MORE Savings Act
- Sponsor
- Rep. Dean, Madeleine [D-PA-4]
- Committees
- Education and Workforce Committee (primary)
- Last action
- Sep 3, 2026
Bottom line
The MORE Savings Act aims to significantly expand access to opioid use disorder treatment and recovery services by removing financial barriers across Medicare, private insurance, and Medicaid programs.
What it actually does
The bill establishes a Medicare demonstration model in 15 states to eliminate cost-sharing for evidence-based opioid treatments and recovery support services. It also mandates that private health plans (group and individual) cover opioid use disorder treatments, overdose reversal medications, and recovery support services without cost-sharing. Additionally, it increases the federal Medicaid matching rate to 90% for medication-assisted treatment and allows states to include recovery support services for this enhanced match.
Proponents argue
Proponents argue that by eliminating cost-sharing and increasing federal support, the bill will make life-saving opioid treatments and recovery services more accessible and affordable, thereby reducing overdose deaths, improving public health outcomes, and ultimately leading to long-term savings by addressing the opioid crisis more effectively. They emphasize the importance of comprehensive care, including behavioral health and recovery support, which is often hindered by financial barriers.
Opponents contend
Opponents might raise concerns about the potential increase in federal and state expenditures due to the elimination of cost-sharing and the enhanced Medicaid match, questioning the long-term fiscal sustainability, especially without a clear CBO score. They might also argue about potential over-reliance on medication-assisted treatment or the administrative burden on health plans and states to implement these new requirements.
The bill is relatively short and clearly structured, making it accessible for a reader to understand its core provisions within a reasonable timeframe.
Section 2, amending Section 1115A(b)(2) of the Social Security Act
Medicare Opioid Treatment Cost-Sharing Elimination Model
This section directs the Center for Medicare and Medicaid Innovation (CMI) to establish a demonstration model in 15 selected states. This model will eliminate coinsurance, copayments, and deductibles under Medicare Parts B, D, and C for drugs and biologicals to treat opioid use disorders or reverse overdose, behavioral health services for opioid use disorders (including non-hospital residential facilities), and recovery support services like peer counseling and transportation. The model will run for at least five years without early termination.
Supporters argue
Supporters argue that eliminating cost-sharing is crucial for Medicare beneficiaries, who often face significant financial barriers to accessing necessary opioid treatment and recovery services, especially in states hit hard by the opioid crisis. The demonstration model allows for data collection on effectiveness and cost-savings.
Critics contend
Critics might express concern about the potential for increased Medicare spending without clear evidence of long-term cost offsets, especially given the five-year no-termination clause. They might also question the selection criteria for states or the administrative complexity of implementing such a model.
Tradeoffs
Balances the immediate cost of eliminating cost-sharing against the potential long-term benefits of improved public health and reduced societal costs associated with untreated opioid use disorder.
Section 3, amending the Public Health Service Act (PHSA), ERISA, and the Internal Revenue Code (IRC)
Mandated Private Health Plan Coverage without Cost-Sharing
This section requires all group health plans and health insurance issuers (both group and individual coverage) to provide coverage for prescription drugs for opioid use disorders or overdose reversal, behavioral health services for opioid use disorders (including non-hospital residential facilities), and community recovery support services (like peer counseling and transportation) without imposing any cost-sharing requirements. These amendments apply to plan years beginning on or after January 1, 2027.
Section 4, amending Section 1905(b) and 1905(ee)(1) of the Social Security Act
Increased Medicaid FMAP for Opioid Treatment and Recovery
This section increases the Federal Medical Assistance Percentage (FMAP) to 90% for amounts expended by states on medication-assisted treatment (MAT) for opioid use disorders under Medicaid. It also allows states, at their option, to include recovery support services (such as peer counseling and transportation) provided in conjunction with MAT, to qualify for this enhanced 90% FMAP.
The provisions allowing for termination or modification of a CMI model (paragraph (3)(B)) will not apply to the Medicare opioid treatment model for its first five years.
Section 2, amending Section 1115A(b)(2)(D)(iii) of the Social Security Act
Why it matters:This is standard legislative practice for ensuring the stability of demonstration projects, not necessarily evasive. It guarantees a sufficient period for data collection and evaluation.
Case for: Proponents would argue this ensures the model has adequate time to demonstrate its effectiveness and gather robust data without being prematurely altered or terminated, which is crucial for evaluating complex healthcare interventions.
Case against: Critics might argue that locking in a model for five years without the ability to modify it, even if it proves ineffective or excessively costly, limits flexibility and could lead to inefficient use of resources.
Estimated impact: Ensures a stable, five-year period for the Medicare demonstration model, affecting its long-term evaluation and potential for broader adoption.