Gov. Chris Christie's recent talk about the importance of protecting health insurance for hundreds of thousands of people covered under the Medicaid expansion gives us new hope.
Will he stick his neck out in the addiction fight and hammer away at the importance of protecting the expansion, even as he auditions for a job with team Trump?
The big threat now is that Republicans will block-grant Medicaid. Christie previously argued that funding for drug treatment would be preserved under a block grant, because everyone agrees we should spend a significant sum on the opioid crisis.
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That's a fantasy. The reality is, once you turn a program into a block grant, the federal funding gets cut. Just look at the 13 federal programs that have been block-granted already, which have been cut by an average of 26 percent since 2000, according to the nonpartisan Congressional Research Service.
A block grant puts a flat cap on federal spending and doesn't adjust for unexpected issues like the opioid crisis, so states have to come up with all the money themselves. Even if overdose deaths skyrocket, as they have in New Jersey over the past five years, the grant wouldn't budge.
Currently, there's flexibility in the Medicaid program: If a state puts up some money for a particular need, the feds will match it at a favorable rate. This is how the Christie administration was able to add more drug treatment benefits, both outpatient and at halfway houses, for thousands of poor people on Medicaid - because the feds were paying up to 95 percent of the cost.
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A block grant would end that partnership, so it would be entirely up to state government to foot the bill for a crisis. That's why other Republican governors, like John Kasich of Ohio, have long been outspoken in their defense of the Medicaid expansion, particularly when it comes to drug treatment.
"Thank God we expanded Medicaid because that Medicaid money is helping to rehab people," Kasich said last month.
More precisely, thank Obamacare. We're skeptical about Christie's claim, which he repeated to CNN's Jake Tapper on Sunday, that the repeal of the Affordable Care Act won't cause Americans to lose health coverage. All the Republican ideas put forward so far would leave huge numbers of people without coverage.
But at least our governor made an effective case for the Medicaid expansion when he cited progress on the addiction front as an example of how this aspect of the Affordable Care Act has clearly helped people.
Christie also added that he wants to play a role in making sure people don't lose their coverage: "I'm really hopeful that we're going to be able to be a participant in that conversation," he told Tapper.
Well, here's his chance: Let's hope he gets a few words in about this today at his lunch with President Trump.
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