Turn the Tide Act

Bill Number

S. 4895

Origin Chamber

Senate

Congress

119th Congress, Session 2

Status

Introduced

Latest Action

2026-06-24: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Last Updated

2026-07-07T04:53:29Z

AI-Generated Summary

Turn the Tide Act (S. 4895)

Purpose This legislation provides direct federal funding and reauthorizes programs originally established under the SUPPORT for Patients and Communities Act (Public Law 115-271) to support substance use disorder prevention, treatment, recovery, and related public health and law enforcement efforts. It targets the opioid crisis by appropriating funds for fiscal years 2027–2030 (with some extensions to 2036) and modifies certain rules to improve access to care.

Key Provisions

• Funding Appropriations: Amends multiple existing laws to appropriate specific amounts for grants and programs, including:
• $4 million annually for substance use disorder treatment access grants.
• $10 million annually for drug disposal programs.
• $77 million annually for first responder training.
• $50 million annually for residential treatment for pregnant and postpartum women.
• $75 million annually for mental and behavioral health education grants.
• $516 million annually for preventing overdoses.
• $5.5 billion annually for State Opioid Response Grants (with flexibility for broader substance use disorders).
• $3 billion annually (2027–2031) for substance abuse prevention and treatment block grants.
• Additional funding for recovery housing ($60 million annually), comprehensive opioid abuse grants ($500 million annually), Drug-Free Communities ($175 million annually), High-Intensity Drug Trafficking Areas ($350 million annually), drug courts ($125 million annually), and other initiatives.
• Insurance and Medicaid Changes: Prohibits states from imposing prior authorization or utilization controls on medication-assisted treatment under Medicaid; limits cost-sharing for opioid overdose reversal medications in private insurance, employer plans, and Medicare Part D; requires Medicaid to pay behavioral health providers at least Medicare rates (with 100% federal match for added costs through 2030).
• Demonstrations and Extensions: Creates a Medicaid demonstration for recovery housing; extends certain delivery system reform waivers to 2028; expands Drug-Free Communities grants with priority for high-need areas.
• Other Programs: Funds law enforcement mental health wellness ($15 million annually), adverse childhood experiences response teams ($10 million annually), and workforce loan repayment increases.

Significant Changes to Existing Law

• Shifts from discretionary authorizations to mandatory appropriations for many programs, locking in funding levels through 2030.
• Updates funding formulas and priorities to favor states with high unemployment, low labor force participation, and elevated drug overdose death rates.
• Removes barriers like prior authorization for medication-assisted treatment and overdose reversal drugs.
• Increases minimum state allocations and adds flexibility for tribes and local governments.
• Ties some grants to performance metrics, such as spending timelines and risk-adjusted budgets.

Potential Impacts

• Government Agencies: Increases resources for the Department of Health and Human Services, Centers for Disease Control and Prevention, Office of National Drug Control Policy, and Department of Justice to expand oversight, data collection, and grant administration.
• Citizens: Improves access to treatment, reduces out-of-pocket costs for reversal medications, and supports recovery services, potentially lowering overdose deaths and emergency care use.
• State and Local Governments: Provides billions in new funding with requirements for rapid spending and formula-based allocations; some states gain priority based on need metrics.
• No direct effects on international relations are specified.

Main Stakeholders Affected

• States, territories, the District of Columbia, and Indian Tribes (as grant recipients and Medicaid administrators).
• Health care providers, behavioral health professionals, and treatment facilities.
• Patients with substance use disorders and their families.
• Law enforcement agencies and first responders.
• Recovery housing operators and community organizations.
• Insurance plans and Medicare/Medicaid beneficiaries.

Notable Legal, Constitutional, or Political Implications

• Mandates specific payment rates and cost-sharing rules, potentially affecting state Medicaid flexibility and insurer practices.
• Includes provisions for technical assistance, evaluation, and formula transparency to comply with congressional oversight.
• Focuses on evidence-based approaches to substance use disorders without altering core constitutional authorities.

This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.

Sponsor

Sen. Shaheen, Jeanne [D-NH]

Cosponsors (1)

Sen. Hassan, Margaret Wood [D-NH]

Recent Actions

• 2026-06-24: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
• 2026-06-24: Introduced in Senate

Bill Versions

• Turn the Tide Act — issued 2026-06-24 — PDF (50 pages)