United States. That is why I have directed my Administration to make fixing the injustice of high drug prices one of our top priorities. Prices will come down.”

Again, the President’s speech was light on policy specifics to address drug pricing. In recent years, drug pricing efforts have taken aim at reducing Medicare Part D drug costs to help older Americans afford their prescriptions. However, with a new Health and Human Services Secretary taking the reins this week, some uncertainty remains as to what actions will emerge as “top priorities” for the Administration.

Opioid Crisis

In highlighting the opioid epidemic, President Trump first noted the gravity of the issue, “In 2016, we lost 64,000 Americans to drug overdoses: 174 deaths per day. Seven per hour.” He continued with broad strokes about how his Administration would respond, “We must get much tougher on drug dealers and pushers if we are going to succeed in stopping this scourge. My Administration is committed to fighting the drug epidemic and helping get treatment for those in need.”

President Trump has spoken frequently about the opioid crisis, and has routinely touted a law-and-order approach to solving the epidemic. However, health policy experts say law enforcement efforts are only one piece of a broader solution that must include access prevention, treatment, and recovery services. He declared the epidemic a national public health emergency in October and renewed that declaration earlier this month.

But so far, it remains to be seen if the President’s words will equal any new funding for addiction treatment or concrete policy solutions. If the President’s FY 2018 budget request is any sign of how the Administration will propose to address addiction in FY 2019, then it would include major funding cuts to SAMHSA, the leading federal agency for addiction and mental health programs. The National Council would urge Congress to reject any attempts to decrease funding to SAMHSA during this time of crisis.