Opioid proposals prompt questions; tax windfall eyed

Proposals to combat opioid addiction were met with questions about effectiveness in a legislative hearing Friday. And senators discussed whether a windfall from federal tax reform could let them avoid budget cuts.

Sen. John Kuehn is proposing customers who pick up opioid prescriptions from pharmacies be required to show photo ID. Kuehn said 11.5 million Americans misuse opioids, and such a requirement is basic. “Current federal and Nebraska state law requires identification for the purchase of over-the-counter products containing ephedrine, including sudafed. You also may be aware that you can’t receive a shipment of wine delivered to your home, even though legally purchased, unless you have someone present with a valid photo ID over the age of 21. It only makes sense that positive identification should be required” for purchasing opiates, Kuehn said.

Andy Hale of the Nebraska Hospital Association supported Kuehn’s proposal. Hale says at least 38 people died of opiate overdoses in Nebraska in 2016, and the number could be higher.

But Joni Cover of the Nebraska Pharmacists Association opposed the bill. Cover says pharmacists know their customers, and the bill could pose problems for people who don’t pick up their own prescriptions. That led Sen. Laura Ebke to ask if that problem could be solved by designating someone at a nursing facility to show their ID. “What we’d rather see is there be no ID requirement for nursing homes or assisted living facilities or nursing homes, where you have a relationship between the facility and the pharmacy,” Cover replied.

Dr. John Massey, a Lincoln pain physician, also opposed the bill. I think we get a false sense of security if we say this is John Smith, this is a prescription for John Smith, everything’s okay,” Massey said. “Really, diversion is about people who have family members who they can leverage to get meds when they shouldn’t, and therefore put themselves at risk or friends, or things like that. So, while diversion is a big problem, I don’t this is going to address that in the way we hope it might.”

Kuehn said he is willing to work with critics to modify his proposal. But he expressed frustration with doing nothing. “When are we going to step forward collectively and say ‘We have to address this problem on every front possible’? Kuehn asked. “We can walk and chew gum in this state. We can walk and chew gum as legislators. And if we’re going to address the issue and prevent family members, our friends, from dying, from having lifelong addictions, from having the total cost to our families and communities across the state, we have to stop making excuses and throwing mud at every solution that’s put forward, and do something.”

The Judiciary Committee also heard proposals to limit opioid prescriptions for patients under age 19 to seven days, with certain exceptions, and to require doctors to inform patients about the risks of overdose and addiction. The committee took no immediate action on the bills.

And on the legislative floor Friday, senators had a preliminary discussion about whether a windfall from federal tax reform could let them avoid cutting the budget. Sen. Adam Morfeld raised the subject, criticizing Gov. Pete Ricketts for proposing changing state tax law to avoid collecting extra money. “His own Department of Revenue admitted that in a press release last week, stating that we have to make some minor adjustments so that we can eliminate (a) $200 million revenue windfall, is the way that they put it, when that’s about the amount of a shortfall that we have to cover in this budget. These cuts are unnecessary, and they’re dangerous,” Morfeld said.

Morfeld is particularly upset about proposed cuts to the University of Nebraska, whose Lincoln campus is in his district. Sen. Jim Smith, who’s introduced a bill for the governor to avoid collecting the windfall, said lawmakers need to pass it. “If we do not, there will be an increase in tax revenues on the backs of individuals in this state, particularly middle-income individuals, because they will have lost one of their personal exemptions. And that could result in a couple of hundred million dollars tax increase on the backs of individuals in this state. I don’t think that’s really what we want to have happen,” Smith said.

Sen. Paul Schumacher said trying to keep the money would disproportionately affect lower income people. “Who pays that bill? It’s the people – everybody who files a tax form. And it’s regressive. No matter if you’re making a million dollars a year or ten thousand dollars a year, it zaps you the same way,” Schumacher said.

Smith’s bill has not yet been scheduled for a public hearing.