AUGUSTA — Two top Trump administration officials came to Maine on Wednesday for a private meeting with Gov. Paul LePage and other state leaders about the opioid addiction epidemic and how best to combat it.
“At this point we are losing the battle,” Health and Human Services Secretary Tom Price said before the hourlong meeting with participants, who ranged from two recovering addicts to the chief justice of the Maine Supreme Judicial Court. Price was accompanied by top White House Counsel Kellyanne Conway. The two are visiting state capitals around the country to discuss the problem.
Price said the problem is one of President Trump’s top priorities.
“We are losing a Vietnam every single year in this nation due to drug overdoses,” he said. “That’s not acceptable.”
Price was referring to the 52,000 people who are dying from drug overdoses each year, a number that approaches the 58,000 American lives lost in the entire Vietnam War.
In Maine, fatal drug overdoses claimed, on average, more than one life per day last year, with the vast majority attributable to heroin, fentanyl or prescription opioids. The 376 Mainers who lost their lives to opioid-related overdoses in 2016 included people from cities and small towns, the young and old, wealthy and poor.
While the state has allocated additional resources to drug treatment and law enforcement, experts say demand for treatment far outstrips availability, especially for those without health insurance. And, despite the meeting Wednesday, both the LePage and Trump administrations have pursued policies and spending cuts that critics say would worsen the problem.
In fact, Sen. Angus King of Maine, an independent who caucuses with Democrats, criticized Trump’s budget proposal to “dismantle” the Office of National Drug Control Policy during a speech on the Senate floor Wednesday.
“Here we are in the midst of the most serious drug crisis in the history of this country and the administration is talking about gutting the very office that’s supposed to lead the fight,” King said. “It’s as if in the middle of World War II we had abolished the Department of Defense. It makes no sense.”
Peter Steele, LePage’s communications director, said attendees who spoke at the meeting Wednesday brought up a range of subjects, including access to treatment, the need for federal support and flexibility for states in crafting programs that work locally.
Members of the media were not allowed to sit in on the session – officials said patient privacy was a concern. But, Price and LePage spoke briefly to reporters afterward and faced questions about reduced funding and access to addiction treatment, including by limiting enrollment in Medicaid, which is called MaineCare in Maine.
In the brief news conference, Price mentioned several times that the Trump administration respects states’ ability to tailor their responses in ways that work best for them. Everything from improving resources to combating the inflow of illegal drugs to Maine, to developing effective treatment programs and improving awareness of existing programs came up during the conversation, he said.
LePage and Price appeared to disagree during the news conference about the need for widespread availability of an overdose antidote called naloxone, often known by its trademark name Narcan.
The Maine Legislature is considering a LePage proposal that would require those treated with Narcan to pay for that medication when it is administered to them by first responders. The first treatment with Narcan would remain free, but people who need multiple injections would pay because “they have to have skin in the game,” LePage said.
LePage has been resistant to making the antidote widely available, saying in the past that it encourages people to keep using the drugs.
Price, meanwhile, said it’s important to make sure antidotes are easily accessible.
“What we have laid out is a strategy coming forward that is working on the treatment and recovery of opioid addiction and making certain that we provide the resources so that the overdose-reducing and reversing drugs are available as often as needed and wherever needed,” Price said.
Price stopped short of directly contradicting LePage and said the governor could speak to his own proposal. “But,” he said, “what I will tell you is the imperative of making certain we have overdose-reversing medications available is absolutely imperative and how that happens may be different in one community or one state to another, but what we do know is they save lives.”
Price said solving the crisis goes well beyond having overdose-reversing drugs, however, and it’s critical to get people into a treatment regime. “We ought not just let that be the last event to occur,” he said.
Price also took questions about LePage-led efforts to reject the expansion of Medicaid in Maine, as well as a policy shifts that eliminated unmarried adults from the public health insurance program and whether the Trump-backed American Health Care Act would only further accelerate that loss of coverage to pay for addiction treatment and other care. The AHCA has been endorsed by the Republican-led U.S. House as a replacement to the Affordable Care Act.
“The president’s commitment is to make certain that every single American has access to the kind of coverage they want for themselves and for their families, not that the government forces them to buy,” Price said.
LePage said it was true Maine had not expanded the state’s Medicaid program, but that many who lost coverage are now buying their own insurance on the health care exchanges that were set up under the Affordable Care Act.
“We have not expanded (MaineCare) and we have lowered the uninsured rate in the state of Maine significantly,” LePage said. “It’s about having people taking accountability and responsibility for their lives if they are able-bodied.”
