A Little History
Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA): requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services that they provide for medical/surgical care.
Patient Protection and Affordable Care Act of 2010 (PPACA): commonly referred to as the Affordable Care Act (ACA) or “Obamacare,” further expands the MHPAEA’s requirements by ensuring that qualified plans offered on the Health Insurance Marketplace cover many behavioral health treatments and services.
Comprehensive Addiction and Recovery Act of 2016 (CARA): established a comprehensive, coordinated, balanced strategy through enhanced grant programs that would expand addiction prevention, education, treatment and recovery efforts.
21st Century Cures Act of 2016: has many primary objectives, not the least of which is giving grants to states worth $1 billion over the next two years for drug abuse prevention and addiction treatment programs.
Addiction Treatment Coverage
Above we listed, and briefly explained some vital pieces of legislation that have helped millions of Americans, not just people living with the disease of addiction. The first two acts allowed for millions of previously uninsured Americans to get coverage; while the latter two legislative acts include provisions to address the opioid addiction epidemic. Both CARA and the Cures Act are still in their infancy, so it is hard to measure their efficacy at this point, but early data is positive. However, both bills were widely hailed by health professionals, addiction experts and lawmakers on both sides of the aisle of democracy as crucial steps in the effort to end the epidemic.
If you have been following the news in the last couple weeks and beyond, you are likely aware of the fact that many lawmakers throughout the land are not huge fans of the ACA. Critics have fought tooth and nail to repeal and/or replace the ACA since it was signed into law. While such efforts were unsuccessful, with a new President and a push to repeal the ACA recommenced, there is a chance that the end of Obamacare is in sight. Or, at the very least, such efforts will make it more difficult for the ACA to achieve the goals laid out in the legislation. So, what does that mean for people living with the disease of addiction and the future of the American opioid epidemic?
The former Director of the White House’s Office of National Drug Control Policy, Michael Botticelli, believes that if efforts to repeal the ACA are successful it could mean the loss of hard fought ground gained towards mitigating the insidious effects of the epidemic, The Huffington Post reports. The ACA has helped states hardest hit by the epidemic, such as Vermont and Maryland, fund diversion programs and helped treatment facilities better integrate primary and mental health care.
“Our response to this opioid epidemic has largely been focusing on ‘How do we narrow that treatment gap?’” said Botticelli. “And certainly one of the biggest contributors to narrowing that treatment gap is making sure that people get insurance coverage and have adequate insurance coverage for substance use disorders... We know that care and coverage has been essential to dealing with the epidemic.” He added: “I think there’s ample evidence to suggest that those states that have been significantly burdened by the opioid epidemic will be more significantly impacted because of any potential repeal of the ACA.”
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At this point it is difficult to tell where all of this will lead. Although, it is important to keep in mind that, no matter what one’s thoughts are on any of the aforementioned bills, lives have been saved because of those legislative acts. And, if the ACA is repealed or replaced, hopefully mental health and addiction treatment will still be a major focus point. Treatment, and access to addiction treatment, will continue to be the most effective measure against opioid addiction in America. Saving both lives and families.