ARI SHAPIRO, HOST:
Each day, nearly 100 people die from heroin and other opioid-related overdoses in the U.S. President Trump campaigned on a promise to address the problem. Now advocates and lawmakers say they're getting mixed messages from the Trump administration. NPR White House correspondent Tamara Keith reports.
TAMARA KEITH, BYLINE: As a candidate, Trump frequently visited New Hampshire, a swing state that had been ravaged by opioids.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: We have a problem here. We have millions and millions of people in our country that are badly addicted and that will die soon.
KEITH: In a campaign that was heavy on platitudes and light on policy, a speech Trump gave in mid-October in Portsmouth, N.H., stood out for its level of detail about how he would deal with the problem.
(SOUNDBITE OF ARCHIVED RECORDING)
TRUMP: I would dramatically expand access to treatment slots and end Medicaid policies that obstruct inpatient treatment. You've got to do this.
KEITH: On another occasion right before the election, Trump sat down with New Hampshire families, law enforcement and advocates. Jessica Nickel, president of the Addiction Policy Forum was there.
JESSICA NICKEL: You know, he shared about his brother's story and sort of how this impacted his family. And he had some great points that we were pleased that he focused so much on prevention and the need for a comprehensive response.
KEITH: Trump's brother was an alcoholic and died young. The candidate told everyone there he'd invite them to the White House if he won. Of course, he did win, and now people who were encouraged by Trump's words on the campaign trail are looking for action. Senator Rob Portman is a Republican from Ohio. He's the co-author of major opioid legislation that passed last year.
ROB PORTMAN: We've used some of his comments from the campaign to say to the folks in his administration, you know, at Department of Justice, at HHS, let's implement these things. This is what he said in the campaign. And we all know this is a crisis.
KEITH: Portman is happy with some recent administration moves and deeply concerned about others. A leaked budget document called for a 94 percent cut to the White House Office of Drug Control Policy, known as the drug czar. The office coordinates drug policy across federal agencies. The document also called for the elimination of two drug-related grant programs, one of which Portman helped create.
PORTMAN: The crisis is getting worse, and people are talking about cutting the funding for things that have been proven to work. It doesn't make any sense.
KEITH: A White House spokesman wouldn't comment on the specifics of the budget document but said the White House's commitment to fighting the problem goes beyond this one office. Democratic Senator from Minnesota Amy Klobuchar says the office and its grant programs help local governments.
AMY KLOBUCHAR: You need a lot of coordination, and you need the police, especially in rural areas, and sheriffs. They just can't do it alone in a small department.
KEITH: The president has yet to nominate a drug czar, and the office has had two acting director since Trump took office. And then there's the matter of health policy. The bill to repeal and replace the Affordable Care Act that passed the House earlier this month would phase out Medicaid expansion, which covers a significant share of addiction treatment. Here's New Hampshire Senator Maggie Hassan, a Democrat.
MAGGIE HASSAN: On the one hand, they're talking about how much they care about this issue. And on the other hand, they're proposing measures that would undermine our efforts to save lives and really roll us backward.
KEITH: This is something Health and Human Services Secretary Tom Price heard recently as he traveled to hard-hit states on a listening tour. In West Virginia, 50,000 people who have challenges related to addiction receive coverage through Medicaid expansion. The state's Health and Human Resources Secretary Bill Crouch spoke at a press conference standing next to Price about what losing Medicaid expansion could mean.
(SOUNDBITE OF PRESS CONFERENCE)
BILL CROUCH: It's a grave concern. Our crisis right now is difficult to deal with. If we have an additional 50,000 individuals with no coverage, no way to get treatment, we think our problem is going to be light years more difficult.
KEITH: Price defended the bill.
(SOUNDBITE OF ARCHIVED RECORDING)
TOM PRICE: We don't believe 50,000 people will lose coverage. What our goal is, is to make certain that anybody that transitions from one program to another continues to have coverage, that the rug isn't pulled out from anybody, that nobody falls through the cracks.
KEITH: That's one of many promises the Trump administration has made recently. Advocates and lawmakers alike are watching, ready to push the president to do what they think is right when it comes to tackling the opioid crisis. Tamara Keith, NPR News.
(SOUNDBITE OF MAC DEMARCO SONG, "MY KIND OF WOMAN") Transcript provided by NPR, Copyright NPR.
