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Affordable Care Act to Substantially Expand Coverage for People Needing Addiction Services, Access Concerns Remain

Today, the Associated Press released a story about the implications of the Affordable Care Act for people in need of addiction treatment. Many Americans who need these services are not able to access treatment, with just around 10% of the 23 million people with alcohol and substance abuse disorders receiving treatment. Also, roughly one cent of every dollar presently spent on health care in the U.S. is for addiction services. Even though stigma contributes to this shortfall, lacking health insurance presents another major barrier for many who require these services.

The Affordable Care Act (ACA) will extend health insurance coverage to between 3 and 5 million people who struggle with addiction. Further, the ACA includes substance use disorder services as one of ten essential health benefits, which must be covered in Exchange and Medicaid health plans, as well as in individual and small group plans purchased outside of Exchanges. This requirement could be of great consequence for many people who currently do not have coverage for this benefit because it could substantially improve their overall health and quality of life.

Yet, concerns about access to care remain. Among the newly insured population, demand for addiction services could be much greater than the available treatment providers can handle. In many areas, treatment facilities are already overbooked, and some health industry experts argue that the number of providers of addiction services in the U.S. must grow by 3,000 to meet demand. Another potential barrier to access is the possibility that many consumers or employers will elect to purchase coverage with higher out-of-pocket costs, which may prevent some individuals from seeking treatment if they find the costs unaffordable. It remains unclear how great these obstacles will be as implementation of the ACA moves forward, yet these capacity issues will likely require a broad, sustained effort to train more providers and increase facilities’ ability to accomodate rising demand.

For the full AP article: