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Get the Facts: Drug Treatment & the Affordable Care Act

By: ATSI Admin March 12, 2014 no comments

Get the Facts: Drug Treatment & the Affordable Care Act

86million_preventiveFor the past few years, the Affordable Care Act has been source of hope for many Americans suffering with mental illness and/or addiction disorders. The Mental Health Parity Act was designed to make healthcare equal for physical and mental illnesses alike. However, many people today still are unable to get insurance coverage for addiction rehab.

The Affordable Care Act (ACA) mandates that insurance companies provide the same coverage for drug and alcohol addiction treatment as they do for any other physical health concern. While the act was passed in 2008, many regulations do not take effect until later this year. It is at that time the real impact of the parity act will be felt, if at all.

Resisting Regulations

Insurance companies often find loopholes and ways to limit coverage. They may put restrictions on the location of the treatment provider, the length of stay or the type of therapies covered. Some insurance companies are simply reducing the coverage they provide for medical services, or dropping the mental health and addiction coverage completely so as not to be bound by regulations.

“The good news is, the ACA does cover many addiction services. What is not necessarily being covered is long-term residential care, and in order to recover, people need long-term care, support services, a continuum, to stay well,” said Debra Wentz, chief executive officer of the New Jersey Association of Mental Health and Addiction Agencies.

Frank L. Greenagel Jr., adjunct professor at Rutgers School of Social Work, agrees. “My experience has been insurance companies work very hard at paying for the lowest level of care that they can legally get away with and for the shortest amount of time. I don’t know if the ACA will change that,” Greenagel said. “They employ smart lawyers and find therapists who will side with them in order to collect a paycheck.”

Helping Those in Need of Treatment

When insurance companies fail to offer mental health benefits, individuals struggling with drug and alcohol addiction suffer. For many, insurance coverage means the difference between getting help or not. When individuals are ready to get help, they often have a very small window of time in which they will accept that help. If it takes too long to figure out the details of their insurance coverage, they may change their mind and not want help anymore.

Drug and alcohol addiction is a growing problem in America. There are millions of Americans that struggle with addiction, but only about 10 percent of them actually get the help they need (NIH). It is important for us as a country to offer more treatment options at higher qualities, and for treatment providers and insurance companies to work together to offer services at an affordable price.

For now, many people are unable to get the help they need for a drug or alcohol addiction because they don’t have the insurance coverage. Our leaders must continue to find ways to help these individuals by working to ensure they have proper insurance coverage and by helping to reduce the stigma associated with addiction and mental health issues.

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