IT WAS AN uncharacteristically quiet afternoon at Dee’s Place, a warehouse turned community center tucked down an alleyway in blighted east Baltimore, but Deborah Agus was nervous. Perched on one of the metal folding chairs that lined part of the warehouse, she alternated between cautious optimism and anxiety about the future of the opioid treatment programs she runs.
The root of her fears lies about an hour away, in Washington, D.C., where Republicans are pushing a new plan to repeal Obamacare and fundamentally restructure Medicaid, the 50-year-old government health program that covers America’s poor and disabled. Obamacare not only made people in Agus’s program—mostly poor working men—eligible for Medicaid but also helped them access the health care services they need to deal with addiction, as well as the panoply of health issues that often accompany it. “For our program, getting people on Medicaid is key,” says Agus, adding that the Republicans’ plan to dramatically shrink federal Medicaid funding would be “devastating.” She was hopeful, however, that it wouldn’t pass.
Indeed, the failure of the GOP health care overhaul in March offered a temporary reprieve to thousands of people working to stave of the opioid crisis. But as President Donald Trump and House Republicans signaled in April, they’re still looking to revive their repeal. And the provisions they’re pushing as part of their latest compromise could lead to deeper cuts in addiction treatment programs, a blow to states at the epicenter of the crisis, including Trump strongholds such as West Virginia and Kentucky.