Poloncarz challenging Senate report’s claim that Medicaid fuels opioid epidemic

Feb 26, 2018

Erie County Executive Mark Poloncarz is challenging a report from the U.S. Senate which claims the Medicaid system is fueling the nation’s opioid epidemic.

Credit WNED|WBFO

A January report titled, “Drugs for Dollars: How Medicaid Helps Fuel the Opioid Epidemic,” claims the nation’s Medicaid system has contributed to the epidemic by establishing incentives which make the abuse and sale of prescription opioids profitable. The report, published by the Senate Committee on Homeland Security and Governmental Affairs also claims that the 2014 expansion of Medicaid under the Affordable Care Act correlates with a rise in cases of opioid-related fraud.

WBFO reached out to the report’s author, Wisconsin Senator and Chairman of the Committee on Homeland Security and Governmental Affairs, Ron Johnson, for comment. His office replied with a copy of Johnson’s opening statements to the committee’s January 17 hearing on the consequences of Medicaid in the opioid epidemic. In it, Johnson cited political economist Nicholas Eberstadt, who concluded the reason that millions of unemployed men could afford a constant supply of pain medication was the Medicaid system.

At Johnson’s request, his staff identified a total of 1,072 cases of improper use of Medicaid to obtain and, in some cases, illegally sell opioids since 2010. As Johnson described, the report “presents evidence that federal spending on health care is being used as a funding source that helps to fuel the opioid epidemic.”

Erie County Executive Mark Polonarz disagrees, and is refuting the report in a letter to Johnson. Poloncarz admits fraud in the Medicaid system exists, but said a few cases don’t reflect the actual impact of Medicaid expansion.

“You actually have to look at the number of prescriptions that have been issued and the individuals that have increased coverage as a result of the Affordable Care Act,” said Poloncarz.

Poloncarz cited national data from the Centers for Disease Control and Prevention showing opioid prescribing rates in the U.S. increased from 2006 to 2010, prior to Medicaid’s expansion, remained constant for two years, and then decreased through 2015.

“So for the Senate to issue a report that the expansion of Medicaid is driving the opioid epidemic – there’s no basis in fact,” said Poloncarz.

Poloncarz is also using data from Erie County in his challenge to the report.

While the number of individuals enrolled in the Medicaid program between 2012 and 2017 in the county was generally on the rise, the number of prescriptions filled for Hydrocodone Acetaminophen – the number one most prescribed opioid for Medicaid recipients nationwide – was generally declining. By 2017, it dropped to number five.

Selected Erie County Medicaid Data for the period of January 1, 2014-December 31, 2017.
Credit Erie County Office of the Medicaid Inspector General

“There was 20,000 less prescriptions filled, even though there were 60,000 more people enrolled into Medicaid,” explained Poloncarz. “So if the majority’s report from the U.S. Senate committee was accurate, you would have seen an explosion in the number of prescriptions because there were more people, technically, available to have prescribed to. You didn’t see that.”

Poloncarz has not yet heard back from Johnson, but has reached out to Missouri Senator Claire McCaskill, ranking member of the Committee on Homeland Security and Governmental Affairs. He will also be sharing his letter and findings with New York Senators Charles Schumer and Kirsten Gillibrand.

Poloncarz said he wants to make sure the public knows the report is not an accurate representation of nationwide trends.

Johnson, in his statement, admits that there is more than one driver behind the opioid epidemic. He also said Medicaid is not alone in creating incentives for abuse and exploitation, pointing to Medicare, Veterans Affairs benefits, and food stamps as other involved programs.

The full report can be found here.

Follow WBFO's Avery Schneider on Twitter @SAvery131.