We have money to fight Kentucky's opioid crisis. Let's not waste it.
Thanks to landmark settlements with pharmaceutical manufacturers and distributors, states and municipalities across the country will receive over $50 billion in opioid abatement funding over the next 18 years. Kentucky alone is poised to receive more than $800 million. These funds represent an unprecedented opportunity to reverse the damage done and build a recovery system that works — not only for those battling substance use disorder (SUD) today but for future generations as well.
But with this opportunity comes a responsibility that we cannot afford to squander.
Already, we're seeing the warning signs. A yearlong investigation by KFF (Kaiser Family Foundation) Health News, along with researchers at the Johns Hopkins University Bloomberg School of Public Health and the national nonprofit, Shatterproof, found many jurisdictions used settlement funds on items and services with tenuous, if any, connections to addiction.
These choices may help balance ledgers, but they fundamentally betray the purpose of these funds. This money was not awarded to maintain the status quo. As Robert Kent, former general counsel for the Office of National Drug Control Policy, put it, 'Certainly, the spirit of the settlements wasn't to keep doing what you're doing. It was to do more."
Kentucky must not follow this path.
To be sure, the temptation is real. Counties face budgetary constraints, state agencies are stretched thin and public servants are overdue for raises. But the long-term cost of misusing these funds will far exceed any short-term relief. Not only could such decisions lead to clawbacks of funds or disqualifications for future disbursements under the terms of the settlement agreements, they would also represent a tragic missed opportunity to finally turn the tide in our battle against addiction.
Gerth: I work with people battling addiction. Trump's tariffs won't stop fentanyl. | Opinion
Fortunately, Kentucky has already shown it knows how to lead.
In 2022, our legislature passed a landmark initiative — the Behavioral Health Conditional Dismissal Program. Backed by $10.5 million in opioid settlement funds, this four-year pilot program provides an alternative to incarceration for individuals charged with certain non-violent, non-sexual misdemeanors and Class D felonies. Instead of jail, eligible participants are evaluated by medical professionals and offered treatment for SUD and/or other mental health conditions. The goal is to use data to create a replicable, collaborative model that breaks the cycle of addiction, reduces recidivism and restores lives.
Early signs are promising, and the legislature is rightly considering expansion. This is exactly the kind of innovative, evidence-based programming that Kentucky should prioritize as we distribute settlement funds.
Other models from across the country offer inspiration as well. In several jurisdictions, police departments are now pairing with mental health professionals for real-time crisis intervention. These partnerships reduce trauma for both officers and individuals in crisis, lead to more humane outcomes and, ultimately, save taxpayer dollars by reducing unnecessary hospitalizations and incarcerations.
The opioid epidemic has already claimed more than 600,000 lives nationally. While recent data from the CDC show a hopeful 17% decline in opioid overdose deaths between July 2023 and July 2024, this drop is not a sign to become complacent — it's a sign that smart policy and targeted investment can work.
Opinion: Pope Leo and the Catholic Church, not Trump, should point the way for our future
And we'll need them. More potent synthetic opioids like nitazenes and dangerous additives like xylazine ('tranq') are beginning to enter the illicit drug supply. Without aggressive investment in innovative treatment options and infrastructure, public education, harm reduction and law enforcement support, we risk falling behind again just as we're beginning to catch up.
Let this be a turning point — not a footnote.
Kentucky's business leaders, health care providers, civic institutions and elected officials must all align around one unifying principle: These funds will be used for their intended purpose — to address the opioid crisis.
That means rejecting the temptation to misuse funds to paper over fiscal problems or bankroll unrelated projects. It means providing accountability and transparency. And it means staying focused on building a future in which fewer families grieve, fewer children are left behind and more Kentuckians live free from the grip of addiction.
This is our shot. Let's not waste it.
