I notice several bills introduced this session in Alabama have to do with drugs. This one, SB 26, probably has less to do with drugs and more with money—but it will fail to solve either our drug problem or our budget crisis.
This wrong-headed bill, which seems to be modeled on one that didn’t pass in Kentucky, would require any adult applying for state-subsidized health care benefits to first pass a drug test. Current recipients would have to pass a test yearly to keep their benefits. Whoever fails the drug test gets kicked off Medicaid and has to wait a full year to try again. I guess they are hoping that this will cut down Medicaid expenses in 2014, when we start adding more adults.
The only exceptions are people who are in nursing homes (that’s right, Grandma and Grandpa can keep sneaking out back to get high) or other institutional facilities. No exception for two extremely important groups—pregnant women and those disabled by serious mental illness who live in the community.
In Alabama, a woman who is poor and who becomes pregnant can qualify for Medicaid to get prenatal care through a program called Best Start. She will be covered throughout pregnancy, and then the newborn will be covered. This really makes a huge difference! Just a couple of days ago, I heard a visiting neonatologist lecture about why Alabama babies die at higher than the national average. It turns out that the newborn of a mother with no insurance is TWO TIMES as likely to die, usually related to prematurity or other birth conditions, as the newborn of a mother with Medicaid.
If this bill passes, mothers who are using drugs will not be able to get medical care during pregnancy, and the babies will be twice as likely to die.
I guess this doesn’t matter, since most of them will at least get out of the uterus. For some reason, personhood after being born doesn’t seem to be as important in this legislative session. (Yes, I’m working on that bill—it turns out there are 300 references to a “person” in the Alabama Code that would be affected). But even if you believe only that first breath counts, I don’t know how on earth this will save money. For every baby that dies and doesn’t need public funds, several more will survive with expensive, life-long disability.
Persons with serious mental illness and addicted to drugs (called “dual diagnosis”) will no longer be able to get medication and therapy. They will have to be psychotic for a full year before they can try and fail again. Maybe they can be committed to a long-term facility, so they can get treated. When they are better, they can be discharged home and will still have to wait a year to re-apply for care. During that time, how many will quickly relapse and have to be committed again? Or wind up in prison, where many of our state’s mentally ill persons live? How much money will that cost? And how many people will suffer permanent damage to their brains? The longer psychosis goes untreated, the less likely a person is to get better.
Guess who will be able to pass the screens and get Medicaid? The casual, “recreational” drug users, who are not addicted. That’s right, the ones who are breaking the law just because they want to. They can wait however many days it takes for the drug to clear their systems, and then use again until their next scheduled test month. They’ll be able to continue getting public money—only those with true addictions (a medical condition) will not be able to get help.
I am told it isn’t getting that much traction yet. One reason might be that similar legislation in other states is under legal challenge as form of unconstitutional search and seizure. You might take a moment and notify your legislators to vote against it, just in case.