The Senate this week overwhelmingly approved legislation to address the opioid crisis, and now Congress is racing to cobble together a final measure that could pass before the midterm elections in November.

The Senate-passed legislation is sweeping in scope: It is composed of more than 70 individual bills approved by five committees. Packaged together, this legislation would expand access to medication-assisted treatment, crack down on illicit drug shipments in the mail and create new funding to spur research on nonaddictive painkillers.

The bill also would expand telehealth coverage for treatment options, give the U.S. Postal Service new tools to block mail delivery of fentanyl and synthetic opioids, and allow the Food and Drug Administration to require that opioids be prescribed in blister packs of three or seven days’ worth of medication rather than 30-day supplies.

The Senate-approved legislation also includes language by Judiciary Committee Chairman Chuck Grassley, R-Iowa, to expand Sunshine Act reporting to include payments by prescription drug and medical device manufacturers to nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists and certified nurse midwives.

Congress is scrambling to combat what’s emerged as an epidemic: Nearly 48,000 Americans died from opioid overdoes in 2017, according to the Centers for Disease Control and Prevention. That’s nearly the seating capacity of Yankee Stadium.

Sen. Alexander Lamar, R-Tenn.

After Senate passage, HELP Committee Chairman Lamar Alexander, R-Tenn., said negotiations with House leaders were already underway in an effort to reconcile the differences between the Senate bill and separate opioids legislation that the House approved in June. Alexander even said he thought lawmakers could wrap up negotiations this week.

But a senior White House official, after the Senate vote, expressed skepticism to Baker Hostetler’s Federal Policy Team that Congress could reach consensus before the House adjourned for the midterm elections.

The holdup? While the House and Senate bills are similar, they also have key differences.

Sen. Rob Portman, R-Ohio

One stumbling block is the estimated $1 billion price tag for House-approved language that would allow Medicaid to cover treatment at inpatient substance abuse facilities with more than 16 beds. Led by Sen. Rob Portman, R-Ohio, a group of bipartisan senators introduced separate legislation that would rollback prohibitions on Medicaid dollars paying for treatment at residential mental health or substance abuse facilities. The group is advocating that the language be included in any final opioids legislation.

The House bill also would streamline the sharing of substance abuse records among providers without violating patients’ privacy rights under the Health Insurance Portability and Accountability Act and its implementing regulations.

Even if Congress doesn’t act before the November elections, lawmakers would likely negotiate and pass final legislation in the lame-duck voting session likely in December.

A section-by-section summary of the Senate-approved bill can be found here.