There has been a lot of debate on whether or not the Affordable Care Act (ACA), dubbed “Obamacare,” is a good thing or not. And really, it depends on who you ask. One thing that can’t be denied is the ways in which Obamacare will change the face of substance abuse and addiction treatment.
Daliah Heller, a consultant working on issues of health care and U.S. drug policy reform, predicts that one of the most important changes stemming from the ACA will be its impact on cultural ideas of what addiction is. In a nutshell, Obama’s health care act protects – in federal law – that substance abuse is, in fact, a medical issue and not the result of poor morals, nor is it a criminal justice problem.
That reflects a greater societal change, as the country as a whole has gotten over some of the stigma it once held for substance abuse, Alden Bianchi, an employee benefits attorney who composed a report on the final regulations for the National Law Review, said. “This is a shift that has taken place over generations,” he said. “It’s not just a matter of a couple of years and a couple of laws.”
“If we view ACA as this document that is now federal policy…it’s sort of de facto recognition that it’s not a criminal justice issue. It needs to be addressed as a health issue.”
Heller added that the ACA changes the federal definition of addiction, clearly addressing it as a healthcare issue, which may even lead to decriminalization.
#1: Obamacare Will Cover Addictions
First, the ACA is a huge step toward getting insurance plans to cover addiction treatment. The new legislation prohibits medical insurers from denying coverage due to pre-existing conditions, and this includes substance abuse.
One of the most important changes being made as a result of Obamacare is the expansion of parity rules. Parity means that insurance plans must cover mental health and substance abuse treatment at the same level as regular medical care.
Heller explains, “So, for example, if there are two medications available for a particular condition, or two types of treatment,” you have to have “the same level of treatment available for mental health and substance abuse disorders in that plan.”
This is huge because, according to estimates from the U.S. Health and Human Services Department, it will give approximately 32 million Americans new access to substance abuse and mental health treatment. Furthermore, the HHS estimates that it will expand mental health and substance abuse benefits for an additional 31 million Americans.
#2: Obamacare and Criminal Justice
Perhaps one of the most profound effects the ACA will have is on addiction healthcare coverage in the criminal justice system. By default, prisons and jails end up treating a large portion of the U.S. population that has substance abuse problems. The ACA could help change all that.
Christie Donner, executive director of the Colorado Criminal Justice Reform Coalition says, “Under the old model, really, poor people didn’t have access to substance abuse or mental health treatment—unless it was through the criminal justice system,” which has been convening a panel of criminal justice and health care representatives to plan how to go about implementing the ACA.
First, lower-income people can get access to health coverage due to the overall expanded insurance access, and “without [them] having to be involved in the criminal justice system at all,” Donner said. And this is huge because a large part of the prison population is made up of people of lower-income backgrounds.
Second, prisoners with substance abuse problems do not get the benefits of something called “continuity of care,” which is the guaranteed on-going medical treatment that is enjoyed by other populations. Basically, prisoners arrive in lock-up with substance abuse issues, receive basic treatment, then, when they leave the criminal justice system, they lose access to medical care. According to Donner, the ACA can continue to cover these individuals after their sentences.
Another way in which the ACA will shape addiction treatment when it comes to the criminal justice system is that the extra federal monies (through Medicaid) could help criminal justice agencies expand treatment access to prisoners who are currently incarcerated – programs such as residential substance abuse treatment, as well as alternatives to imprisonment and an overall improved quality of care.
If you or someone you love is struggling with substance abuse or addiction and is seeking treatment, please call toll-free 1-800-951-6135.