On Tuesday, state Attorney General Josh Shapiro stopped in Altoona to discuss a renewed push against opioid addiction — one that relies on treatment as much as arrest numbers.

By the end of the week, two pieces of news from Washington were poised to deeply complicate those state efforts.

On Thursday, the House narrowly passed the American Health Care Act, a sweeping bill that repeals major components of former President Barack Obama’s signature Affordable Care Act. While the bill appears to have little chance in the Senate in its current form, some of the hoped-for changes are clear.

Among those changes: the effective end of recent Medicaid expansions that have increased access to the program in many states, including Pennsylvania. In addition, the AHCA would allow states to repeal requirements that insurers cover certain “essential health benefits,” one of which is substance-addiction treatment.

If passed, changes like those could make treatment and care harder to access for some dealing with addiction. Groups like the American Society of Addiction Medicine have come out against the bill, with the society calling on members to oppose the plan even after it passed the House.

In January, two experts in health care and public policy from Harvard University and New York University estimated that as many as 2.8 million Americans with substance-abuse disorders could lose some or all of their access under a full-scale Obamacare repeal.

Gov. Tom Wolf, a Democrat, protested the Republicans’ earlier version of the AHCA in March, specifically citing addiction treatment among the areas harmed by the bill.

Republicans who backed the bill have taken a sunnier view, with Rep. Bill Shuster, R-9th District, claiming the act would “reduce the federal deficit, drive down premium costs and increase access to care.” The Con­gressional Budget Office predicted an earlier AHCA version would eliminate insurance for tens of millions; the office did not rate the latest iteration.

Meanwhile, with the AHCA’s future unsure, a second discovery Friday seemed poised to further roil the opioid war. Citing internal sources and a leaked memo, news outlets reported President Donald Trump’s administration hopes to effectively eliminate the Office of National Drug Control Policy with a 95 percent budget cut.

The office, which oversees antidrug programs across the country, provides periodic grants to community groups fighting drug and alcohol addiction, particularly among children. Personal Solutions Inc., a Bedford-based group that provides services across the county, is listed as a multiyear grant recipient.

“Those grants are (for) grassroots movements,” Personal Solutions Executive Director Dawn Housel said. “They’re designed to engage the community at a grassroots level. They’re very important as one component of substance-abuse prevention.”

The Trump administration has made other efforts to address the opioid crisis — most prominently, a planned commission spearheaded by New Jersey Gov. Chris Christie and Trump’s son-in-law, Jared Kushner. Congress has provided aid, including $1 billion for the opioid fight approved late last year as part of a broader medical package.

At this early stage, it’s impossible to tell what the final AHCA might look like and just how deep the reported drug program cuts could be. But Democrats in Congress are shaping up for a long second round.

“What passed today isn’t a health care bill,” Sen. Bob Casey, D-Pa. wrote on Thursday, “but a scheme to cut taxes for millionaires and big corporations (and) a giveaway for special interests.” Casey vowed to “fight like hell” against the proposal.

Anti-sanctuary bills move forward

A state House committee is set to discuss a bill this week — backed by three local representatives — to cut all public funds from any university that bucks national immigration policy.

House Bill 14, cosponsored by Rep. Rich Irvin, R-Huntingdon, Rep. Judy Ward, R-Hollidaysburg, and Rep. Tommy Sankey, R-Clearfield, would bar state appropriations from any so-called “sanctuary campus.” A similar Senate bill recently passed through the upper chamber’s Education Committee, headed by Sen. John H. Eichelberger Jr., R-Blair.

“Turning a blind eye to illegal conduct for the sake of making some kind of political statement on this nation’s immigration policy endangers the lives of those that the institution should be protecting,” the House bill’s main sponsor, Rep. Jerry Knowles, R-Tamaqua, wrote.

As with cities across the country, students at many college campuses have pushed for their schools to refuse cooperation with federal immigration officers who don’t have warrants.

The issue has been particularly thorny at colleges that host so-called Dreamers — the 750,000 or more residents brought to the country illegally as children. They were protected from deportation under the Obama administration, but a few have been detained since Trump took office.