This bill, the MORE Savings Act, would remove cost-sharing and require coverage for certain opioid treatments and recovery supports. For Medicare, it creates a model to test eliminating coinsurance, copayments, and deductibles under Parts B and D (and Part C as applied) for drugs and biologicals to treat opioid use disorders or reverse overdose, behavioral health services for opioid use disorder (including licensed non-hospital residential treatment), and recovery support services like peer counseling and transportation. The model must be implemented within six months of enactment in 15 States that have many Medicare beneficiaries, high opioid overdose death rates, and significant rural areas. The model cannot be terminated or modified for the first five years after it starts.
The bill would also require group health plans and health insurance issuers of group and individual coverage to provide these same items and services without any cost-sharing. Those requirements for private plans would apply to plan years beginning on or after January 1, 2027. For Medicaid, the bill sets the Federal medical assistance percentage (FMAP) at 90 percent for amounts a State spends on medication-assisted treatment during the specified period and allows States to include recovery support services (such as peer counseling and transportation) as part of medication-assisted treatment.
If you are a Medicare beneficiary in a participating State, the bill would test removing out-of-pocket costs for covered opioid treatment drugs, behavioral health care for opioid use disorder, and recovery supports while the model is active. If you have private group or individual health insurance, your plan would have to cover these items without copays, coinsurance, or deductibles beginning in plan years on or after January 1, 2027. If you are covered by Medicaid, States could receive a higher federal match for medication-assisted treatment and could include recovery support services in what Medicaid covers.
No publicly available information on estimated federal or state costs. The bill does specify a 90 percent federal match for Medicaid spending on medication-assisted treatment for the period described, and it creates a Medicare model that eliminates certain Medicare cost-sharing in 15 States. The private coverage requirements would take effect for plan years starting January 1, 2027, which could affect insurer and employer plan spending and enrollee out-of-pocket costs, but the bill text does not include cost estimates.
The bill’s stated purpose is to promote affordable access to evidence-based opioid treatments and require coverage of medication-assisted treatment, opioid overdose reversal medications, and recovery support services without cost-sharing. Proponents say the bill makes these treatments and supports more affordable and accessible for people covered by Medicare, Medicaid, and private plans.
No publicly available information on opponents' views contained in the bill text or provided metadata.