Opening Statement of Rep. Diana DeGette, Ranking Member Subcommittee on Oversight and Investigations
Every day, somewhere in this country there’s a news account about how opioid addiction has wrecked a small town or family -- personal stories of typical Americans who became addicted to pain pills, and then got hooked on heroin.
These are heartbreaking stories of Americans dying and leaving loved ones, often children, to pick up the pieces.
The opioid epidemic is unprecedented. It is also escalating, and we need a comprehensive strategy to confront it.
In 2015, more than 33,000 Americans died of an overdose involving a prescription or illicit opioid, and more than two million people had an opioid use disorder. Today, we will hear about fentanyl, an even deadlier layer to this crisis.
Fentanyl is a synthetic and short-acting opioid. It can be up to 50 times more potent than heroin and 100 times more potent than morphine. It is lethal at even the tiniest amounts, and anyone exposed to it can be at risk.
There are reports of law enforcement agents, for example, who became ill after handling fentanyl, with one agent apparently falling into a coma. In 2015, the U.S. Drug Enforcement Administration issued a nationwide alert that fentanyl is a threat to public health and safety.
Illicit fentanyl use is not a new problem. What is new, however, is fentanyl’s growing prevalence.
Since 2010, fentanyl recovered by American law enforcement nationwide has risen twenty-fold, from 640 samples tested to 13,000 samples tested in 2015, according to data from the DEA’s National Forensic Laboratory Information System.
U.S. law enforcement believes China is the primary source of illicit fentanyl and precursor chemicals. Chinese producers ship fentanyl or chemicals to make it directly into the United States. Precursor chemicals or finished fentanyl is shipped to Mexico and Canada where it is trafficked across our borders in pure form or is mixed into other illicit drugs such as heroin.
We will be asking the panel today tough questions about law enforcement and diplomatic efforts to stem the tide of fentanyl flowing from China, and whether they are sufficient. We will also be asking which vectors drug traffickers use to ship this drug into our country, such as through express consignment carriers and international mail.
Today’s hearing is another important step in exploring what must be done to address the opioid epidemic. For the record, I want to work closely with my colleagues on the other side to help address the supply side of the fentanyl crisis.
That said, Mr. Chairman, I also want to find a way to address the treatment side of this epidemic, and that is where I have significant differences with my Majority colleagues.
Passage of the Affordable Care Act (ACA), as you know, has led to nearly 20 million Americans gaining health care coverage. In addition, the ACA has enabled governors to expand the Medicaid services they offer, which was crucial in states overwhelmed by the opioid epidemic.
Studies estimate that since 2014,1.6 million uninsured Americans gained access to substance abuse treatment across the 31 states that expanded Medicaid coverage. This is particularly important for hard-hit states like Kentucky, where one study reports that residents saw a 700 percent increase in Medicaid beneficiaries seeking treatment for substance use.
Two weeks ago, the Majority rushed through this committee a bill to repeal the ACA that many believe will threaten the progress Medicaid expansion has made in getting people suffering from addiction into treatment.
In its assessment of that bill last week, the non-partisan Congressional Budget Office said it will cause millions of Americans to lose health care coverage. Many will be those currently receiving Medicaid assistance, which include those receiving treatment for opioid addiction.
In January, health care experts from Harvard and New York University wrote an op-ed for the Hill about how repealing the ACA would reverse important public health gains. They focused primarily on the 21st Century Cures Act that this committee approved unanimously, and that passed the House and Senate with overwhelming bipartisan support. And Mr. Chairman, we could have a whole hearing just on how badly the GOP’s bill will hamper the progress enabled by Cures. But let me draw your attention to one part of that op-ed, where they wrote:
Repealing the ACA — and its behavioral health provisions — would have stark effects on those with behavioral health illnesses. We estimate that approximately 1,253,000 people with serious mental disorders and about 2.8 million Americans with a substance use disorder, of whom about 222,000 have an opioid disorder, would lose some or all of their insurance coverage.
At the end of the day, it is hard to know what kind of bill, if any, will reach the President’s desk.
But if it appears anything close to the measure that our Committee passed on a party-line vote two weeks ago, I believe it will have devastating consequences in our fight to reverse the opioid epidemic.
CBO estimated that bill will cut $890 billion over the next decade from Medicaid. You will never convince me that cutting nearly a trillion dollars from Medicaid will somehow magically result in better drug treatment for those now suffering from addiction.
Today’s hearing examines the fentanyl problem. However, I would argue that the fentanyl problem is a subset of the larger opioid addiction problem challenging the United States.
If we want to address the fentanyl crisis, we must also address the broader opioid addiction crisis and that requires making evidence-based treatment more accessible to those who need help.
As we heard from experts in previous hearings before this Subcommittee, access to evidence-based treatment is not easily accessible to many, including rural residents and the poor.
Mr. Chairman, I want to work with you to combat the menace of fentanyl and the growing opioid addiction problem facing the U.S. But if we are serious about confronting this growing menace, we must examine ways to get Americans into addiction treatment programs.
Thank you, and I yield back.