One recovering addict who attended the meeting, Liza Parker, thanked LePage for supporting recovery programs that she credited with saving her life and keeping her family together. Parker told reporters after the session that it took her facing a felony drug charge to finally seek the help she needed.
“People need to realize there is help and support, but you need to want it for yourself,” Parker said.
Parker has been a client at Open Door Recovery in Ellsworth, which offers intensive treatment for adults and adolescents. LePage has provided $75,000 to Open Door from the Governor’s Contingency Fund to help maintain the treatment program offered to pregnant women.
Although LePage recently has backed more funding for addiction treatment and services while moving to increase available treatment beds, including a new 200-bed inpatient treatment facility for addicts at the state prison in Windham, his administration has faced criticism for not doing enough to combat the overdose crisis.
For several years as the problem worsened, policymakers – led by LePage – made it harder to get treatment. The state reduced reimbursement rates for methadone, a drug used to treat opioid addiction. It tightened eligibility for MaineCare, the state’s version of Medicaid, leaving many low-income people without the ability to pay. LePage fought against increased access to Narcan, prompting Attorney General Janet Mills, a frequent adversary of the governor, to sidestep him and use funds her office controls to provide the drug to local police departments.
The LePage administration agreed last December to spend $2.4 million for medication-assisted treatment for uninsured Mainers, many of whom lost insurance during cuts to MaineCare. And in February, the administration worked with lawmakers to add $4.8 million for treatment into a supplemental budget.
At the federal level, Conway said Trump responded in the early weeks of his presidency by organizing a commission to focus on the issue. The national listening tour is intended to identify the most effective responses, she said.
“We look at opioid addiction in the White House as a nonpartisan issue in need of a bipartisan solution,” Conway said.
But the Trump administration also has been criticized for its early approach to the problem.
A draft internal memo obtained by CNN reportedly suggested that the administration was considering cutting the budget of the Office of National Drug Control Policy by more than 90 percent in order to streamline the organization and eliminate duplicative programs offered by other agencies.
Maine Democratic Party Chairman Phil Bartlett issued a terse statement Wednesday that thanked Price for coming to Maine, but criticized Trump’s support for reduced funding for Medicaid and Trump’s federal budget proposal that slashes funding for the Office of National Drug Control Policy.
“To add insult to injury, the Trump administration is cutting these funds to pay for more tax breaks for millionaires and billionaires,” Bartlett said in a statement.
Price spoke during a brief, tightly controlled news conference one day after a West Virginia reporter was arrested while persisting in his questioning of Price about health care. The reporter approached Price and asked whether women who are victims of domestic violence would be considered to have a pre-existing condition and face higher insurance fees under a Republican-backed health bill that recently passed the U.S. House.
Price, LePage and Conway took questions at the State House as a crowd made up mostly of women dressed in red chanted political slogans and waved signs just outside the governor’s Cabinet room, at times nearly drowning out those speaking at the news conference. Wednesday also was Women’s Day at the State House, where organizers were drawing attention to the issues Maine women are facing, including the possibility many could lose access to health care services under the recent House bill.
As Price’s entourage, guarded by Secret Service agents, exited the State House via a cordoned-off side door, the crowd chanted, “Shame, shame, shame.”
Price addressed questions from reporters about whether those who suffer from addiction disorders would be considered to have a pre-existing condition that could make them ineligible for health insurance under the American Health Care Act.
“I think it’s important to appreciate that one of the president’s absolute commitments in the area of health care is to make certain that anyone with a pre-existing condition, illness or injury is not precluded from gaining access to the coverage they need,” Price said. He said the AHCA included “explicit language” preventing exclusion for pre-existing conditions and that included addiction disorders, but Price did not address the concern that people with pre-existing illnesses or injuries could be forced to pay significantly more for insurance coverage.
Lori Gramlich, executive director of the Maine Chapter of the National Association of Social Workers, issued a statement Wednesday noting that provisions in the American Health Care Act could allow states to opt out of providing addiction treatment services.
Gramlich noted that Maine’s rejection of an expansion of Medicaid meant nearly 25,000 Mainers in need of treatment for addiction did not get help.
“We applaud meetings and open communication, but we are hopeful that Secretary Price and Gov. LePage will take action that supports Maine’s need for mandatory coverage of mental health and addiction needs,” Gramlich said in a statement.
Scott Thistle can be contacted at 791-6330 or at:
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