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The Affordable Care Act & Substance Abuse Treatment

The Affordable Care Act and actions which have and will follow the law have both positive and negative effects on substance abuse treatment for those in need. Because “the ACA includes substance use disorders as one of the ten elements of essential health benefits,” there have been great leaps made toward helping more individuals receive treatment (ONDCP). But in some ways, there are impacts that show us we still have a long way to go.

ACA has made many positive strides in helping individuals get help for substance abuse.

More healthcare providers offering reimbursed services to addicts thanks to the Affordable Care Act.

Both Sides of the ACA

An article from Insurancenewsnet.com states that “ACA realities may have a detrimental impact on the number of people able to receive treatment.” While the goal is the opposite, there are indeed two sides to the ACA’s effect on substance abuse treatment. We must consider all of the places where the ACA has an impact on substance abuse treatment and whether or not more individuals are actually being treated. Then we can take the necessary steps to make even more changes.

Positive Aspects of the ACA Affecting Substance Abuse Treatment

There are still many positive aspects of the ACA that will help to affect substance abuse treatment. They are:

  • “The new system covers more services for more people.”
  • It states that “patients are entitled to mental health and substance abuse treatment without arbitrary or discriminatory limitations.”
  • It keeps providers from denying coverage to those with preexisting conditions so someone who has had issues with abuse in the past will not be denied coverage. This is important as relapse is often part of recovery.
  • It “further eliminates annual and lifetime limits on essential health benefits,” which is also very beneficial to those who have experienced relapse more than once.
  • “More health care providers can offer and be reimbursed for these services” (ONDCP).

Many of these effects will be very beneficial to those who need treatment. However, other effects could be more negative.

Negative Aspects of the ACA Affecting Substance Abuse Treatment

Some of the negative aspects of the ACA and its policies are:

  • Providers who cover more patients and do not see “a corresponding increase in their overall earnings” may decide not too take on more Medicare or Medicaid patients. These providers could “determine the government reimbursement rates to be too low” which is why they will not want to take on patients like these.
  • Smaller facilities may not be able to take on the high amount of new patients and, therefore, will turn patients away.
  • The types of treatments and prices for Medicaid programs are often left up to the state’s discretion which means that “predominant courses of treatment may thus vary significantly from one state to another.”
  • Different states may have different reimbursement rates, and low reimbursement rates mean that insurance providers will be less likely to cover patients from whom they do not receive the kind of reimbursement necessary for treatment in an inpatient facility, which can be expensive.

The ACA has made many positive strides, but there is still a long way to go in order for those with substance use disorders to be able to receive all the treatments they need. With any luck, we can continue to improve upon the system.

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