The Affordable Care Act (ACA), formally called The Patient Protection and Affordable Care Act (PPACA), and commonly known as Obamacare, is a federal statute that was signed into law by President Barack Obama on March 23, 2010. It is one of the most significant of laws that overhaul the U.S. healthcare system since the creation of Medicare and Medicaid in 1965.
Simply put, The Affordable Care Act provides for wide-ranging health insurance reforms that will make health insurance available to many more people, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans.
The purpose of the ACA is threefold: to increase both quality and affordability of health insurance, lower the rate of uninsured Americans, and reduce health care cost to the individual and to the government. The Affordable Care Act also requires insurance companies to cover all regardless of pre-existing conditions or sex. Additional reforms intend to decrease costs and increase healthcare outcomes by shifting the system towards quality over quantity through greater competition, regulation, and incentives to simplify the delivery of health care. The overall aim of the ACA is to lower both future deficits and Medicare spending.
The Affordable Care Act and Addiction Treatment
The ACA has ten elements of what is considered to be essential health benefits, and substance abuse and addiction treatment is one. This means that, starting in 2014, all health insurance that is sold on Health Insurance Exchanges or as provided by Medicaid to eligible Americans must offer services for substance use disorders, such as addiction treatment.
By including such benefits in their health insurance plans, more providers can offer and be reimbursed for addiction treatment services, which then results in more people having access to substance abuse treatment. The specific substance abuse services have yet to be determined but will allow those in need to get treatment and help them with recovery.
The Need for Expanded Addiction Treatment
Over the last decade, numerous studies of the population of those suffering with mental health disorders and/or addiction have been conducted. These studies show that people with mental health and/or addiction disorders die at a younger age than those in the general population. Causes of these premature deaths are likely to included treatable health conditions such as heart disease, diabetes, and addiction. For example, people diagnosed with schizophrenia die from these conditions at two to three times the rate of those without these conditions. Those struggling with addictions also have the higher rates of many chronic, life-threatening conditions. A major reason for these high rates of illness and death among people with addiction or mental health conditions has been their lack of contact with primary care services.
The ACA and The Mental Health Parity and Addiction Equity Act
Under The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), a group health plan or group health insurance issuer cannot require an additional financial obligation, such as a copayment, or restrict the number of outpatient visits or inpatient days covered on mental health or substance use disorder benefits. The ACA further makes health insurance, in general, more accessible and to more Americans and therefore can help more people who are struggling with addiction. If someone you know is struggling, give us a call at 1-800-951-6135.