Healthcare Reform and how it Affects Addiction Treatment

Editor Dan Schimmel, LCSW, CAP
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When it comes to addiction treatment, there is an ugly fact that many people often times overlook: those in need of professional help slip through the cracks, time and time again, because they don’t have health insurance and are worried about the overall cost of treatment.

The Affordable Care Act (ACA) began to address this problem.

According to the Office of National Drug Control Policy, the Affordable Care Act has added reforms that will make health insurance available to a larger number of people, while also enhancing the quality of care for Americans.

Additionally, the Affordable Care Act includes substance use disorders as one of its many health benefits. In short, this means that all health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults starting in 2014 must include services for substance use disorders.

The Trump Administration has brought Serious “Change”

President Trumps failed attempt to roll back the “ACA” moved the burden back onto the individual States. The failure to repeal the “ACA” speaks volumes for it to remain an integral aspect of our countries health care system for years to come. Party lines were not strong enough for a full repeal. With the Opioid Epidemic being a key health issue in the United States It is unlikely to see the “Parity” provisions to be eradicated from the legislation. Former President Obama allocated funding for the issue as well as President Trump has followed suit.

For those who have faced issues with this in the past, things are not what the “ACA” intended but are not as bleak as they once were.

With the inclusion of residential addiction treatment in the Affordable Care Act, a larger number of health care providers offer these services while knowing that they will be reimbursed, even though the commercial health insurance carriers have fought this hard. Resulting in a larger number of patients continuing to have access to treatment

2.3 Million People were expected to Receive Treatment due to the “ACA”

Every year, more than 2.3 million people receive treatment for substance use disorder through the specialty care treatment system. While this sounds like a large number, it is important to point out that the National Survey on Drug Use & Health shows that more than 25 million suffer from some sort of substance abuse. In other words, there are quite possibly more than 20 million people who need help but are not getting it for one reason or another.

Parity for Substance Use Disorder Treatment

There is no illness currently being treated that has been more affected by the Affordable Care Act than addiction. That’s because we have a system of treatment that was built for a time when they didn’t understand that addiction was an illness. Fortunately, Patrick Kennedy stood up and fought to have Mental Health Parity inserted in of all things, the George W Bush Banking Bailout. This provision now strengthened with the “ACA” legislation, especially with the aspect that allows parents to maintain their children on their health insurance policies to age 26, has afforded more people Behavioral Health care including Substance Use Disorder treatment.

As contested as it has been, the Affordable Care Act has changed the way addiction is treated for the foreseeable future. The old system, while some may argue did not need to be changed, was constructed during a time when addiction was not nearly as big an issue as it is today.

This could go a long way.

The Affordable Care Act especially the Parity provision could go a long way in helping millions of patients get the professional help they need without financial concerns.


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