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Obamacare & Addiction Treatment

When it comes to addiction treatment, the elephant in the room is always health insurance. It’s a touchy subject that no one wants to talk about — obviously, treatment costs money. And that money has to come out of someone’s wallet…that’s why insurance exists in the first place. But there’s also a human side to healthcare, which addicts are all familiar with. Those sick and suffering from addiction are not just numbers and statistics and dollar signs. They are people, and they ought to be treated as people. Nevertheless, there’s no way to get around the issue of health insurance. And there’s no way to talk about health insurance without mentioning Obamacare. But how do Obamacare and addiction treatment intertwine? Keep reading to find out.

Obamacare & Addiction Treatment: How Does It Help?

“Obamacare”, aka the ACA or Affordable Care Act, aka the Patient Protection and Affordable Care Act, is the single largest reform of healthcare and health insurance in the past half century. Quite simply, it was designed to solve many American healthcare problems. The relation to addiction treatment is quite clear. Addiction is one of the biggest health issues this nation faces, perhaps the biggest.

The Problem

A previous article asked why addiction treatment isn’t a healthcare priority. There are many reasons: shame and social stigma, the fact that addicts are jailed rather than treated, and the failure of doctors to accurately diagnose cases of addiction. One missing reason is that it’s expensive. There’s no denying that many addicts cannot afford to go to drug rehab, and that goes a long way toward explaining why only 1 in 10 addicts/alcoholics get the treatment they need.

What Obamacare Does

Though not explicitly related to addiction treatment, Obamacare does attempt to expand Medicaid eligibility. This means that addicts who were previously too poor to afford healthcare may now get some level of care. But the question remains: is addiction treatment part of the package of benefits?

The answer: sort of.

Obamacare lists ten “essential health benefits” that must be included in plans sold on Health Insurance Exchanges and Medicaid packages (which went into effect this year). The category “Mental Health and Substance Use Disorder Services” is one of those 10 essential benefits.

So, no new plans obtained through Medicaid or an exchange can deny you coverage for addiction treatment. The law also strengthens patient privacy while accurately documenting your substance abuse history so all your doctors are aware of it.

What Obamacare Doesn’t Do

Does the ACA go far enough? Even if they can obtain Medicaid, addicts still face roadblocks. An older law restricts certain hospitals and drug rehabs from billing for Medicaid services. This leads them to deny treatment for Medicaid patients, forcing addicts to go to designated Medicaid hospitals that are already stretched thin.

In addition, Obamacare may force insurers to pay for treatment, but it doesn’t say for how long. This has led to a gap in addiction treatment: insurance often pay for 30 days, which is often not enough time for recovery to take place. Of course, some treatment is better than no treatment. But if either case fails to address addiction, then does it really make a difference?

Obviously, insurance and addiction treatment are complex issues that require complex solutions. Does Obamacare make progress in providing access to drug rehabs? Yes? Does it solve every problem? No. Is there still more work to be done? Absolutely. A journey of a thousand miles begins with a single step, and we’ve made that step. There are still many steps in the future.

  1. started writing my life story. am 60 yrs. old, aomslt, and have been an alcoholic, addict for 43 years. funny, but when i sat down to type, the first thing that came to me was my insatiable desire to eat sweets and sugar as a young girl. so i googled it and found you. thankyou so much for verifying what i was thinking. just incase my book ever gets published, remember . . . you were a part of my story and maybe a part of my recovery from my sugar addiction which i have not yet addressed. thankyou and good luck. good work!!!

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