The NCSL Blog


By Haley Nicholson

Earlier this month, the U.S. Congress passed HR 6—the SUPPORT for Patients and Communities Act, also known as the Opioid Crisis Response Act.

A protest last month outside the headquarters of Purdue Pharma, maker of Oxycontin, included Christine Gagnon, whose son, Michael, died of an overdose. CreditJessica Hill/Associated PressThe core of the bill deals with the increasing public health costs and lives lost to opioid misuse disorder. In a show of bipartisanship, both chambers passed the legislation, and sent it to the president for his signature.  

This bill provides flexibility to several Medicare and Medicaid programs by:

  • Increasing awareness in pain medication addiction among seniors.
  • Providing expanded mental health support for those recovering from opioid misuse as well as to their families.
  • Expanding resources for opioid and substance use disorders to use more integrated treatment models.  

The House and Senate debated on key issues including lifting an older restriction on Medicaid reimbursements for patients staying in mental disease institutions with more than 16 beds. The House language that would lift this restriction and allow those with an opioid or cocaine use disorder to stay for up to 30 days in a year at these types of facilities was approved in the final bill, with the ban lifted for five years at a cost of $1 billion.

Another contentious issue was privacy protections for individuals with substance use disorders. Also known as “the 42 CFR rule,” it provides protections to patients with substance use disorders, allowing them to choose if they want to release their substance use information on their health records. The House language would have made that information easier to share but was ultimately struck from the final bill.  

The bill also expands several provisions in government-run and private health programs to include:  

  • An expansion of the Children’s Health Insurance Program eligibility for incarcerated youth and Medicaid eligibility for foster youth.
  • A requirement that the Health and Human Services Department conduct investigations to determine if there are practices and payment incentives to prescribe opioids and provide suggestions on how to change those practices if they exist.
  • Expanded treatment and recovery options outside of Medicare and Medicaid to include medication-assisted treatment (MAT) and greater use of community “wrap-around” services, including peer support and family-focused services.
  • A provision to permanently allow nurse practitioners and physician assistants to prescribe buprenorphine, a medication commonly used in MAT, and initiate a five-year trial period in which other non-physicians could become qualified prescribers.
  • An authorization of almost $8 billion in grants to states for residential treatment programs for pregnant women with substance use disorders and to support tracking and treating hepatitis C infections.

This legislation was a bipartisan effort to address America’s growing issues with the prevention, treatment and law enforcement policies associated with opioids and substance use disorder. The bill provides welcome resources to states and their communities and provides states the flexibility to address the unique concerns of their communities as they deal with this public health crisis.  

Read a summary of the entire bill from the House Energy and Commerce Committee.

Haley Nicholson is a policy director, health, in NCSL's State-Federal Program based in Washington, D.C.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.