H.R. 6

H.R. 6 was a major legislative package enacted by the 115th United States Congress to address the Opioid epidemic in the United States. Formally titled the SUPPORT for Patients and Communities Act, it was signed into law by President Donald Trump in October 2018. The comprehensive bill aimed to advance treatment, recovery, and prevention initiatives while reforming aspects of Medicaid and Medicare related to substance use disorders. Its passage represented a significant bipartisan effort to combat a public health crisis affecting communities across the United States.

Legislative history

The legislation was introduced in the United States House of Representatives by Representative Greg Walden of Oregon, who chaired the House Energy and Commerce Committee. The bill consolidated numerous proposals from multiple House committees, including the Judiciary Committee and the Ways and Means Committee. Following a swift markup process, it passed the House of Representatives with overwhelming bipartisan support in June 2018. The United States Senate then amended and passed its own version in September 2018, with the final reconciled bill clearing both chambers before being sent to the White House.

Provisions

The act contained a wide array of provisions targeting various facets of the opioid crisis. Key measures included expanding access to Medicaid coverage for substance use disorder treatment in certain facilities and allowing Medicare to cover opioid treatment programs. It aimed to strengthen the Food and Drug Administration's authority over packaging and disposal of controlled substances and promoted the development of non-addictive painkillers. Other sections focused on improving prescription drug monitoring programs, supporting law enforcement efforts like the Drug Enforcement Administration's work, and enhancing services for infants born with neonatal abstinence syndrome and their families.

Support and opposition

The bill garnered broad support from both political parties, as well as from major healthcare and advocacy organizations like the American Medical Association and American Hospital Association. The Trump administration, including the Department of Health and Human Services under Secretary Alex Azar, strongly endorsed the legislative effort. Some opposition arose from certain fiscal conservatives concerned about the cost and scope of new federal programs. A limited number of progressive lawmakers argued the bill did not go far enough in funding treatment or addressing the role of major pharmaceutical companies in the epidemic, but these critiques did not prevent near-unanimous final passage.

Legislative action and status

After passing the House of Representatives in June 2018, the legislation moved to the United States Senate, where it was combined with elements from other proposals. The Senate passed an amended version with only a single dissenting vote from Senator Mike Lee of Utah. A conference committee was not required, as the House agreed to the Senate's amendments. The final enrolled bill was presented to President Donald Trump, who signed it into law at a ceremony in the Oval Office on October 24, 2018, making it Public Law 115-271.

Impact and analysis

The SUPPORT Act has been cited as a landmark in federal policy response to the opioid crisis, authorizing and appropriating billions of dollars over several years for state grants, research, and public health programs. Analysts from institutions like the Congressional Budget Office and the Bipartisan Policy Center have studied its effects on treatment capacity and overdose rates. While the law significantly increased resources for agencies like the Substance Abuse and Mental Health Services Administration, subsequent reports from the Government Accountability Office and public health experts have noted ongoing challenges in implementation and the evolving nature of the epidemic, particularly with the rise of Fentanyl and other synthetic opioids.