It has been estimated that untreated addiction has a price tag of over 400 billion dollars a year, in large part in health care, enforcement efforts, and lost productivity. The Affordable Care Act, or Obamacare, aims to alleviate a substantial portion of this cost by offering coverage for treatment. The hope is that breaking the cycle of addiction will mitigate health issues related to addiction, reduce the need for enforcement, and re-integrate former addicts into the workplace.
Under the ACA, treatment is offered to people newly insured via the exchanges or Medicaid. According to the White House’s own web site, “The ACA includes substance use disorders as one of the ten elements of essential health benefits. 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.”
One key feature of the new rules is that pre-existing conditions are now covered under the ACA. Thus, not only can a diabetic sign up for coverage and get treatment for the condition, but so can an addict, whose addiction may have existed for years.
Still being worked out are the important details such as, coverage for extended stays at treatment facilities. Thirty days in treatment can make a tremendous difference, but often a longer stay is indicated, or aftercare. Under current rules, insurers can refuse payment for longer programs. Also, drugs like methadone, ativan, and others that can in some cases help heroin addicts may be ineligible for coverage.
At the heart of it all, under the legal wrangling and small print and insurance industry resistance, there is a crucial philosophical distinction being made: for the first time in history, the US Government is acknowledging, in legislation, that addiction is a health issue subject to treatment rather than a law enforcement issue. This could influence policy in many ways and positively affect accessibility for treatment for addicts and alcoholics.