The "Turn the Tide Act" proposes extensive reauthorization and increased appropriations for a wide array of federal programs designed to combat substance use disorders (SUDs), with a particular focus on the opioid crisis. This legislation allocates substantial funding across various initiatives under the SUPPORT for Patients and Communities Act and other related statutes, primarily for fiscal years 2027 through 2030 or 2031, and in some cases, through 2036. The bill provides significant financial support for controlled substance provisions , including grants to enhance access to SUD treatment ($4 million annually) and to increase drug disposal efforts ($10 million annually). It also bolsters public health provisions with substantial annual appropriations for programs such as first responder training ($77 million), residential treatment for pregnant and postpartum women ($50 million), mental and behavioral health education and training grants ($75 million), and the National Child Traumatic Stress Initiative ($112 million). Furthermore, the Act addresses housing and Department of Justice provisions , reauthorizing the Recovery Housing Program with $60 million annually for fiscal years 2027-2032 and prioritizing states with the greatest need based on unemployment, labor force participation, and drug overdose death rates. It also appropriates $500 million annually for the Comprehensive Opioid Abuse Grant Program and $175 million annually for the Drug-Free Communities Program. A major component involves bolstering commitments to State grants for SUD treatment and prevention. This includes $5.5 billion annually for State Opioid Response Grants for fiscal years 2027-2031, and $3 billion annually for Substance Abuse Prevention and Treatment Block Grants for fiscal years 2027-2031, with flexibility for states to use funds for any SUD diagnosis. These grants include set-asides for Indian Tribes and states with the highest opioid mortality rates. To address financial barriers, the bill aims to eliminate insurance barriers to medication-assisted treatment (MAT) by prohibiting Medicaid from imposing utilization controls or prior authorization requirements for MAT. It also mandates limitations on cost-sharing for opioid overdose reversal medications , requiring group health plans, individual health insurance, and Medicare Part D to cover at least one formulation without cost-sharing, effective January 1, 2027. The legislation also targets the health workforce by increasing funding for loan repayment programs for SUD treatment professionals to $65 million annually and prioritizing training demonstration programs in states with the highest drug overdose death rates. It mandates enhanced Medicaid payments for behavioral health and mental health providers , requiring states to pay physicians and applicable professionals for SUD-related services at rates not less than Medicare Part B, with 100% federal matching for the increased costs. Finally, the bill establishes a Medicaid demonstration project to test providing recovery housing for individuals with opioid use disorder, offering elevated capitated budgets to managed care entities. It also extends certain Medicaid Section 1115 waivers for delivery system reform in states with high drug poisoning deaths, expands Drug-Free Communities Support Grants, funds law enforcement mental health programs, and creates a new grant program for Adverse Childhood Experiences (ACEs) Response Teams.