Turn the Tide Act

Full Title:
Turn the Tide Act

Summary#

This bill, the Turn the Tide Act, adds funding and changes rules for many federal programs that address substance use disorders, overdose prevention, and related services. It amends parts of the SUPPORT for Patients and Communities Act, the Public Health Service Act, the Social Security Act, and other laws. Key actions in the bill include: increasing and authorizing specific annual appropriations for treatment, prevention, surveillance, training, and recovery programs; creating a Medicaid demonstration for recovery housing; changing Medicaid and other insurance rules to limit prior authorization and cost-sharing for medication-assisted treatment and opioid overdose reversal agents; increasing payments and temporary minimum payment rates for certain behavioral health services under Medicaid; expanding State and community grant programs; and authorizing grants for law enforcement mental health pilots and adverse childhood experiences response teams.

What it means for you#

  • Individuals with substance use disorders: the bill funds many treatment, recovery, and prevention programs and creates a Medicaid demonstration to allow recovery housing for some beneficiaries. It also includes provisions that prevent some prior authorization or utilization control rules for medication-assisted treatment in Medicaid.
  • People at risk of overdose and caregivers: group and individual health plans, many employer plans, and Medicare Part D plans must cover at least one formulation of an opioid overdose reversal agent without cost-sharing and without prior authorization starting in plan years beginning in 2027 (for most provisions).
  • Health care providers and behavioral health professionals: the bill sets temporary minimum Medicaid payment rules for certain mental and behavioral health services for patients with substance use disorder (effective Oct 1, 2026 through Oct 1, 2030) and authorizes enhanced Federal matching for increases needed to meet those minimums.
  • States, Tribes, and local organizations: the bill provides large new and reauthorized grants (see Expenses) and new allocation rules and priorities for several grant programs, and it permits State flexibility in some grant uses (for example, State Opioid Response grants may be used for non-opioid substance use disorders).
  • Insurers and plan sponsors: the bill adds requirements across the Public Health Service Act, ERISA, and the Internal Revenue Code to limit cost-sharing and prior authorization for overdose reversal agents and includes a safe harbor so high-deductible health plans need not count naloxone against their deductible status.

Expenses#

The bill lists many specific authorizations and appropriations. Examples from the text include (amounts are annual amounts and the fiscal years are those specified in the bill):

  • State Opioid Response Grants: $5,500,000,000 for each of fiscal years 2027 through 2031.
  • Substance abuse prevention and treatment block grants: $3,000,000,000 for each of fiscal years 2027 through 2031, then $2,500,000,000 for each of fiscal years 2032 through 2036.
  • A wide set of public health and prevention grants (selected examples): preventing overdoses program $516,000,000 per year (FY2027–2030); National Child Traumatic Stress Initiative $112,000,000 per year (FY2027–2030); mental and behavioral health education grants $75,000,000 per year (FY2027–2030); first responder training $77,000,000 per year (FY2027–2030); many other programs are funded at amounts ranging from $1,750,000 to $500,000,000 per year as specified in the bill.
  • Housing and recovery supports: Recovery Housing program reauthorized at $60,000,000 per year for FY2027 through FY2032; a Medicaid recovery housing demonstration is established with selection and budget rules but no single dollar total in the demonstration text.
  • Justice and community grants: Comprehensive Opioid Abuse Grant Program $500,000,000 per year (FY2027–2030); Drug-Free Communities support $175,000,000 per year (FY2027–2030); High-Intensity Drug Trafficking Area program funding $350,000,000 per year (FY2027–2030); Drug court grants $125,000,000 per year (FY2027–2030); law enforcement mental health and wellness grants $15,000,000 per year (FY2027–2030); Adverse Childhood Experiences Response Team grants $10,000,000 per year (FY2027–2030).
  • Workforce and training: Health workforce loan repayment increased to $65,000,000 per year for FY2027–2031; training demonstration funds include $10,000,000 per year plus $20,000,000 per year targeted to hardest-hit states (FY2027–2030).
  • Insurance and coverage rule changes do not by themselves list a separate appropriation but include effective dates (for example, many plan-year changes begin Jan 1, 2027; Medicaid and provider payment changes begin Oct 1, 2026).

Proponents' View#

No publicly available information.

Opponents' View#

No publicly available information.