Turn the Tide Act
Sponsored By: Senator Shaheen, Jeanne [D-NH]
Introduced
Summary
Expands federal support for prevention, treatment, recovery, and housing for people with substance use disorders. It pairs large new grant programs and Medicaid payment changes with coverage rules that limit prior authorization for medication-assisted treatment and require zero cost-sharing for opioid overdose reversal agents.
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 7 benefits, 0 costs, 0 mixed.
Justice and enforcement opioid funding
If enacted, the bill would fund several law‑enforcement and justice programs addressing opioids and related harms. Examples include $500 million a year for a Comprehensive Opioid Abuse grant program, $125 million a year for the Drug Court Program (plus $5 million for training), $350 million a year for HIDTA, $50 million a year for ONDCP activities, and $15 million a year for law enforcement mental health pilots for FY2027–FY2030. It would also create a DOJ grant program for ACE response teams with $10 million a year for FY2027–FY2030.
Big state opioid response grants
If enacted, the bill would authorize $5.5 billion a year for State Opioid Response grants for each of FY2027–FY2031. The program would reserve $50 million a year for Indian Tribes, send 15% of remaining funds to the States with the highest opioid mortality, and guarantee at least $4 million to each State. No more than 2% may be used for federal admin, training, and evaluation.
More prevention, treatment, and recovery grants
If enacted, the bill would fund many new and expanded grants for overdose prevention, child trauma, youth prevention, family residential treatment, recovery centers, community recovery, drug disposal, infection surveillance, and related public-health activities for FY2027–FY2030 (and some programs through FY2032). Examples include $516 million a year for overdose prevention, $112 million a year for child traumatic stress, $50 million a year for residential care for pregnant and postpartum women, and $60 million a year for recovery housing for FY2027–FY2032. Grants would go to States, Tribes, local groups, and community providers.
Higher Medicaid behavioral health pay
If enacted, Medicaid payment rates for certain behavioral health services for patients with substance use disorders would be set at no less than 100% of the Medicare Part B rate from October 1, 2026 through October 1, 2030. For the part of spending above each State's July 1, 2026 rate, the federal share would be 100 percent. The HHS Secretary must issue rules quickly on when services count under this change.
Medicaid MAT and recovery housing
If enacted, States could not apply utilization controls, such as prior authorization, to medication-assisted treatment (MAT) for Medicaid beneficiaries starting October 1, 2026 if they want federal Medicaid payments for that care. The bill would also create a Medicaid demonstration to let some States test paying managed-care plans more to provide recovery housing to eligible enrollees aged 21–64 who have opioid use disorder and lack a permanent residence. The measure would require the HHS Secretary to extend certain State delivery-system waivers and let States use the same annual allotment to train direct service workers during the extension.
More SUD workforce training and loan help
If enacted, the bill would boost funding for the substance use disorder workforce. It would raise targeted loan repayment to $65 million a year for FY2027–FY2031 and fund multiple training and demonstration programs (for example, $77 million a year for first responder training, $75 million a year for mental and behavioral health training, plus targeted training grants and technical assistance). It would also fund model training on SUD records and regional education centers for FY2027–FY2030.
No-cost naloxone in health plans
If enacted, group and individual health plans and Medicare Part D plans would have to cover at least one FDA-approved opioid overdose reversal drug with no cost-sharing starting for plan years on or after January 1, 2027. Plans could not use prior authorization or similar utilization controls for that covered agent. The bill would also create an IRS safe harbor so high-deductible plans could waive a deductible for an overdose agent and still be HSA-eligible for plan years beginning on or after January 1, 2027.
Sponsors & CoSponsors
Sponsor
Shaheen, Jeanne [D-NH]
NH • D
Cosponsors
Sen. Hassan, Margaret Wood [D-NH]
NH • D
Sponsored 6/24/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov