In a rare bipartisan move, both the House and Senate have reached a compromise on legislation to address the opioid epidemic. Another part of the legislation could make it easier for Medicaid recipients to get inpatient care for substance abuse over the next five years.

Containing a mix of law enforcement and public health measures, including one that aims to block deadly fentanyl from being imported through the mail and one that will allow more nurses to prescribe medication for opioid addiction, the bill is 653 pages long, The New York Times reported.

But addiction experts say that while many of the measures will help incrementally, the investment still falls short of what is needed to stem the tide of opioid abuse. Nearly 50,000 Americans died in opioid-related deaths in 2017, The Times reported.

Both chambers still need to vote on the compromise bill. The House could vote this week before its members adjourn to hit the campaign trail, and the Senate could take it up next week.

Improved access to treatment

One of the most expensive provisions — which had been a sticking point between the two chambers — will repeal an obscure rule that blocks states from spending federal Medicaid dollars on residential addiction treatment at centers with more than 16 beds.

The rule was originally intended to discourage warehousing of people with mental illnesses in psychiatric hospitals, which was far more common when it was written in 1965. More recently, the rule has limited the number of beds available for low-income patients suffering from addiction, although there were several ways for states to circumvent it.

Some addiction specialists worry that the bill’s expansion of inpatient care will eclipse the importance of longer-term outpatient programs that focus on medication-assisted treatment, which researchers consider the gold standard for treating opioid addiction. Many residential programs for opioid addiction still don’t offer such treatment as part of their protocol, and the bill does nothing to address that.

Blocking mail orders of illegal drugs

The bill includes a provision to help stop the flow of illicit opioids into the country by mail, especially synthetic fentanyl and its analogs, which are fueling the rise in overdose deaths. The provision was pushed by Senator Rob Portman, Republican of Ohio, whose state has been especially hammered by the opioid epidemic.

It will require the United States Postal Service to start collecting information on international mail shipments, just as private carriers like Fed Ex and DHL already have to do.

By the end of this year, the Postal Service will need to provide the name and address of the sender and the contents of the package, as described by the sender, for at least 70% of all international packages, including all of those from China. It will have to provide the information on all such shipments by the end of 2020.