The MORE Savings Act seeks to expand access to evidence-based opioid treatments by removing cost-sharing for medications, behavioral health services, and recovery support tied to opioid use disorder. It would advance a Medicare model to eliminate coinsurance, copays, and deductibles for these services and materials, and would extend a coverage mandate to private group plans and health insurers under PHSA, ERISA, and the Internal Revenue Code.
The bill also adds a Medicaid enhancement and a state option to fund recovery support services as part of medication-assisted treatment, with a sweeping effective date in 2027. The package focuses on payer rules and incentives rather than creating new treatment modalities, aiming to reduce financial barriers to care and support sustained recovery.
At a Glance
What It Does
The act creates a pilot-like model to remove cost-sharing for evidence-based opioid treatments—drugs, behavioral health services, and recovery support—under Medicare Parts B and D, and requires private plans to cover these items with no cost-sharing. It also codifies expanded Medicaid support for MAT and recovery services and sets up a higher FMAP for MOUD.
Who It Affects
Medicare beneficiaries, participants in group health plans and private insurance, and state Medicaid programs. Providers delivering MAT, behavioral health treatment, and recovery services will see coverage expansion, and rural or high-need states may be targeted for initial testing.
Why It Matters
By removing financial barriers to MAT, overdose reversal medications, and recovery support, the bill aims to improve treatment uptake, reduce overdose deaths, and support long-term recovery, potentially lowering overall health costs and volatility in opioid-related care.
More articles like this one.
A weekly email with all the latest developments on this topic.
What This Bill Actually Does
The MORE Savings Act targets financial barriers to opioid-use disorder treatment across multiple payers. It includes a pilot-like model within Medicare that would eliminate coinsurance, copayments, and deductibles for drugs and biologicals used to treat opioid use disorders or reverse overdoses, as well as for behavioral health services and community recovery support services tied to such treatments.
The model would be tested in 15 states chosen based on Medicare beneficiary share, overdose death rates, and rural presence, with special rules limiting termination or modification for the first five years of the model. The intent is to create affordable access to a full continuum of care for opioid use disorders through Medicare and to explore how such coverage could work more broadly in the system.
Separately, the bill codifies mandatory coverage under multiple payers for opioid treatments: prescription drugs for treatment and overdose reversal, behavioral health services for treating opioid use disorders (including non-hospital residential facilities licensed to provide such treatment), and recovery support services such as peer counseling and transportation. This coverage would apply to group health plans and health insurers under PHSA, ERISA, and the Internal Revenue Code, ensuring no cost-sharing for these services.
The practical effect is a broad, no-cost-sharing baseline for evidence-based OUD care across public and private plans. The legislation also makes a Medicaid-related advance by offering an enhanced federal match for medication-assisted treatment and recovery support services.
States would have the option to include recovery support as part of MAT, funded at a 90 percent FMAP rate during the designated period. In addition, the bill extends MOUD and recovery-support coverage to the Medicaid program, creating incentives for states to expand and sustain these services beyond the private market.
The overall architecture centers on payer rules and incentives, not new clinical models, with a 2027 effective date for the private-sector and ERISA/IRC provisions and a transitional period for Medicaid.
The Five Things You Need to Know
The bill eliminates coinsurance, copayments, and deductibles for opioid-use-disorder drugs and related services under Medicare Parts B and D, and prohibits cost-sharing for recovery support services.
A CMS Innovation-style model will be piloted in 15 states to test no-cost-sharing for evidenced-based OUD treatments, with selection criteria including overdose rates, Medicare beneficiary share, and rural presence.
Private group health plans and health insurance issuers must cover opioid-use-disorder drugs, behavioral health services, and recovery supports without cost-sharing under PHSA, ERISA, and IRC, effective for plan years beginning in 2027.
Section 4 boosts Medicaid funding for MAT and recovery support by offering a 90% FMAP for MOUD expenditures during the initial period, and allows states to cover recovery-support services as part of MAT.
