H.R. 6, the SUPPORT for Patients and Communities Act
H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, is a bipartisan bill that will help in our overall efforts to combat the opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting our communities, and bolstering our efforts to fight deadly illicit synthetic drugs like fentanyl.
On June 22, 2018, the House passed H.R. 6 by a vote of 396 to 14 . On September 17, the Senate passed an amended version of H.R. 6 by a vote of 99-1. On September 28, the House passed a final bipartisan, bicameral agreement on H.R. 6 by a vote of 393 to 8. On October 3, the Senate passed the final version of H.R. 6 by a vote of 98-1. The final bill was signed into law by President Trump on October 24, 2018.
Originally introduced by Energy and Commerce Committee Chairman Greg Walden (R-OR), Ways and Means Committee Chairman Kevin Brady (R-TX), Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ), and Ways and Means Committee Ranking Member Richard Neal (D-MA), the underlying text of H.R. 6 included several Medicaid, Medicare, and public health reforms to help combat the opioid crisis, which were advanced through regular order by the House Energy and Commerce and Ways and Means Committees. In addition, H.R. 6 included numerous provisions that were previously passed by the House of Representatives.
- Summary of Provisions (House Passed)
- Letter of Support from 161 Patient Advocacy Groups (House Passed)
- Section-by-Section Summary (as introduced in House)
H.R. 6082, the Overdose Prevention and Patient Safety Act
This bipartisan bill, sponsored by Reps. Markwayne Mullin (R-OK) and Earl Blumenauer (D-OR), and cosponsored by Chairman Greg Walden (R-OR), expands the circumstances under which medical records relating to substance use disorders can be disclosed to healthcare providers, plans, and health care clearing houses, thereby enabling medical professionals to access that information when treating patients. Such disclosures must be made in accordance with the Health Insurance Portability and Accountability Act’s (HIPAA) privacy regulations and the bill prohibits any entity from discriminating against an individual on the basis of information contained in substance abuse medical records. This bill simply uses the same model that other federal privacy laws have, which is that exchanging health care information within the health care system produces better outcomes for that patient. On June 20, 2018, the House passed H.R. 6082 by a vote of 357 to 57.
A Collaborative, Bipartisan Process
This latest effort to combat the opioid crisis follows the passage of the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act last Congress, the $4 billion appropriated in 2018 the omnibus earlier this year to help combat the opioid crisis, as well as the $6.7 billion included in the recent Defense-Labor-HHS appropriations package to boost programs that fight, treat, and stop substance abuse, and support access to mental health services. Taken together, this is the most significant congressional effort against a single drug crisis in history.
Our legislative process kicked off in October 2017, when more than 50 bipartisan members from both on and off the committee testified to share personal and local stories, statistics, and potential solutions to combat the opioid crisis. The committee then pursued an aggressive timeline to produce a legislative package prior to Memorial Day. Following three legislative hearings, an additional legislative hearing focused solely on an outdated law that impedes patient care and safety, a subcommittee markup and two full committee markups, Energy and Commerce advanced numerous bipartisan bills to the House Floor, which ultimately were included in H.R. 6.
February 28, 2018: “Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety.”
- Hearing Recap: “#SubHealth Reviews Legislation to Improve Patient Safety and Bolster Enforcement Tools in Midst of Opioid Crisis.”
March 21 & 22, 2018: “Combating the Opioid Crisis: Prevention and Public Health Solutions.”
- Hearing Recap: “#SubHealth Reviews Additional Prevention and Public Health Solutions to Combat the Opioid Crisis.”
- Hearing Recap: “#SubHealth Reviews Medicare and Medicaid Solutions to Help Combat the Opioid Crisis.”
- Hearing Recap: “#SubHealth Reviews Outdated Law that Impedes Patient Care and Safety.”
April 25, 2018: #SubHealth Markup of Opioids Legislation
- Markup Recap: “#SubHealth Votes to Advance 57 Bills to Combat the Opioid Crisis, Reauthorization of ADUFA and AGDUFA.”
- Markup Recap: “#FullCmte Advances 25 Bills to Combat the Opioid Crisis, Other Committee Priorities.”
- This was the first of two scheduled full committee markups on legislation to combat the opioid crisis.
- Markup Recap: “E&C Advances 57 Total Bills to Combat the Opioid Crisis, Clearing Path to House Floor.”
- This was the second of two scheduled full committee markups on legislation to combat the opioid crisis.
Energy and Commerce’s Full Committee Markups By the Numbers:
- 57 bills advanced to the House of Representatives
- 56 advanced with bipartisan votes out of committee
- 53 passed by voice votes out of committee
- 4 passed by roll call votes out of committee
Last Congress, E&C led two major initiatives being signed into law that provide critical resources for combating the crisis: The Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act
- CARA included 11 committee bills which ranged from additional resources to combat the epidemic to establishing an inter-agency task force to review, modify, and update best practices for pain management and how it is prescribed. In September 2017, HHS released $144.1 million, largely through CARA to help prevent and treat opioid addiction.
- The 21st Century Cures Act – Provides $1 billion in state grants to be applied to the fight on the front lines. The first half of these grants were issued in April 2017 and totaled $485 million. The second half were issued in April 2018, and also totaled $485 million.
Earlier this Congress, the 2018 Consolidated Appropriations Act (Omnibus) provided $4 billion to help address prevention, treatment, and enforcement issues – including $130 million for the Rural Communities Opioid Response program, striving to reach rural communities that have been hit especially hard by the opioid crisis and $1 billion in new grants to be dispatched to the states and Indian tribes. Additionally, $6.7 billion was included in the recent Defense-Labor-HHS appropriations package to boost programs that fight, treat, and stop substance abuse, and support access to mental health services.
October 2017 Full Committee Hearing Reviewing Previous Legislation and Federal Response to the Opioid Crisis
“The primary purpose of this hearing is to hear from the federal agencies charged with implementing the provisions of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act,” said Chairman Walden during his opening remarks. “But it also allows this committee to have an important conversation with the Drug Enforcement Administration (DEA).”
During the full committee hearing on federal efforts to combat the opioid crisis, Chairman Walden grilled the DEA on their lack of cooperation or responsiveness to the committee’s ongoing investigation.
Chairman Walden detailed the committee’s ongoing bipartisan investigation into alleged pill dumping in the state of West Virginia, adding, “It is time for DEA to get this committee the information we need, and to do it quickly. No more dodges. No more delays.”