Drug overdose deaths have declined in recent years both nationally and in Kentucky, but that progress is now at risk due to potential cuts threatening more than $800 million in federal funding the state receives to address substance use disorders and opioid use disorders. Kentucky’s success stems partly from improved access to evidence-based treatments and significant investments in harm reduction strategies, largely enabled by Medicaid expansion and federal public health investments. However, Congress is moving toward significant potential Medicaid cuts that could undermine progress made on an epidemic that took nearly 2,000 Kentucky lives in 2023.
Medicaid’s Critical Role in Treatment
Medicaid serves as Kentucky’s largest investment in substance use disorder treatment. According to an analysis by RTI International, in 2020, 155,342 Kentuckians receiving Medicaid—or 9.5% of all Medicaid recipients—used at least one substance use disorder service. In 2021, more than 54,140, or 3%, were specifically receiving treatment for opioid use disorder. Among Kentuckians with Medicaid who have been diagnosed with a substance use disorder, 81% are receiving any medication, treatment or supportive service; 70% are receiving medications for opioid use disorder; and 45% are receiving therapy or counseling. Kentucky expanded Medicaid eligibility in 2014 to include all adults under 138% of the federal poverty level, with roughly 480,000 adults currently enrolled. Federal funding comprises 90% of this expansion’s budget—$5.7 billion in Kentucky in 2024 alone.
Federal Grant Programs Under Threat
Multiple federal funding streams support Kentucky’s opioid response. In fiscal year 2023, the State Opioid Response grant helped distribute 96,768 Narcan units and supported justice-involved individuals with opioid use disorder. The Substance Use Prevention, Treatment, and Recovery Services Block Grant provided $21 million to Kentucky in 2023, with 74% directed to substance use disorder treatment services. The CDC awarded a $43.4 million Public Health Infrastructure Grant to the Kentucky Department of Public Health in fiscal year 2023 and a $9.5 million grant to the Louisville Metro Department of Public Health and Wellness.
Immediate Funding Disruptions
On March 24, the Trump administration suspended $11.4 billion in federal funding to state and local health departments. If allowed to proceed, Kentucky will face a $148.8 million reduction in public and behavioral health funding. Potential eliminations of CDC grants would remove $102,751,590 through the Epidemiology and Laboratory Capacity Program for data modernization and $5,119,682 allocated to bring health services to underserved areas.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://kypolicy.org/federal-funding-cuts-to-medicaid-and-public-health-will-worsen-kentuckys-opioid-crisis/