'Show me the money': Critics question funding of Trump's opioid crisis plan

Many say his plan does not go far enough in providing funding.

ByABC News
October 26, 2017, 6:31 PM

— -- In a speech from the East Room of the White House on Thursday, President Donald Trump declared the opioid crisis a national public health emergency.

However, the fund designed to support such a declaration -- the Public Health Emergency Fund -- currently stands at $57,000, Matt Lloyd, a Health and Human Services spokesperson told ABC News.

Experts say a public health emergency declaration could be effective, but HHS could be limited in their response with only $57,000 ready to be used.

The White House will be working with Congress to add money to the fund, a Trump administration official told reporters during a background briefing on Thursday.

Under today's order, the president will direct acting HHS Secretary Eric Hargan to declare a public health emergency under the Public Health Services Act. This action will allow federal agencies to redirect existing resources as they see fit to combat the epidemic.

Since fiscal year 2015, the government has appropriated $2.45 billion towards combating opioid abuse to various government agencies including HHS, Veterans Affairs and the Department of Justice, according to a Senate Appropriations official.

Two senior House and Senate Appropriations officials told ABC News that the White House has not yet requested additional funding to combat the epidemic.

Richard Frank, a Harvard University health economics professor told McClatchy News that the price of necessary services to combat the growing opioid problem is roughly $190 billion over 10 years.

A crisis decades in the making

The president touted the epidemic as the worst drug crisis in American history, a problem that some experts say dates back to the Vietnam War when some soldiers turned to opioids to manage their pain and returned home to the states addicted.

The amount of prescription opioids legally sold nearly quadrupled from 1999 to 2010, despite no change in the amount of pain that Americans reported, according to the Centers of Disease Control and Prevention. Today, drug overdose is the leading cause of accidental death in the United States -- the majority of those lethal episodes involve an opioid.

According to the CDC, 91 Americans die every day from an opioid overdose.

A White House commission led by Gov. Chris Christie, previously recommended the president declare a national emergency via the Stafford Act or the Public Health Service Act. The commission's final report comes out next week.

The president's plan

Trump chose to employ the Public Health Service Act; not the Stafford Act that many interpreted he would use after several promises to declare a "national emergency." The Stafford Act is typically used for major natural disasters or terrorism events and gives the president broad power and opens FEMA's Disaster Relief Fund.

Drug policy experts have told ABC News utilizing money from FEMA's Disaster Relief Fund could jeopardize the country's ability to recover from natural disasters.

A senior administration official echoed the sentiment, saying the Stafford Act is not the right fit for this emergency because FEMA money is meant for natural disasters, not a health crisis.

The public health emergency declaration gives HHS and other federal agencies the freedom to lift red tape and deploy resources to areas where assets were previously limited limited.

This course of action could yield results, but additional congressional action would be necessary, public policy experts say.

During his address on Thursday, Trump told the audience that HHS would be waiving the restriction under Medicaid limiting reimbursement for opioid treatments to larger medical facilities dedicated to mental diseases.

Trump's crackdown

The president also said law enforcement and national security agencies will be strengthening their efforts to prevent the importation of fentanyl, a lethal synthetic opioid.

Trump promised to go after drug companies distributing to over prescribing medical facilities "very soon."

"We will be bringing some very major lawsuits against people and against companies that have been hurting our communities," he said.

The president's former nominee to head the White House Office of National Drug Control Policy, Rep. Tom Marino, R-Pa., withdrew last week after a report from the Washington Post and CBS News revealed Marino's role in writing a law that made it more difficult for the Drug Enforcement Administration to pursue charges against such companies. Marino's office later defended the bill saying it "facilitate(s) a balanced solution."

Questions about funding

Under the Public Health Service Act, the order from President Trump and HHS must be renewed every 90 days until they believe it is no longer necessary.

While the public health emergency declaration allows federal agencies, most notably HHS, to lift restrictions allowing easier access to treatment and redirecting of resources to prevent the flow of illegal opioids, there is no federal funding in the order.

Congress created the fund in 1983 and designed it to be replenished to up to $30 million on an annual basis. The last time congress reauthorized the fund was in 1990 when the balance was raised to $45 million, but refunding has since ceased.

One official warned that the law surrounding the fund is dated and does not reflect the way in which agencies currently respond to an emergency. Administrations since 1993 have not requested additional funding for the reserve, the source told ABC News.

President Trump's latest budget proposal includes such an emergency fund, but does not provide a dollar amount. If the budget passes in its current form, HHS would lose more than $4 billion in funding.

House Minority Leader Nancy Pelosi questioned the value of President Trump's opioid declaration today, calling on the White House to push for more funding to combat the epidemic.

"What I would say to the president on that is, "Show me the money,'" she said. "What is the point?"

Democratic Sen. Bob Casey tweeted, "While I commend the Administration for taking this step, the federal government must do more than issue declarations."

In a statement to reporters on Thursday, the Baltimore City Health Department said it supports the president's declaration but questioned "why there is no specific funding committed?"

"We await next steps following this declaration."