Nearly 5 months into Donald Trump’s Presidency, and Congress remains divided over a bill to repeal Obamacare, which was President Trump’s number one campaign promise. Holding 52 of 100 Senate seats, Republicans are trying to pass the bill using the budget process of reconciliation to avoid a Democratic filibuster.

Fearing the possibility that the bill may not pass the Senate, Republican leaders have focused their attention on appealing to the moderate members within the caucus. GOP Senators have already conceded several key issues, including the the continuation of several Obamacare taxes and prohibiting states from repealing a health insurance rule known as community rating, which protects those with pre-existing conditions. Other issues in question are Medicaid expansion and increased tax credits for low-income Americans to buy insurance.

So far, the approach of appeasing the Senate GOP moderates stands in stark contrast to the approach of the House last month, when House leaders relented on several key issues to appease the most conservative lawmakers in the House.

As the Senate continues negotiations, President Trump is urging lawmakers to begin work on other legislation such as infrastructure and tax reform. However, lawmakers are more divided. Senate Majority Leader Mitch McConnell seeks to protect swing state Republican Senators whose seats are up in 2018. Many Republicans, including Senator John Thune of South Dakota, are concerned about the consequences if lawmakers are unable to make good on President Trump’s campaign promises in 2017.  

For now, the Senate will continue its painstaking efforts on the American Health Care Act.

Opioid and heroin abuse are growing matters of concern across the United States, particularly in the state of Wisconsin. Data analysis has revealed an expansion of prescription and non-prescription opioid-related drug abuse; and the devastating results on Wisconsin families, correctional systems, law enforcement, healthcare providers, first responders, and others is astounding.

In response to the alarming rate at which opioid abuse had metastasized, Representative John Nygren first took action in September 2013 when he introduced seven bills that laid the foundation for his Heroin Opiate Prevention and Education (H.O.P.E.) Agenda. H.O.P.E. received unanimous bipartisan support, and ten additional bills targeting prescription opiates were added to the H.O.P.E. Agenda in 2015 and 2016. In September 2016, Governor Walker began assembling an Opioid Abuse Task Force, co-chaired by Lieutenant Governor Rebecca Kleefisch and Representative John Nygren. The other eighteen members of the Task Force were announced on October 25, 2016, and the first task force meeting was held three days later on October 28, 2016.

Just over two months later, on January 5, 2017, Governor Scott Walker’s Opioid Abuse Task Force issued a report that communicated the alarming figures associated with opioid-related abuse and the immediacy of taking action to reverse the current trends. According to the report, from 2003 to 2014, opioid-related fatalities more than tripled. Although extensive research on the causes of the increase is limited, analysts have concluded that the rise in fatalities may be due to any combination of the following: the rise in use and abuse of pain killers with opioids, lowered prices and readily-distributed heroin, new developments in heroin abuse demographics, and reduced need for heroin injections due to a rise in the prevalence of pure heroin. In addition, more deaths have occurred as a result of drug overdose than from motor vehicle accidents, breast cancer, colon cancer, suicide, firearms, HIV, or influenza.

The report included the bills presented through the H.O.P.E. Agenda as well as recommendations to the Governor from the Opioid Abuse Task Force. The recommendations were divided into three categories including Legislation and Statutes, Funding and Programs, and Executive Actions.

In response to the recommendations made in the report, Governor Walker took immediate action and signed three executive orders. The orders contained the following directives:

• Executive Order #228 directed state agencies to take added action to combat opioid addiction and abuse based on the recommendations made by Lieutenant Governor Kleefisch and Representative Nygren of the Opioid Abuse Task Force.
• Executive Order #229 directed the Wisconsin Department of Health Services to apply for funding from the federal government made available through the 21^st Century Cures Act. The Act makes up to $7,636,938 available annually for two years through the State Targeted Response to the Opioid Crisis Grant for opioid crisis response programs.
• Executive Order #230 called a session of the Wisconsin State Legislature to assemble at 11:00 a.m. on January 5, 2017, to discuss the following legislation:
  • LRB-1026, relating to opioid antagonist administration in schools
  • LRB-1327, relating to treatment and diversion programs and providing funding
  • LRB-1323, relating to limited immunity for persons who receive first responder care after experiencing a drug overdose
  • LRB-1325, relating to requirements for prescriptions for certain Schedule V controlled substances
  • LRB-1328, relating to the civil commitment of persons experiencing substance abuse addiction
  • LRB-0639, relating to the University of Wisconsin System chartering a recovery school
  • Legislation relating to the rural hospital graduate medical training program and $63,000 in each year of the 2017-2019 biennium for additional fellowships
  • Legislation relating to $1,000,000 in each year of the 2017-2019 biennium for grants to support new medically assisted treatment centers
  • Legislation relating to $500,000 in each year of the 2017-2019 biennium for a consultation service for medical professionals to access addiction medicine specialists
  • Legislation relating to $420,000 in each year of the 2017-2019 biennium for four additional criminal investigation agents at the Wisconsin Department of Justice focused on drug interdiction and trafficking
  • Legislation relating to $100,000 in each year of the 2017-2019 biennium to expand the Screening, Brief Intervention, and Referral to Treatment (SBIRT) training program offered by the Wisconsin Department of Public Instruction.

On January 5, 2017, in a weekly radio address, Governor Walker stated: “The orders I signed today are another step in the right direction, and build upon our previous efforts including the H.O.P.E., or Heroin Opiate Prevention and Education legislation we signed into law late last spring . . . Chances are we all know someone who has been personally affected by a drug overdose. Together, we will work to save lives and eliminate this public health crisis.”

Governor Scott Walker, the Opioid Abuse Task Force, Wisconsin agencies, and other individuals are dedicated to fighting against opioid abuse in Wisconsin one step at a time until the problem is resolved.