Vickie Yates Glisson is a lawyer and arbitrator who focuses her practice on health care and health insurance issues. She is president and founder of VYBG Consulting, PLLC and former secretary of the Kentucky Cabinet for Health and Family Services
This article originally appeared on Louisville Courier Journal: KY can't afford to waste funds to fight the opioid crisis | Opinion
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
21 minutes ago
- Yahoo
ACA insurers propose biggest premium hikes since 2018 as Trump policies take hold
Affordable Care Act insurers are proposing their steepest premium increases since 2018, driven in part by the looming expiration of Biden-era enhanced premium subsidies and by the Trump administration's tariffs, a new KFF analysis has found. Insurers are asking for a typical rate increase of 15% with more than a quarter proposing hikes of 20% or more. KFF, a nonpartisan health policy research group, looked at 105 Obamacare insurers in 19 states and the District of Columbia that have filed rates so far. Steep rate increases in 2018 were also fueled by Trump administration policies, which were focused on weakening the ACA during the president's first term after Republicans in Congress failed to repeal it in 2017. While rising health care costs account for about half of the coming year's proposed increases, two other forces under the control of President Donald Trump and congressional Republicans are also driving up rates, KFF found. The expiration of the enhanced ACA premium subsidies at the end of this year is prompting many insurers to hike rates by an additional 4%, on average. Insurers are concerned that the disappearance of this beefed-up assistance will prompt many, largely healthier consumers to drop their coverage — leaving sicker, costlier policyholders on the exchanges. Initially created by the Democrats' American Rescue Plan Act in 2021, the enhanced premium subsidies enable lower-income enrollees to sign up for coverage with very low or no monthly premiums. Also, middle-income Americans can qualify for assistance for the first time. The Biden administration repeatedly said the more generous subsidies allow the majority of enrollees to select plans that cost less than $10 a month. The enhanced subsidies helped drive Obamacare signups to a record 24 million people for 2025. Most enrollees qualify for subsidies, which greatly lower their monthly premium payments. But once the beefed-up assistance lapses, those payments are expected to spike by 75%, on average, KFF said. Trump and GOP lawmakers did not include an extension of the subsidies in their 'big, beautiful bill' and it remains to be seen whether they push for it in subsequent legislation. However, the clock is ticking since insurers are currently finalizing their rates, and the Obamacare federal and state exchanges need time to prepare for open enrollment, which starts on November 1. Several states are highlighting the looming loss of the enhanced subsidies as driving up insurers' proposed rates on their exchanges. In Maryland, for instance, carriers have requested an overall average premium change of 17.1%, the highest since 2019. If Congress extends the enhanced subsidies, the rate increases would be 7.9%, on average, according to the Maryland Insurance Administration, which is looking into creating a state-sponsored subsidy to offset some of the premium increases. Also, some insurers are pointing to the tariffs that the Trump administration has promised to impose on pharmaceutical imports, KFF said. Those that cite tariffs say the levies will add 3% to their premium proposals. The rate filings, however, do not mention specific impacts of the 'big, beautiful bill' because insurers generally had to submit their proposals prior to the bill being signed into law on July 4. Those that mention it point to the uncertainty it is causing, said Cynthia Cox, director of KFF's Program on the ACA. 'We're going to be watching over the next few weeks whether insurers come back and say, 'the big, beautiful bill passed, and here's how we think that might affect our premiums,'' she said. The filings also don't take into account the provisions in a rule that the Centers for Medicare and Medicaid Services finalized in late June that will make several changes to Obamacare, including shortening the open enrollment period, increasing verification requirements and limiting the ability of low-income Americans to sign up for coverage year-round. The measures are a 'mixed bag' for insurers in terms of how it might affect premiums, Cox said. One major insurer has already announced its departure from the Affordable Care Act in 2026. Aetna said in May that it would stop selling plans on the individual market because 'it became clear we would not be able to provide the same level of value we've offered in prior years,' the company said on its website. The insurer also left the Obamacare exchanges in 2018 but later returned. Insurers' 2026 rates are preliminary and are subject to change, particularly in states that run their own exchanges, where state regulators have more of a say in setting the final rates. The final rates should be published later this summer, and consumers will be able to view plan premiums shortly before open enrollment starts.


CNBC
a day ago
- CNBC
ACA marketplace health plan enrollees could face 'subsidy cliff' in 2026 — here's how to avoid it
Starting in 2026, millions of Americans could see a steep increase in the cost of marketplace health insurance — unless Congress extends a pandemic-era boost that made Affordable Care Act plan premiums more affordable. This could affect millions of Americans, including students, self-employed or contract workers and younger retirees, who buy marketplace insurance and claim the so-called premium tax credit, which makes coverage cheaper. The enhanced benefit is set to expire at the end of the year. If it does, some enrollees could face a "subsidy cliff," which eliminates the premium tax credit entirely, once income exceeds certain thresholds, financial experts say. More from Personal Finance:Trump's 'big beautiful bill' includes these key tax changes for 2025Student loan bills to double for some borrowers as Biden-era relief expiresWhat a Trump, Powell faceoff means for your money If you pass the threshold by even $1 and lose the credit, "costs could go up by hundreds of dollars a month," said certified financial planner Cathy Curtis, CEO of Curtis Financial Planning in Oakland, California. But precise income projections can be tricky, said Curtis, who is also a member of CNBC's Financial Advisor Council. The average ACA enrollee saved roughly $700, about 44%, from the enhanced premium tax credit in 2024, according to November research from the Center on Budget and Policy Priorities, a nonpartisan policy organization. Enacted in early July, President Donald Trump's "big beautiful bill" made permanent the Republicans' 2017 tax cuts. But it did not extend the enhanced ACA subsidies passed via the American Rescue Plan in 2021. It's unclear whether the GOP-controlled Congress will consider such a measure before year-end. Here is a breakdown of what to know about the premium tax credit and how to avoid the "subsidy cliff" if enhancements expire after 2025. If you're eligible for the premium tax credit, you can use it to reduce monthly ACA premiums upfront or claim the credit on your tax return. The tax break was originally for enrollees earning between 100% and 400% of the federal poverty level. But the American Rescue Plan expanded eligibility above 400%. For 2025, that threshold was $103,280 for a family of three, according to The Peterson Center on Healthcare and KFF, which are both health-care policy organizations. For 2025, more than 22 million people — about 92% of enrollees — receive premium tax credits, according to KFF. That group could be "significantly affected in 2026" if Congress doesn't extend the larger benefit, said Tommy Lucas, a CFP at Moisand Fitzgerald Tamayo in Orlando, Florida. It's important to run tax projections for 2025 and 2026 if premium tax credit changes may affect you, experts said. If you're receiving the tax break for 2025 with earnings over 400% of the federal poverty level, you could explore ways to reduce 2026 income, Lucas said. For example, you may consider accelerating 2026 income into 2025, tax-loss harvesting or claiming a deduction for health savings account contributions, he said. If the bigger premium tax credit expires for 2026, "we're going to have to monitor [income] on a pretty regular basis, at least quarterly, if not monthly" to avoid the cliff, Lucas said.
