This blog is part of our Medicaid Awareness Month series, in which we highlight the ways that Medicaid supports the health of vulnerable populations. Guest bloggers for the series are state advocates who work on behalf of Medicaid from different vantage points.
Last year Maine People’s Alliance in coalition with our allies, led a successful effort to expand Medicaid through a citizen’s initiative process. While we knew addiction was a major public health issue all across Maine, we didn’t know how deeply it connected to the issue of Medicaid and to health access.
As we canvassed door-to-door listening to voters and garnering support for Medicaid expansion, we learned that substance use disorders and the current opioid crisis were top of people’s minds. In Lewiston, Maine, we have more Alcoholics Anonymous meetings per capita than anywhere in the country, and the opioid crisis continues to devastate communities statewide. Nearly everyone we spoke with had witnessed the perils of addiction. As I equipped organizers for these face-to-face conversations, I also channeled my lived experience. I began sharing my own family story and encouraging organizers to do the same.
I am living in recovery. In my early twenties, I was raped by an acquaintance and mutual friend. I developed a substance use disorder with alcohol. For six years, I drank two liters of wine or a 12-pack every single day. I was powerless to the substance – on the one hand, it was killing me, and on the other hand, I felt that it was saving me. It saved me from digging deep, from confronting shame, from being vulnerable, but it prevented me from pushing through the trauma that I had suffered.
At times, I’ve felt completely powerless over my own life and my future. But because I benefitted from consistent, comprehensive medical treatment and social supports to help me in my recovery journey, I am one of the success stories. I found strength in those around me, and I continue to every day. I am five years sober. I contrast my experience with my cousin’s, who over the years had been cut off from MaineCare (Medicaid) and its essential recovery supports. Until a couple months ago, he was still using, addicted to alcohol, heroin and other opioids. I fear for Sam’s life every day, and I fear he won’t have the support he needs to remain in recovery. I cannot bear to see my family suffer this way.
Everyone deserves a chance to live in recovery. Everyone deserves the privilege and access to treatment that I had.
We heard again and again at the doors how deeply this opioid crisis was touching the voters we were speaking to. Addiction knows no boundaries – whether we were in urban, suburban, low-income or rural communities, we found similarly high rates of experience with substance use disorders and opioids. We even found support among harder-to-reach constituencies like older adults, once we educated them about the issue. For those who viewed addiction as a moral failing – “They would stop using if they cared!” – we made sure our canvassers were well trained to respond with personal stories like mine.
Being poised to respond to the electorate, and what was at the top of people’s minds, proved to be a winning strategy. We could not ignore what we were hearing at the doors. It’s easy to be overwhelmed by a problem as big as our nation’s overdose crisis. Instead of throwing up our hands in frustration, we must stay solution-oriented. First, we must acknowledge that addiction is treatable. Second, we need to recognize the life-saving role health insurance, especially Medicaid, plays in preventing and treating addiction.
Before the Affordable Care Act, low-income individuals with substance use disorders could not get Medicaid coverage unless they had other qualifying conditions or circumstances. The evidence now shows that states expanding Medicaid are increasing access to care for people with substance use disorders. With Medicaid, medication-assisted treatment (MAT) is more affordable, and people in Medicaid-expansion states also have lower out-of-pocket medical costs and fewer unpaid bills.
There are literally millions of people nationwide still facing barriers to substance use disorders care. Recent data shows there were more than 15 million adults who reported needing treatment for alcohol use, and more than 5 million for illicit drug use, who didn’t get it in the past year. We need to change that by increasing access to the life-saving addiction treatment and services that people need. Thanks to the success of Ballot Question 2 in Maine, more than 80,000 people across the state are newly eligible for Medicaid and have access to care.
I encourage advocates in other states to prioritize increasing access to Medicaid’s substance use disorders services and supports, as we have done in Maine. I also urge them to share their own powerful stories as they promote the importance of Medicaid.
Genevieve Lysen, Lead Organizer, Maine People’s Alliance