A bipartisan bill was introduced in the US Congress in 2019 to help fund additional residency positions in hospitals and health systems in an effort to help stem the opioid crisis that the country has been facing.
H.R. 3414, the Opioid Workforce Act of 2019, was introduced in the House on June 21, 2019, by Rep. Bradley Schneider (D-Illinois) and 65 co-sponsors (54 D and 11 R). Assigned to the House Energy and Commerce Subcommittee on Health and the House Ways and Means Committee, the bill increases the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have addiction or pain medicine programs, with an aggregate increase of 1,000 positions over a 5-year period starting 2022. The first 500 positions would be available in fiscal year 2022 and the remaining 500 over fiscal years 2023-2026.
According to the Congressional Budget Office (CBO), H.R. 3414 would increase direct Medicare spending by $1.1 billion over 2020-2029, assuming the bill becomes law and is enacted by the end of 2019. CBO also estimates a budget deficit of over $5 billion over 4 consecutive 10-year periods beginning in 2030.
A related bill, S. 2892, was introduced in the Senate on November 11, 2019, by Sen. Margaret Hassan (D-New Hampshire) with Sen. Susan Collins (R-Maine) as the co-sponsor. The bill now has 7 co-sponsors (3 D and 4 R) and has been referred to the Committee on Finance.
In a letter of support for H.R. 3414, the American Hospital Association said that the shortage of substance use treatment providers has increased waiting periods for treatment and also increased opioid misuse and addiction–related deaths. Funding to increase residency programs in addiction medicine, addiction psychiatry and pain management would be a major step to improving access to substance use disorder (SUD) treatment, the letter asserts.
Thanking Senators Hassan and Collins, David Skorton, MD, president and CEO of the Association of American Medical Colleges said in a statement, “This targeted and necessary approach to addressing the opioid epidemic will help patients access the care they need by increasing the number of physicians specifically trained to care for patients with substance use disorders.”
According to a 2017 White House report, the United States has about 4,400 actively participating certified addiction specialist physicians, way short of the estimated 6,000 needed even before the peak time of the opioid crisis. There also is a recognized shortage of fellowships in addiction medicine: only 66 of the 187 accredited medical schools offered these fellowships as of February 2019. Subsequently, under the 21st Century Cures Act, Congress authorized an annual $10 million in grant money for institutions to train medical resident and fellows in psychiatry and addiction medicine, nurse practitioners, physician assistants and other care providers to deliver SUD treatment in underserved communities.