Bill Overview
Title: MORE Savings Act
Description: This bill modifies coverage of opioid treatments and recovery support services under Medicare, Medicaid, and private health insurance. Specifically, the bill requires the Center for Medicare and Medicaid Innovation to test a model in which specified opioid treatments and recovery support services are provided under Medicare without cost-sharing (e.g., coinsurance, copayments, and deductibles). The bill also allows state Medicaid programs to cover recovery support services as part of medication-assisted treatment (MAT) and increases the applicable Federal Medical Assistance Percentage for MAT. Private health insurers must also cover specified opioid treatments and MAT-associated recovery support services without cost-sharing.
Sponsors: Sen. Casey, Robert P., Jr. [D-PA]
Target Audience
Population: People needing opioid treatments and recovery support
Estimated Size: 40000000
- The bill focuses on modifying the coverage of opioid treatments and recovery support services under major healthcare programs.
- This includes Medicare, Medicaid, and private health insurance, indicating a wide demographic.
- Medicaid represents low-income individuals and families, who are significant consumers of opioid-related healthcare services.
- Medicare generally covers older adults aged 65 and above, as well as some younger people with disabilities, impacting those populations.
- Private health insurance covers a large section of working-age adults and their families, extending the bill's impact.
Reasoning
- A diverse range of people are affected by the policy, given it addresses Medicare, Medicaid, and private insurance, which span across different income levels and age groups.
- The policy aims to reduce cost barriers for opioid treatment, which can significantly impact personal finances and health outcomes, especially for low-income individuals.
- Not everyone affected by opioid use disorder (OUD) is a direct user; families and caregivers are also impacted by the financial and emotional strains of treatment costs.
- Considering budget limitations, effects might vary among individuals in terms of substantial life changes. Thus, capturing a spectrum of low, medium, and high impact scenarios is necessary.
- Non-impacted individuals are also included to understand who falls outside the policy’s effective reach and why.
- It is critical to simulate different stages of wellbeing progression over various time frames to project long-term effects against immediate relief.
Simulated Interviews
Construction worker (Ohio)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Without this policy, I struggle with out-of-pocket costs for treatments.
- No-cost for my recovery would relieve a huge burden.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 9 | 4 |
| Year 10 | 9 | 3 |
| Year 20 | 8 | 2 |
Graphic Designer (California)
Age: 32 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- The policy would help with my brother's treatment costs, lifting a financial burden off my shoulders.
- I feel hopeful about the support the policy offers.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Retired school teacher (Florida)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 6/20
Statement of Opinion:
- Eliminating cost-sharing helps me manage my chronic pain better without worrying about additional expenses.
- It's a relief to know this burden is eased during my retirement.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
Unemployed (Kentucky)
Age: 29 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- Free recovery support is essential for me, it would remove a lot of stress.
- I can focus more on my recovery and less on costs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 3 |
| Year 3 | 8 | 3 |
| Year 5 | 8 | 2 |
| Year 10 | 9 | 2 |
| Year 20 | 8 | 1 |
Nurse (New York)
Age: 50 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 1.0 years
Commonness: 15/20
Statement of Opinion:
- I feel the policy might not impact me directly, but it's a good safety net.
- Anything helps in case situations change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
College Student (Texas)
Age: 22 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- I see this mostly affecting some of my friends directly, as they struggle with access to proper treatment.
- It's a comfort knowing they have better support options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Retired administrator (Michigan)
Age: 60 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Removing these costs will definitely help in managing my finances better.
- It should ease some of the strain I feel month-to-month.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
Truck driver (Tennessee)
Age: 40 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 12/20
Statement of Opinion:
- No immediate impact expected since I rarely rely on opioids.
- Could be beneficial if I need more treatment in the future.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Homemaker (Arizona)
Age: 55 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 8.0 years
Commonness: 6/20
Statement of Opinion:
- Having treatment costs covered would lift a major emotional and financial load on our family.
- We'd likely see improvement in our overall wellbeing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 3 |
| Year 20 | 7 | 3 |
Small business owner (Vermont)
Age: 47 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 9/20
Statement of Opinion:
- It's comforting to know this policy exists as a support system.
- It strengthens my social circle's ability to assist one another.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
Cost Estimates
Year 1: $3500000000 (Low: $3000000000, High: $4000000000)
Year 2: $3600000000 (Low: $3000000000, High: $4200000000)
Year 3: $3700000000 (Low: $3100000000, High: $4300000000)
Year 5: $3900000000 (Low: $3200000000, High: $4500000000)
Year 10: $4100000000 (Low: $3500000000, High: $4800000000)
Year 100: $7000000000 (Low: $5000000000, High: $9000000000)
Key Considerations
- Will insurers increase premiums due to higher costs from mandatory coverage?
- The long-term effectiveness of opioid recovery support services in reducing healthcare costs.
- Variability in state implementation of increased FMAP might affect financial outcomes differently across states.
- Potential public health improvement reducing overall economic expenses related to opioid addiction.