Mental health and addiction crisis

How Pete Buttigieg would tackle the mental health and addiction crisis

By BRIANNA EHLEY

Democratic presidential candidate Pete Buttigieg on Friday unveiled a plan to bolster mental health and addiction services his campaign estimates would cost about $300 billion to coincide with a campaign stop in Manchester, New Hampshire — a state hit hard by the opioid crisis.

The wide-ranging plan, which includes $100 billion in grants, calls for integrating treatment into primary care settings, increasing the number of available treatment beds, making it easier for patients to get access to medication for opioid addiction, investing in suicide prevention for veterans and addressing disparities in behavioral health care.

“For years, politicians in Washington have claimed to prioritize mental health care while slashing funding for treatment and ignoring America’s growing addiction and mental health crisis,” Buttigieg, the mayor of South Bend, Ind., said in a statement. “That neglect must end. Our plan breaks down the barriers around mental health and builds up a sense of belonging that will help millions of suffering Americans heal.”

Buttigieg says his plan will ensure at least 75 percent of people who need treatment receive care. About 11 percent of the 21.7 million people who needed substance use treatment over the course of a year receive it, according to federal figures from 2015.

What would the plan do?

Beyond adding resources, the plan attempts to address the public health effects of isolation and loneliness.

The plan would beef up the behavioral health workforce by increasing reimbursement rates and making health workers' loan repayment programs more generous, specifically for those in rural, underserved areas. It also aims to increase access to opioid addiction treatment and inpatient care at psychiatric facilities.

Buttigieg would invest more in veteran suicide programs and create a three-digit suicide hotline. His plan also calls for more mental health workers in schools and increased investments in early intervention programs.

How would it work?

The plan would provide $100 billion in grants over 10 years to communities for prevention and care integration. It proposes expanding access to inpatient treatment by repealing a decades-old Medicaid law that prohibits reimbursements for patients in residential treatment facilities with more than 16 beds. The Obama and Trump administration have taken steps to allow states to work around the restriction. Buttigieg’s plan would completely repeal it.

The plan would deregulate buprenorphine, one of three FDA-approved medication-assisted treatments for opioid addiction, to increase access to that drug. Prescribers, under federal law, can only prescribe the medication to a limited number of patients. Buttigieg’s plan requires all private insurers and Medicare and Medicaid to cover all three forms of medication-assisted treatment. It also prioritizes research to develop treatments for other drug addictions, like methamphetamine. It would also create national standards for addiction care.

What are the weaknesses in the proposal?

It’s unclear how Buttigieg plans to pay for the plan, which not only provides $100 billion in grants, but includes many proposals like increasing provider reimbursement rates and repealing a Medicaid law, that would come with a hefty price tag. Fiscal conservatives have balked at similar proposals.

It’s also unclear how Buttigieg plans to further enforce federal parity laws and require private insurance plans to cover all three forms of medication assisted treatment.

What have other Democrats proposed?

Sens. Elizabeth Warren and Amy Klobuchar have both proposed $100 billion plans to combat addiction and address mental health issues.