The act creates a formal, cross-payer approach to OUD treatment coverage across Medicare, private plans, and Medicaid with a 2027 effective date and a focused 15-state pilot.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
Short title and citation
This section designates the act as the Maximizing Opioid Recovery Emergency Savings Act (MORE Savings Act). It establishes the identifier by which the bill will be referenced in policy discussions and formal records.
Testing of elimination of Medicare cost-sharing for evidence-based opioid treatments
Section 2 amends the Social Security Act to create a model (the described subparagraph) that eliminates cost-sharing for drugs and services used to treat opioid use disorders or reverse overdose, including behavioral health and recovery support services. The model is to be piloted in 15 states selected by criteria such as high Medicare beneficiary concentration, overdose death rates, and rural presence. The five-year window is staged so that termination or modification provisions do not apply in the initial five-year period.
Coverage of opioid treatments
Section 3 adds new coverage requirements across PHSA Part D, ERISA, and IRC. Plans and issuers must cover and not subject to cost-sharing: (1) opioid-use-disorder drugs and overdose reversal medications; (2) behavioral health services for OUD treatment, including non-hospital residential facilities licensed to provide such care; and (3) community recovery support services linked to MAT, such as peer counseling and transportation. The section also codifies a parallel but separate set of coverage obligations in each of PHSA, ERISA, and the IRC, with clerical amendments to reflect the new section numbers.
Enhanced federal match for MOUD and recovery support under Medicaid
Section 4 broadens Medicaid's financial support for MAT and recovery services. It provides a 90 percent FMAP for MOUD-related expenditures during the specified period for states meeting the criteria, and it allows states to include recovery support services (e.g., peer counseling and transportation) as part of MAT. This section also describes the broader implementation timeline and the interplay with MOUD coverage.
This bill is one of many.
Codify tracks hundreds of bills on Healthcare across all five countries.
Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Medicare beneficiaries with opioid use disorder gain lower or zero out-of-pocket costs for MAT, overdose reversal meds, and recovery services.
- Participants in group health plans and private insurers benefit from no-cost-sharing for covered OUD treatments, improving access and adherence.
- Medicaid beneficiaries in states adopting MOUD expansion and recovery-support payment rules benefit from enhanced funding and broader service availability.
- Community-based recovery providers (peer counselors, transportation services) may experience higher demand and clearer reimbursement pathways.
- Licensed non-hospital residential facilities and other treatment providers receive expanded coverage for services tied to MAT and recovery support.
Who Bears the Cost
- Health plans and private insurers may face higher upfront costs due to eliminated cost-sharing and expanded benefit mandates.
- Employers sponsoring self-funded or ERISA-based plans could incur increased plan costs associated with broader coverage.
- State Medicaid programs face higher federal-outlay matching requirements during the MOUD-focused period.
- Some providers and facilities might incur administrative costs to align with new coverage rules and reporting requirements.
- The federal government bears the cost of the enhanced FMAP for MOUD during the designated period.
Key Issues
The Core Tension
The central dilemma is balancing broad access to evidence-based OUD treatment and recovery services with the cost and administrative feasibility of removing cost-sharing across multiple payers and programs, while ensuring the federal funding mechanisms (like the FMAP increase) remain sustainable and correctly targeted.
The bill leans on a pilot-like model with select states, which raises questions about generalizability and how results will be measured across diverse markets. While it removes cost-sharing, the actual budgetary impact remains to be quantified, and there is potential tension between payer-wide cost controls and the expanded benefit set.
The definition of recovery support services is broad and could invite variability in eligibility and pricing across plans and states. Additionally, the 90 percent FMAP expansion in Medicaid creates a large federal obligation whose duration and sunset are not fully specified in the excerpt, raising questions about long-term sustainability and state-level budgeting.
The interaction between Medicare, private payers, and Medicaid in a single reform package also creates implementation complexity for issuers, employers, and state agencies.
Try it yourself.
Ask a question in plain English, or pick a topic below. Results in seconds.