Header image by CDC
Colorado has been on the front lines of the opioid epidemic for years. Across our state we’ve seen families shattered, emergency rooms overwhelmed, and communities struggling to cope with the deep and lasting impact of this crisis. Fighting back has required sustained attention, real resources, and champions willing to push when others looked away.
As someone who is a senior citizen and always looking for ways to save on Medicaid, I know that Congresswoman Diana DeGette has been one of those champions — but now, there is another critical step she can take.
When the Trump administration’s 2017 opioid declaration fell short of the commitment our communities needed, DeGette did not stay quiet. She called it out directly and forcefully, saying the declaration “falls far short and does not deliver on his promise,” and she pressed for more. As a senior member of the House Energy and Commerce Committee, she has pursued this issue through legislation, hearings, and investigations into the very systems that enable prescription drug abuse. That is a record worth recognizing and building on.
Today, a new dimension of the opioid crisis demands her attention. Medicare’s benefit structure is actively steering older Americans toward opioids. It has nothing to do with clinical need, and everything to do with cost. Low-cost generic opioids frequently sit on cheaper tiers within Medicare Part D drug plans, while FDA-approved non-opioid pain medications carry copays that can be many times higher. On top of that, prior authorization and fail-first policies routinely require patients to try opioids before they can access a safer alternative. The result is a system that penalizes seniors for making a medically responsible choice.
This is not a minor issue. Older Americans face disproportionately high rates of opioid use disorder and overdose. Every unnecessary opioid prescription handed to a Medicare beneficiary represents a risk that better policy could prevent. And the physician’s role of exercising clinical judgment on behalf of the patient gets undermined every time an insurer’s administrative protocol overrides that judgment.
The Alternatives to PAIN Act would correct both failures. The bill would ensure that seniors never pay more out of pocket for a non-opioid pain medication than they would for an opioid equivalent. It would also prohibit Medicare Part D plans from requiring opioid use as a precondition for coverage of safer alternatives. These are practical, targeted fixes that restore balance to a system currently tilted in the wrong direction — asking nothing more than a level playing field for safer drugs.
The ripple effects reach Medicare’s bottom line as well. Preventing unnecessary opioid exposure reduces addiction, cuts hospitalizations, lowers emergency care utilization, and decreases the long-term treatment costs that follow. More than 100 organizations — physician groups, patient advocates, and veterans’ organizations have endorsed this legislation as a common sense, bipartisan response to a crisis that has persisted too long.
Rep. DeGette’s record on this issue is long and concrete. As the Democratic co-author of the 21st Century Cures Act, she helped deliver $1 billion in federal funding to combat the opioid epidemic, dollars that Colorado put to immediate use. Colorado received $7.8 million through that legislation, funding medication-assisted therapy, overdose reversal medications, family counseling, crisis services, and partnerships between health providers and law enforcement. Those were real programs that reached real people in real crisis.
Rep. DeGette has spent years demonstrating that she understands the human stakes of the opioid epidemic and is willing to act. The Alternatives to PAIN Act is another logical chapter in that body of work. Colorado’s seniors should have access to modern, evidence-based pain care, without being financially punished for choosing an option that doesn’t come with the risk of addiction. I urge Congresswoman DeGette to support the Alternatives to PAIN Act and help deliver on the promise of prevention over addiction.
Ed Augden
President, Colorado Alliance for Retired Americans
