The November 2016 U.S. elections resulted in a Republican sweep of the Presidency and both chambers of Congress. Republicans’ first major policy priority has been to “repeal and replace” the Obama Administration’s effort to reform healthcare, the Patient Protection and Affordable Care Act (ACA), signed into law in 2010. To date, a key component of proposed legislation from both the House and Senate has been severe cuts to Medicaid, which currently provides the lion’s share of health insurance for low-income Americans.

These legislative proposals have been introduced at a time when the U.S. is experiencing an epidemic of opioid addiction and overdose. In 2015, there were more than 2.6 million Americans with opioid use disorder (OUD) [1]. During the same year, more than 33,000 died of overdoses involving one or more opioids, corresponding to an age-adjusted opioid-related death rate of 10.4 per 100,000 [2]—more than triple the rate in 2000 [3]. The U.S. now accounts for about a quarter of the world’s drug-related deaths [4].

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