White House rejects appeal to call national emergency over opioid epidemic


President Trump, with Health and Human Service Secretary Tom Price and first lady Melania Trump, shortly before a meeting on the opioid crisis.EVAN VUCCI/AP



ASHINGTON — The Trump administration on Tuesday stopped short of declaring the opioid epidemic a national emergency, rejecting an urgent recommendation from a White House panel on tackling the crisis.

“We believe at this point that the resources we need or the focus that we need to bring to bear to the opioid crisis, at this point, can be addressed without the declaration of an emergency,” Health and Human Services Secretary Tom Price said at a press conference in Bedminster, N.J., after a meeting with President Trump and other White House officials.

He added that the option, like the rest of the policies suggested in the commission’s report, was still “on the table.”

The Commission on Combating Drug Addiction and the Opioid Crisis, chaired by New Jersey Gov. Chris Christie, called an emergency declaration it’s “first and most urgent” recommendation, in an interim version of a long-awaited report last week that included a number of policy proposals for addressing the crisis.

“Declare a national emergency under either the Public Health Service Act or the Stafford Act,” the five-member panel wrote to the president, adding that the option is “direct and completely within your control.”

Nationally, the number of overdose deaths has topped 50,000 in recent years, and experts see no sign of a leveling off. Trump himself has promised repeatedly, since his presidential campaign, to tackle the crisis head on.

“We’re going to have a tremendous team of experts and people that want to beat this horrible situation that has happened in our country — and we will. We will win. We have no alternative,” Trump said in brief remarks before Tuesday’s meeting.

But Price suggested that most of the policy solutions that advocates have called for, like offering waivers from certain Medicaid reimbursement rules, don’t require an official declaration.

“We’re talking about what should be done and working through the department and through the other agencies to come forward with that coherent strategy, that comprehensive strategy and recommendation for the president, and will do so in short order,” he said.

It was not immediately clear what an emergency declaration would have meant for the federal government’s response to the opioid crisis. Under the laws that govern emergency declarations, the president himself must spell out what resources will become available and what powers his administration will have under the emergency declaration.

An emergency declaration under the Stafford Act — the law that governs natural disaster declarations and some public health emergencies — could let states in some of the hardest-hit areas apply for millions of dollars in federal aid through the Disaster Relief Fund.

Price himself could also declare a public health emergency. Under such a declaration, he could change federal Medicare or Medicaid rules to make it easier for different health care professionals to address the crisis. He could, for example, let doctors provide care in states where they’re not officially licensed, or waive certain rules about how doctors can refer patients. He might also be able to direct more public health personnel toward states overwhelmed by the epidemic.

“There’s never been a federal emergency declaration for something like opioids — they’re for things that are more traditionally thought of as public health emergencies, like hurricanes or infectious disease outbreaks like H1N1, so there’s not a lot of precedent for something that’s not a natural disaster and not a communicable disease,” said Lainie Rutkow, an associate professor at the Johns Hopkins Bloomberg School of Public Health.

In his remarks, Trump emphasized that law enforcement officials are targeting drug dealers and working to stop the flow of drugs from China and Mexico, two of the main sources of opioids like heroin and illicit fentanyl. He only briefly mentioned working with health experts.

While experts say stemming the flow of drugs is part of any solution, many, including top administration officials, have said that law enforcement alone cannot end an addiction crisis. That points to the need to expand treatment for people who are already addicted to opioids, experts say.