Healthcare reform has always been a hot button issue in the United States, which is why several politicians make it a point to include healthcare reform in their platform. Under the Obama Administration, the Patient Protection Affordable Care Act (PPACA) passed in 2010. Programs like this have existed, in one form or another, as part of individual state health programs or in other countries. The primary goals of the PPACA are to provide equality in coverage that does not discriminate over sex or with preexisting conditions. More importantly, it establishes a base cost for reasonable and adequate coverage for the insured. Several provisions went into effect immediately while others were to be phased in over time. Programs like this have existed, in one form or another, as part of individual state health programs or in other countries.
The PPACA, commonly shortened to ACA and colloquially referred to as Obamacare, is a comprehensive health insurance reform that will make health insurance available at lower cost, guarantee more health care choices, and enhance the quality of health care for all Americans. One major reform is that, under ACA, substance use disorder is one of the ten elements listed under essential health benefits.
So what does this mean for addiction treatment? Now that treatment for substance use disorder is listed as an essential health benefit, starting in 2014, all health insurance plans need to include services relevant to substance use disorder. The coverage for substance use disorder is now comparable to other chronic diseases such as diabetes or heart disease. Coverage may vary by state because of the stipulation that essential benefits should mimic those offered by a “typical employer plan”.
Government Insurers (Medicare and Medicaid) will cover:
- Physician visits
- Clinic visits
- Family counseling
- Alcohol and drug testing
- Monitoring tests
- Rehabilitative services and devices
- Preventive and wellness services and chronic disease management
The impact of these new policies will be substantial and the Affordable Care Act will revolutionize the way substance use disorders are treated in America. As substance use disorder is brought to the forefront so that it can be treated as the chronic disease that it is, many more Americans are now able to afford addiction treatments. Currently, only 2.3 million, less than one percent of people affected by substance use disorders, are receiving treatment. These steps will help reduce the stigma of drug addiction treatment so that those afflicted will not have to suffer. More importantly, it will be easier for addicts to seek and receive quality treatment when it is needed the most. It’s refreshing to see a broadening of care to better treat Americans and the vastly different health considerations that they have.