MORE Savings Act
- Sponsor
- Sen. Blumenthal, Richard [D-CT]
- Committees
- Finance Committee (primary)
- Last action
- Jun 12, 2025
Bottom line
The bill aims to significantly expand access to affordable opioid use disorder treatment and recovery services across Medicare, Medicaid, and private insurance by eliminating cost-sharing and increasing federal support.
What it actually does
This bill establishes a Medicare pilot program to eliminate cost-sharing for opioid use disorder (OUD) treatments and recovery services in 15 selected states. It mandates that private group and individual health insurance plans cover OUD prescription drugs, overdose reversal medications, behavioral health services, and community recovery support services without cost-sharing. Additionally, it increases the federal matching rate for state Medicaid expenditures on medication-assisted treatment (MAT) to 90% and allows states to include recovery support services in their MAT definition for enhanced federal funding.
Proponents argue
Proponents argue that eliminating financial barriers to evidence-based OUD treatments and recovery support services will save lives, reduce overdose deaths, and ultimately lead to long-term healthcare cost savings by fostering sustained recovery. They contend that a comprehensive approach across all major insurance types is necessary to effectively combat the ongoing opioid crisis.
Opponents contend
Opponents may raise concerns about the increased federal spending associated with the Medicare pilot and enhanced Medicaid match, as well as the potential for federal mandates on private health plans to increase premiums for employers and individuals. They might argue that such mandates could lead to unintended consequences in the insurance market or place undue burden on states.
The bill is concise and relatively straightforward, allowing an informed reader to grasp its core provisions within the typical time allotted for legislative review.
Section 2, amending Social Security Act 1115A(b)(2)
Medicare Model for Affordable Opioid Treatment Access
This section directs the Center for Medicare and Medicaid Innovation (CMI) to establish a model program in 15 states. This model will eliminate coinsurance, copayments, and deductibles under Medicare Parts B, D, and C for drugs and biologicals to treat OUD or reverse overdose, behavioral health services for OUD (including non-hospital residential facilities), and recovery support services like peer counseling and transportation. States selected for the model must have a high proportion of Medicare beneficiaries, a high rate of opioid overdose deaths, and a significant percentage of rural areas.
Supporters argue
Supporters argue that this model will remove significant financial barriers that prevent Medicare beneficiaries from accessing life-saving OUD treatment and recovery services, leading to improved health outcomes and reduced overdose fatalities among a vulnerable population. They also suggest that early and comprehensive treatment can lead to long-term cost savings.
Critics contend
Critics may contend that eliminating all cost-sharing could lead to overutilization of services or increased federal spending without clear evidence of long-term effectiveness or cost savings. Concerns might also be raised about the administrative complexity of implementing such a model across 15 states.
Tradeoffs
The provision balances the immediate benefit of increased access to care for beneficiaries against the potential for increased federal expenditures and the administrative complexities of a large-scale pilot program.
Section 3, amending PHSA, ERISA, and IRC
Mandated Coverage of Opioid Treatments by Health Plans
This section requires all group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage for, and not impose any cost-sharing requirements on, prescription drugs for OUD treatment or overdose reversal, behavioral health services for OUD (including non-hospital residential facilities), and community recovery support services (like peer counseling and transportation) when provided with medication-assisted treatment. These requirements apply to plan years beginning on or after January 1, 2027.
Section 4(a), amending Social Security Act 1905(b)
Enhanced Federal Match for Medication-Assisted Treatment (MAT) under Medicaid
This section increases the Federal Medical Assistance Percentage (FMAP) to 90% for state expenditures on medication-assisted treatment (MAT) for opioid use disorder under Medicaid. This enhanced match applies during a specific portion of the period described in subsection (a)(29) of the Social Security Act, for states that are one of the 50 States or the District of Columbia.
Section 4(b), amending Social Security Act 1905(ee)(1)
State Option to Include Recovery Support Services in Medicaid MAT Definition
This section amends the definition of 'medication-assisted treatment' under Medicaid to allow states, at their option, to include recovery support services such as peer counseling and transportation. These services must be provided in conjunction with MAT to support individuals in maintaining a healthy lifestyle following opioid misuse treatment. This means states can receive the enhanced 90% federal match for these recovery support services if they choose to include them.
The Medicare model for affordable access to evidence-based opioid treatments cannot be terminated or modified by the Secretary of HHS for the first five years after its implementation.
Section 2(D)(iii), amending Social Security Act 1115A(b)(2)
Why it matters:This is standard legislative practice to ensure stability and allow sufficient time for evaluation of a new pilot program before it can be altered or ended, preventing premature termination based on short-term data.
Case for: Supporters would argue that this provision ensures the Medicare pilot has adequate time to demonstrate its effectiveness and gather robust data without political interference or early termination, which is crucial for evaluating complex healthcare models.
Case against: Critics might argue that a five-year lock-in period prevents necessary adjustments if the model proves ineffective, too costly, or has unforeseen negative consequences in its early stages, limiting the Secretary's ability to respond dynamically.
Estimated impact: Ensures the Medicare pilot program will run for a minimum of five years, guaranteeing sustained federal investment and beneficiary access during that period.
The requirements for private health plans to cover opioid treatments without cost-sharing will apply to plan years beginning on or after January 1, 2027.
Section 3(b)
Why it matters:This is standard legislative practice to clearly delineate the effective date of new requirements, allowing health plans and employers sufficient time to adjust their offerings and administrative systems.
Case for: Proponents would argue that a delayed effective date provides necessary lead time for health plans, employers, and regulators to implement the new coverage mandates, ensuring a smooth transition and minimizing disruption.
Case against: Critics might argue that delaying the effective date means individuals with private insurance will continue to face cost barriers for OUD treatment for an extended period, prolonging the public health crisis for those affected.
Estimated impact: Delays the full implementation of private insurance mandates by approximately 1.5 years from the bill's introduction, affecting millions of privately insured individuals.