D.C. Faces Backlash Over Using Opioid Settlement Money to Fund Medicaid

Washington, D.C. plans to allocate opioid settlement dollars toward its Medicaid contribution, prompting criticism from recovery advocates and officials who say the funds must not replace existing budget items.

In its upcoming fiscal 2027 budget, Washington, D.C. intends to draw about $2.3 million from opioid settlement proceeds to cover part of its Medicaid share and to shift $5.5 million toward addiction treatment programs previously funded from the general budget. Advocates such as Queen Adesuyi and Shelly Weizman contend that the settlement was meant for new, innovative responses to the opioid crisis, not to fill existing obligations, citing a statute that bars supplantation.

More than 80 residents and 30 local groups have lodged a formal complaint, urging the Department of Behavioral Health to explain the legality of the move. Department spokesperson Denise Reed affirmed compliance with all legal requirements, noting that the council-approved budget also funds grants for 17 community providers serving nearly 9,800 people. The plan is pending a 30-day congressional review, the final step in the city’s budgeting process. Stakeholders remain divided over whether the settlement can be used as a stopgap amid broader fiscal pressures.