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Stimulus Not So Stimulating for Treatment

January 30, 2009
by Daniel Guarnera
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The leading news story across the country for over a week has been President Obama's much talked about economic stimulus package. Officially known as the American Recovery and Reinforcement Act (ARRA), the $819 billion stimulus package is intended to boost our economy and increase our workforce. Critics point out that some of the money doesn't seem likely to do that, at least in the short term, and there was a near party-line vote in the House (10 Democrats voted against ARRA, no Republicans voted for it). The Senate will begin debating its version of the bill next week, and whatever version they ultimately pass will have to be reconciled with the House's language. President Obama hopes the package will be signed, sealed, and delivered by February 16 (also known as Presidents Day).

$819 billion is a lot of money (and the Senate bill's price tag is expected to break $900 billion), and many health programs in particular were given an influx of funds. The House bill provides:

   ·        $13 billion to strengthen the health care infrastructure and improve service delivery and availability
·        $20 billion in health information technology grants
·        $39 billion on COBRA short term health insurance options
·        $1.5 billion for community health centers
·        $600 million for the National Health Service Corps, which trains doctors, nurses and dentists to work in underserved communities

Conspicuous by its absence was the lack of funds specifically for addiction (as well as mental health) treatment. In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) is the only division under the United States Public Health Service (which also includes the CDC, NIH, FDA, HRSA, Indian Health Service, and two other agencies) that will not receive immediate funding through the ARRA. The closest that ARRA came to funding addiction treatment was $4 billion to support the Byrne Justice Assisted Grants program, which supports state and local law enforcement efforts (and some of the Byrne JAG money can be used on treatment for people in the criminal justice system). But that's it.

The lack of treatment dollars in the ARRA is a reminder that, as advocates, we still have a long way to go to convince Congress just how central addiction treatment is to Americans' health. There's no question that treatment helps the economy—in 2003, mental illnesses and substance abuse disorders led to $171 billion lost in workplace productivity; this is projected to rise to over $300 billion by the year 2013. This doesn't even begin to account for the savings that would be realized by reduced health care and criminal justice. We must be vigilant and insistent as the Administration and Congress work on the upcoming federal budget to ensure that the increases they missed in the ARRA are included in the upcoming budget proposals.

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Daniel Guarnera

Daniel Guarnera is the Director of Government Relations for NAADAC, The Association for...