Few would have predicted at this time last year that a policy like the Comprehensive Addiction and Recovery Act of 2015 (CARA) (S. 524/ H.R. 953) would pass the Senate in a near unanimous vote. Behavioral health leaders are truly pleased by its passage but acknowledge that CARA is only one step to begin addressing addiction in the United States. They generally believe it’s not enough.
The legislation authorizes $600 million for grants—however it does not actually appropriate federal funds. That's an important distinction. Instead, money would come out of the budget bill, which already passed last December. Funds would be used under CARA for treatment and recovery services, alternatives to prison, law enforcement initiatives and programs to prevent overdose deaths and overprescribing.
Efforts to include an amendment for $400 million in upfront emergency funding under CARA were struck down.
CARA moves to the House of Representatives with an identical bill that has 92 co-sponsors, where it will potentially face a more difficult journey because the House tends to be more fiscally conservative.
“Senator [Sheldon] Whitehouse [D-R.I.] and I believe we’ll get a strong vote in the House as well, and we can get it to the president’s desk for signature and begin to reverse this trend,” said Sen. Rob Portman (R-Ohio) on the Senate floor in advance of the bill passing. “The bill went through what is a unique process around here, which is bipartisan, or nonpartisan, from the start and a process of bringing in experts from all around the country, rather than us saying we know all the answers.”
Portman and Whitehouse introduced CARA in the Senate Feb. 12, 2015.
And the president will sign it?
Highly likely. The White House is angling to make its mark on addiction. Just last month, the administration asked for $1 billion in new mandatory funding to tackle the opioid crisis in the fiscal year 2017 budget, including $920 million to help states increase the use of medication assisted treatment (MAT). Currently 22 states receive MAT funding, and the new proposal would increase the number to 45.
Additionally, leaders are currently reviewing a number of reports that the president previously requested from federal agencies late last year—reports that specifically address barriers to MAT and what should be done about them.
Who was the dissenting vote?
“Republicans Lindsey Graham and Tim Scott [of South Carolina] were among the 94 members who voted in favor of the bill,” Ron Manderscheid, PhD, executive director of the National Association of County Behavioral Health and Developmental Disability Directors tells me. “Only one senator, Republican Ben Sasse of Nebraska, voted no.”
According to The Hill, Sasse said he doesn’t believe it’s the federal government’s role to fight addiction.
What does the industry say?