When congressional Republicans proposed a multiyear, $45-billion increase in opioid spending in their 2017 bill to roll back the Affordable Care Act, Ohio Gov. John Kasich, a Republican, dismissed the money as akin to “spitting in the ocean,” especially because the bill also would have cut Medicaid significantly. Kasich has been among the most aggressive governors in tackling the opioid crisis and opposing Medicaid cuts.

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Trump talks up combating opioids, yet his funding shortfall and Medicaid cuts blunt his plans