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Tonko Pushes to Expand Addiction Treatment at Congressional Hearing

Congressman called on HHS Secretary to support major legislation to combat surging overdose deaths across the U.S.

  • Rep. Paul Tonko

WASHINGTON, DC—Congressman Paul D. Tonko addressed the top Biden Administration health official today during a Health Subcommittee hearing to push for the advance of two major, bipartisan addiction treatment bills he authored. Tonko called for U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra to support the Mainstreaming Addiction Treatment (MAT) Act and the Medicaid Reentry Act

The MAT Act would vastly increase access to life-saving addiction medicine by eliminating a duplicative bureaucratic hurdle—colloquially known as the “x-waiver”—currently blocking millions of highly-trained health professionals from prescribing buprenorphine to their patients. After France took similar action to make buprenorphine available without a specialized waiver, opioid overdose deaths declined by 79 percent over a four-year period. 

The Medicaid Reentry Act empowers states to restore access to addiction treatment through Medicaid for incarcerated individuals up to 30 days before their release, responding to alarming data that show individuals released from incarceration are 129 times more likely to die of a drug overdose during the first two weeks after release.

Read Rep. Tonko’s full remarks and questions to Secretary Becerra below:


Thank you, Madam Chair. And thank you Secretary Becerra for your leadership and for joining us today.

I applaud the Department of Health and Human Services (HHS) important step in moving forward with new buprenorphine practice guidelines that will save lives. I am concerned though that the x-waiver itself remains which means prescribers will have to actively apply for what essentially will be a waiver to the waiver. This will leave an unnecessary barrier in place.  

Secretary Becerra, I appreciate your previous comments that the x-wavier requirement should be removed, and we look forward to working with you to accomplish this important goal. The x-waiver reflects a longstanding stigma around substance use treatment, and sends a message to the medical community that they lack the knowledge or ability to effectively treat individuals with substance use disorder. Keeping the waiver in place continues to create a barrier to access to treatment.

  • Was HHS limited in the actions it could take regarding fully eliminating the x-waiver and lifting patient caps?
  • Can HHS fully eliminate the x-waiver without congressional action?

I would also like to enter for the record a letter supporting urgency in passage of the bipartisan Mainstreaming Addiction Treatment Act. The letter is signed by 120 organizations including the American Medical Association, The Pew Charitable Trusts, End Substance Use Disorder, the American Academy of Pediatrics, National Association of Boards of Pharmacy and the National Association of Attorneys General.

As you know, I am a proud supporter of the MAT Act which would fully eliminate the x-waiver requirement, and authorize the Secretary of HHS to conduct a national campaign to educate practitioners about the change in law, and encourage providers to integrate evidence-based medication-assisted treatment into their practices.

  • Would HHS support congressional action to authorize the Secretary of HHS to conduct a national campaign to educate practitioners about the change in law, and encourage providers to integrate evidence-based medication-assisted treatment into their practices?

Thank you for this tremendous step forward and I hope we can work together to pass the bipartisan MAT Act without delay, and further expand access to lifesaving medication-assisted treatment by eliminating the stigma and barriers associated with the x-waiver.



Another effort that would make a huge difference in this crisis is the Medicaid Reentry Act which would empower states to restore Medicaid eligibility for incarcerated individuals up to 30 days before their release to ensure those transitioning will have immediate access to critical services including mental health support, addiction treatment and COVID testing.

Granting states the ability to jump-start Medicaid coverage for these individuals will mean they are not only able to receive life-saving treatment for mental health, substance use disorders and other conditions, it will also help them stay out of our already overburdened hospitals and on the path to recovery and rebuilding their lives. We were grateful to have the President’s support on Reentry and were disappointed that the language was removed from the final reconciliation package for jurisdictional concerns.

  • Is the President still committed to this population, and would he be willing to include this provision in his budget?
  • As HHS identifies ways to reduce the increasing number of overdose deaths and to strengthen access to evidence-based SUD treatment services and medications, would passage into law of the Medicaid Reentry Act help to achieve those important goals?
  • Have you or will you consider talking to OMB about including Medicaid Reentry in your budget?


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