Yahoo
2 days ago
- Yahoo
Dear Grandma: Trump took your Medicaid, so it's time for you to work the fields
The Trump administration is cutting $1 trillion from Medicaid over the next decade while ruthlessly deporting hardworking migrants and decimating America's agricultural workforce, but don't worry. Republicans have a sensible plan: Your grandma is going to have to work the fields. Agriculture Secretary Brooke Rollins presented her farm-work-for-Medicaid-coverage plan on July 8, Tuesday, saying: 'There will be no amnesty. The mass deportations continue, but in a strategic way, and we move the workforce toward automation and 100% American participation, which, again, with 34 million people, able-bodied adults on Medicaid, we should be able to do that fairly quickly.' Staff farms with Medicaid recipients – it's the Republican way The Los Angeles Times quoted Ventura County citrus and avocado farmer Helen McGrath responding to Rollins' idea: 'I can confidently say that most farmers in the country either laughed out loud or were just deflated by those comments. It just shows how uninformed and out of touch some of these officials are with what food production looks like in this country.' Oh yeah, Farmer McGrath. What exactly do you know about 'farming' and 'forcing people to work on farms in exchange for basic health care'? Opinion: Did Donald Trump eat Jeffrey Epstein's client list? Logic suggests he did. Republicans always want to believe 'able-bodied' people are on the dole Some might quibble with Rollins' whole 34 million 'able-bodied adults on Medicaid" bit, largely because it's fictional. As of 2023, according to KFF, there were about 26 million working-age adults on Medicaid who weren't getting Supplemental Security Income or Social Security Disability Insurance. Of those, most are not working because they're in school, have a disability or are caregivers. Only 8% are either retired or unable to find work. So that would be about 2 million able-bodied adults on Medicaid. But what does math know about numbers? I'm going to take Secretary Rollins' word for it and assume it's high time meemaw and peepaw got off the Medicaid dole and into the tomato fields. Your Turn: Medicaid handouts only create dependency. Able-bodied adults should work. | Opinion Forum Since it will undoubtedly be hard for some to let their loved ones know they must transition from a popular government-funded program that provides health insurance to help low-income individuals and families to working long hours in the sweltering heat, harvesting fruits and vegetables, I've prepared a form letter. This can be modified to fit the specifics of your soon-to-be-booted-off-Medicaid-so-billionaires-can-get-tax-breaks family member. I'm sure you'll find it a dignified way to teach them they need to earn their keep. A letter telling your loved ones they now have to do farm work for Medicaid Dear Grandma: I hope this note finds you and everyone at the Sleepy Pines Adult-Living Facility doing well and enjoying the free health insurance my tax dollars are buying you. Unfortunately, I have to tell you the gig is up. Because the Trump administration has deemed you able-bodied, the health insurance allowing you to live with a modicum of dignity will now be contingent on how well you handle a rake and how many bushels of apples you fill per day. Please don't start telling me about your arthritis. You're able to play canasta with your one good hand, so I'm pretty sure you can handle 10 hours of picking oranges as long as we give you a hat and a wagon for your oxygen tank. I realize you are technically 'retired' and worked and paid taxes all your life, but it's high time you stopped using chronic kidney disease and blindness as an excuse to get free health insurance. I know if this situation were reversed, you'd be telling me to lift myself up by the bootstraps and get out in the shadeless fields. It's what Grandpa would have wanted had he not worked in the mines well past his retirement age and died of emphysema, penniless. Opinion alerts: Get columns from your favorite columnists + expert analysis on top issues, delivered straight to your device through the USA TODAY app. Don't have the app? Download it for free from your app store. There are important people out there, like billionaires Elon Musk and our great President Donald Trump, and they all deserve tax breaks and a chance to be mean to immigrants. If that means sending you, my beloved grandma, to harvest lettuce that those fine men will one day drizzle with expensive balsamic vinegar, then so be it. They need their roughage, and you need to stop sitting around on your fancy broken mobility scooter and start lugging farming equipment and getting your one good hand calloused. Please be ready to report to the farms on Monday morning. Love, INSERT NAME HERE Follow USA TODAY columnist Rex Huppke on Bluesky at @ and on Facebook at You can read diverse opinions from our USA TODAY columnists and other writers on the Opinion front page, on X, formerly Twitter, @usatodayopinion and in our Opinion newsletter. This article originally appeared on USA TODAY: Trump's farm work for Medicaid plan sends grandma to fields | Opinion Solve the daily Crossword