A bipartisan coalition of state attorneys general on Monday called on Congress to allow Medicaid funding to flow to larger drug treatment centers, potentially expanding the number of addicts who can get help as the nation grapples with an overdose crisis. The government lawyers for 38 states and Washington, D.C., sent a letter to congressional leaders requesting the change. They say it’s needed to help fight the opioid abuse and overdose epidemic, which continues to claim tens of thousands of lives a year. “If we have any hope of reversing this terrible trend, we need every treatment option at our disposal,” said the letter, which was spearheaded by Ohio Attorney General Mike DeWine, a Republican, and Pennsylvania’s Josh Shapiro, a Democrat. They noted that people “often develop opioid addiction through prescribed medical usage, with no intent by the patient to engage in abusive behavior, simply because of the addictive properties of opioid drugs.” One study found that drug overdoses killed up to 65,000 Americans last year. The majority of them involved opioids such as prescription painkillers and heroin, as well as related synthetic drugs such as fentanyl. The attorneys general want Congress to allow Medicaid, the state-federal health insurance program for low-income people, to pay for drug treatment in centers with more than 16 beds. Only smaller facilities qualify for payments under a 1965 law that was intended to break up large, state-run mental asylums. The change would allow Medicaid-covered addiction treatment at larger centers, which the attorneys general say would open up more beds. The proposed change would retain the cap on the size of mental health institutions that can qualify for payments. Monday’s letter was the latest step taken by attorneys general from both parties in response to the opioid epidemic. In September, several announced subpoenas and other requests for information in an investigation of companies that make and distribute powerful prescription opioid painkillers, possibly setting the stage for a major nationwide settlement. They also called on health insurers to cover an array of pain treatments other than opioids. Several states and cities, including Washington and Seattle, have sued drug companies, blaming the opioid epidemic for ravaging communities.

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