If last year taught us anything, it’s that the majority of Republicans used ObamaCare as their DACA: a campaign talking point to gain votes. But much to the surprise of many of us politics nerds—after three attempts at repealing the overreaching, economic albatross that is the ACA—we were pleasantly surprised by the tax bill that repealed ObamaCare’s individual mandate. It was a victory for economic freedom: we’re no longer forced to buy a product we don’t necessarily need or want, then suffer penalties via the heavy hand of the IRS for not complying. Winning!

So why do I bring up the Repeal³ fiasco? Because it just may rear its head again with a fix buried within the bloated Trump budget proposal:

Trump budget pushes Graham-Cassidy Obamacare repeal bill https://t.co/SLXEcYVpF7 pic.twitter.com/L7bIwzBUFW

— Washington Examiner (@dcexaminer) February 12, 2018

President Trump’s budget plan released Monday endorsed an Obamacare repeal and replace bill that gives funding to states and makes cuts to Medicaid.

The budget called for the [Graham-Cassidy] bill to be enacted “as soon as possible,” even though Republican Senate leaders have been skeptical of taking up Obamacare again this year after failing last year to repeal it.

“The president is committed to rescuing states, consumers and taxpayers from the failures of Obamacare, and supporting states as they transition to more sustainable healthcare programs that provide appropriate choices for their citizens,” the budget said…

The bill would end the Medicaid expansion under Obamacare but supporters say states can implement it individually if they want. However, the bill makes cuts to Medicaid overall by capping federal funding per beneficiary.

Now, I’m all for returning power to the states. That’s a welcome change from the Feds sticking their noses into examination rooms across America. But here’s the problem with a potential expansion of Medicaid by states: Medicaid was originally designed to cover children and the destitute elderly, not as blanket health care for everyone, as good ol’ Bernie dreams of. It doesn’t reimburse doctors at sufficient rates; many doctors don’t even accept it; and then there’s this: in case you haven’t heard, this study came out of the Senate Homeland Security Committee earlier this month, to, not surprisingly, little fanfare:

Obamacare is fueling the opioid epidemic. That’s according to an explosive new report from the Senate Homeland Security Committee. My latest in @forbes: https://t.co/FgaOpO4MzC

— Sally Pipes (@sallypipes) February 6, 2018

About 80 percent of heroin and fentanyl users spiraled into their addictions after first getting hooked on prescription painkillers. The Medicaid expansion made those painkillers widely and cheaply available.

Some people chose to sell their painkillers on the black market. As the Senate committee’s report notes, “Medicaid co-pays can run as low as $1 for as many as 240 pills — pills that can be sold for up to $4,000 on the street.”

This lucrative, albeit illegal, business model explains why there was a 55 percent increase in the number of Medicaid-opioid fraud cases in the four years following expansion compared to the previous four years. More than 80 percent of fraud cases occurred in Medicaid expansion states, including New York, New Jersey, and Michigan.

The Senate report also notes that drug-overdose death rates are rising almost twice as quickly in expansion states as in non-expansion states.

You read that right: the study ties the opioid epidemic directly to ObamaCare’s Medicaid expansion. Of course, no one wants to lay that turd onto the laps of those who saddled us with same. After all, it’s their Messiah whose name is attached to the very legislation that is the cornerstone of his otherwise failed presidency. Preserving his title as the Most Altruistic POTUS Evah is far more important that telling the truth and attacking the roots of the problem. Exhibit A from Obama for America:

This budget calls for a repeal of #Obamacare too, including cutting #Medicaid—affecting millions of Americans and many who are struggling with opioid addiction.

— OFA (@OFA) February 12, 2018

I guess they haven’t read the Senate’s study challenging their cow manure.

But there’s more: also included in Trump’s proposal are monies intended to fight the opioid epidemic. But while it would kill the Medicaid expansion under Obamacare, it would also provide freedom for states to expand Medicaid should they so choose. Which is a good thing from a 10th Amendment standpoint. But according to CDC statistics, 42,000 people died in 2016 from opioid overdoses. That’s a 28 percent increase over the prior year. So it’s a Catch 22: the opioid crisis is reportedly tied to ObamaCare’s Medicaid expansion, yet untold numbers of states are planning further expansion of the very system that’s said to have led to the crisis. How does one fight an opioid crisis while growing the very thing from which the epidemic arguably sprouted? That question epitomizes why the federal government should stick to its core mandate of national defense, and leave the rest to the states. Because everything it touches, it breaks.

So what’s the answer? I don’t know. But I suspect the free market will figure it out. Whatever the solution, it’s not bigger government, and this president seems to understand that. But it appears as of now, Congress won’t find their courage to attack the perpetrator of so much misery a second fourth time around. At least not until even more Americans have lost their lives to opioid addiction.