The Patient Protection and Affordable Care Act (also known as “ObamaCare”) grants eligibility for insurance coverage to 3 to 5 million uninsured Americans with drug or alcohol problems.
The long-awaited change in drug policy is being widely celebrated, and rightly so.
But change isn’t always easy. What does health care reform mean for addicts and their families as well as the people who treat them?
Health care reform for addicts and their families
If you or a loved one needs treatment for addiction but have avoided seeking help because of a lack of insurance, access to health care is now a reality for many.
Addiction treatment is classified as an “essential health benefit” for most commercial plans. This means most major insurers and Medicaid will cover treatment for substance abuse. In addition, low-income families may be eligible for government subsidies to help them afford private insurance coverage.
Depending how many addicted individuals seek treatment and when, there is concern that the treatment system, which is already at or near capacity, will be overwhelmed. This may mean long waiting lists or people turning to overcrowded emergency rooms and urgent care clinics for assistance, all of which pose serious risks to people in the throes of a potentially life-threatening addiction.
It may take time for current treatment systems to catch up, but the new health care law is a step in the right direction. More than ever, if you or a loved is suffering, help is available. Because health care reform offers patients a broader choice of treatment providers, do your research and choose the facility that best meets your particular needs.
Changes for addiction treatment providers
Enormous changes are on the horizon in the field of substance abuse treatment.
In many states, there aren’t enough beds to meet the growing demand. While some states have been investing in addiction treatment for years and are better prepared than others, the entire system has to grow to accommodate the influx of new patients. The bigger question – and one that will have to be answered by each state – is where will the funding come from for new facilities, staff and services?
Equally pressing as the need for more beds is the need for more addiction doctors and psychiatrists. By some estimates, the pool of addiction doctors will need to grow by 3,000 nationwide, almost double the current number. Treatment providers will also need to develop the capacity, through staffing changes, partnerships with other providers and electronic record-keeping, to track the specific services provided and bill Medicaid and private insurance accordingly.
Addiction treatment will no longer be on the fringes of medical care, but integrated with primary care providers. Drug rehab centers can expect to partner with hospitals, doctor’s offices and other medical organizations in addressing the full continuum of drug and alcohol problems, from the person in the early stages of the disease to those requiring inpatient treatment or additional support to prevent relapse.
Since patients will have a broader selection of treatment providers available to them, competition should drive up the quality of treatment. Providers will need to measure outcomes and make this information available to referrers and prospective clients on a much larger scale than currently exists.
Are addiction treatment rehabs ready?
Clearly, major changes are called for in the field of addiction treatment. How ready are we? That’s the question asked by researchers who developed the Health Reform Readiness Index, a survey that asked addiction treatment agencies to assess their health reform readiness on a scale of “Needs to Begin,” “Early Stages,” “On the Way” and “Advanced.” As of May 2012, the mean scores ranked in the “Early Stages,” with smaller organizations scoring lower in all areas, indicating that the field has a long way to go.
As addiction treatment moves into mainstream medicine and the stigma of drug and alcohol problems slowly dissipates, demand for addiction treatment services will increase. Although no one can predict how many people will take advantage of the new law, what Obamacare makes clear is that it’s time to invest in substance abuse treatment on a broader scale.