Trump Declared the Opioid Crisis a Public Health Emergency. Then Provided Almost No Funding to Fight It.

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The Commission on Combating Drug Addiction and the Opioid Crisis, chaired by Chris Christie, issued its interim report in July 2017 with a direct and urgent request: "Please declare a national emergency under the Stafford Act or the National Emergencies Act. The declaration would allow your Administration to act with the urgency and flexibility needed to confront this crisis." The Stafford Act declaration would have unlocked federal disaster relief funds — the same mechanism used for hurricanes and other disasters. Trump waited six weeks to respond, then declared the weaker public health emergency, which unlocked regulatory flexibility but no new money. The distinction was not technical. It was the difference between a crisis response and a press conference.

The opioid crisis disproportionately devastated rural and suburban communities — many of them Trump's core constituencies. The promises made were specific: millions of Americans suffering from addiction, 91 Americans dying of opioid overdose every day, entire communities destroyed. The response was a declaration that allowed states to use existing Medicaid funds more flexibly and to hire physicians under certain waivers. These were not nothing, but they were far less than what the crisis required and far less than what had been promised. The administration later proposed budgets that cut Medicaid — the primary payer for addiction treatment — by hundreds of billions. The opioid crisis did not abate. The deaths continued to rise.