By Rachel Spears and Aneri Pattani, KFF Health News
Washington, D.C.’s proposed fiscal year 2027 budget would shift funding for opioid treatment and prevention services away from the district’s Medicaid program and toward money the city won from opioid manufacturers and distributors in national settlements, a move addiction policy experts and advocates say could leave a critical safety net worse off.
The district’s Department of Behavioral Health (DBH) has proposed using opioid settlement dollars to backfill funding gaps left by federal Medicaid cuts, rather than treating the settlement money as an addition to existing behavioral health spending, as the settlements were largely intended.
“These settlement funds were supposed to be new money for a new problem,” said Shelly Weizman, a Georgetown University addiction law and policy expert. “Using them to replace money that’s already being cut defeats the purpose.”
Chad Jackson, a DC resident in recovery, said the services funded through Medicaid and settlement dollars alike have been essential to keeping him alive and stable. Advocates including Queen Adesuyi have pushed the DC Council to reject the budget shift.
DC Councilmember Christina Henderson has raised concerns about the proposal, and DC Attorney General Brian Schwalb’s office, which negotiated the settlements, has weighed in on how the funds should be spent. A DBH spokesperson, Denise Reed, said the agency is working to ensure continuity of services during the budget transition.
Documents obtained by KFF Health News, including letters from advocacy groups, show growing pressure on the council ahead of a final budget vote. The city’s opioid settlement oversight commission is reviewing how funds are allocated under DC law governing settlement spending. Groups such as Reframe Health and Justice have also raised concerns about the precedent nationally.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF and KFF Health News.