Pettersen bill would improve Medicaid coverage for substance use disorder treatment

U.S. Rep. Brittany Pettersen announced a bill that would improve Medicaid coverage for substance use disorder treatment to celebrate her mother’s sobriety anniversary on Sept. 5, 2024, at the Sobriety House in Denver. (Courtesy of U.S. Rep. Brittany Pettersen’s office)

U.S. Rep. Brittany Pettersen this week introduced a bill that would improve Medicaid coverage for recipients being treated for substance use disorders. 

The Recovery Act would allow states to include substance use disorder treatment in their Medicaid coverage plans and remove a cap on the number of days someone’s treatment can be covered. Currently, states have to apply for a waiver through Medicaid to cover in-patient substance use disorder treatments.

Pettersen, a Lakewood Democrat, announced the bill at a press conference Thursday alongside her mother, who celebrated her 7-year sobriety anniversary. The event was held at the Sobriety House in Denver, where Pettersen’s mother was treated for her substance use disorder.

“My mom wouldn’t be alive today without finally getting the medical care she needed,” Pettersen said in a statement. “My mom is an example of what’s possible when people struggling with substance use disorder have access to the resources and support they need, but I know she was one of the lucky ones. Far too many people are left without care because of the stigma associated with addiction and the lack of funding and priorities at every level of government.”

The bill aims to incentivize the adoption of expanded treatment plans by increasing federal matching funds for states who opt into Medicaid coverage for substance use disorders for the first five years of the program’s existence.

Crystal Ahles, executive director of Sobriety House, said expanding Medicaid to cover substance use disorder treatment will “significantly increase our ability as providers to serve more clients.”

“Without this coverage, state and federal funding is limited, and access to care is difficult for those needing help,” Ahles said in a press release. “The change in legislation will allow for expanded access, which is imperative.”

Colorado’s Medicaid program, Health First Colorado, covers nearly 1.2 million people, including about one out of every seven Colorado adults aged 19 to 64.

Currently, Medicaid only covers three days of detox and generally does not cover in-patient or residential care, as Pettersen discovered while trying to get her mother into treatment. While serving in the Colorado General Assembly in 2018, Pettersen sponsored the bipartisan House Bill 18-1136, which directed the state’s Medicaid program to apply for a federal waiver to cover certain treatments for substance use disorders.

The Department of Health and Human Services approved Colorado’s waiver for a five-year demonstration period beginning in 2021. In one year under the waiver, more than 12,000 Colorado Medicaid recipients received residential substance use disorder care, according to Pettersen’s office.

“While Colorado has made great strides, there are still significant barriers that exist at the federal level to provide the necessary continuum of care,” Pettersen’s office said in a press release.

“We must reduce the stigma around opioid addiction and those in recovery,” Colorado Attorney General Phil Weiser, a Democrat, said in a statement in support of the Recovery Act. “More support for treatment is needed because too many people lack access to treatment or have inadequate treatment. This crisis continues to take and harm lives, and we must do more.”

Last year, Pettersen introduced a bill that would reimburse hospitals for distributing opioid overdose-reversal treatments to people at risk for an overdose.