ST. PAUL - District 22A Rep. Joe Schomacker, R-Luverne, voted Jan. 31 against bill HF400, which seeks to reform prevention and treatment for opioid addiction in Minnesota.

The Minnesota House of Representatives Health and Human Services Policy Committee convened to discuss the bill and heard testimonies in support of and in objection to the proposed legislation. A few citizens expressed concern that the registration fees may penalize wholesale distributors unfairly.

The bill would establish an Opioid Stewardship Advisory Council, an opioid stewardship account, a registration fee for opioid manufacturers and distributors, and new efforts toward prevention, education and intervention of opioid addiction throughout the state. Schomacker’s objection to the bill centers on the registration fee.

The bill proposes to exact an annual registration fee on each opioid manufacturer and distributor who operates in the State of Minnesota based on the reported number of opioids made or sold.

The fees would bring a total of $20 million annually, which would be placed in an opioid stewardship account for the purposes of funding social services for children placed due to parental opioid addiction, providing grants to non-profit organizations that advocate for prevention and provide treatment for opioid addiction and increasing salaries for people who work in substance abuse services.

Funding would be distributed at the discretion of the state commissioner of human services under recommendation from the Opioid Stewardship Advisory Council, 20 members made up of legislators, medical professionals, law enforcement representatives and individuals with personal experience fighting opioid addiction.

The bill also requires all health insurance plans to cover acupuncture for pain management; prescribers to take two credits of continuing education on best practices; and schools to teach opioid addiction prevention in grades 5, 6, 8, 10 and 12.

It would establish a limit of a seven-day supply on the amount of opioid medication that can be prescribed following trauma or surgery. Additionally, patients would not be allowed to fill an opioid prescription more than 30 days after the medication has been prescribed.

All of these adjustments, along with others the bill outlines, are a step in the right direction, Schomacker said, except for the method of funding. He believes pharmaceutical companies who have advertised and pushed opioids and medical professionals, who have over-prescribed opioids, ought to be held financially accountable. That concurs with a statement lawmakers heard last week from Chris Johnson, an emergency medicine physician in St. Louis Park.

“This crisis was not an accident,” said Johnson, citing the 50,000 deaths from opioids in 2016. “That was engineered.”

In contrast to manufacturers, opioid distributors are just middlemen. They sell all kinds of pharmaceuticals and don’t benefit as directly from the production of opioids.

Matthew Di Loreto, vice president for the Healthcare Distribution Alliance, also spoke to lawmakers and said requiring distributors to pay a registration fee will just make opioids more expensive for the consumer. He also predicted some distributors might decide the registration fee is too big a burden and simply stop distributing opioids - an action that would limit accessibility to the consumer.

Schomacker agrees that charging distributors will increase costs to families. The law would apply to veterinary care and end-of-life care as well, so many Minnesotans would be potentially impacted by the price increase.

Regional statistics show that locally, opioid overdoses and deaths are not a major health concern, though prescribing rates appear high compared to the state average of 410 per 1000 residents.

While there may not be a great need for the additional resources the bill seeks to offer, local consumers would still bear the increased cost of opioid prescriptions that stands to result if the bill as it currently reads is passed.

“We do not have the bill right yet,” bill co-author Rep. Dave Baker, R-Willmar, conceded during Thursday’s meeting. “We have a lot of places to make it better, and we are committed to doing that.”