ObamaCare is in full swing. Those who are seeking the new health care plans offered under the Affordable Care Act can go online and apply for coverage.
When the the plans became available for enrollment on October 1, 2013, the volume at which people were trying to access healthcare actually created a complete shutdown on the website. The shear number of individuals and families who were uninsured, and who are wanting to be covered, is telling of the healthcare problem in our country.
The New York Times ran a story saying that the Affordable Care Act will potentially cover 32 millions Americans who did not have health insurance before. For many of those 32 million people, a preexisting condition has kept them from being insurable, according to private healthcare providers.
When medical conditions, mental health disorders, chemical dependency, and eating disorders are left untreated, the individuals suffering only get worse. If a condition already exists, individual health insurance is denied. These previously uninsured people, many with a preexisting condition, can now seek medical and mental health services in the United States.
What Does This Mean for Those Currently Addicted to Drugs and Alcohol?
The short answer: the millions of people who are abusing substances and cannot stop on their own, and who did not have access to substance abuse treatment before, can now access treatment.
Covered Like All Other Illnesses
The Affordable Care Act, or the ACA, has determined ten elements to be defined as essential health benefits that must be covered by all health insurance plans. For the first time, substance abuse and addiction treatment is to be covered the same way as the other elements on the list. What this really means is that facilities that do not currently offer addiction treatment, mainly because the facility would not be reimbursed for services rendered to an insured person, can now offer these services without question.
In other words, if a patient is seeking medical attention for chronic headaches, and a physician requests a CT scan or an MRI, the insurance company has a specific way of paying the facility that administers the tests. The ACA now offers plans that will also have predetermined reimbursement schedules, and patient copays, for each service that is needed, including substance abuse services.
A individual who has not enrolled in an addiction treatment program because of being uninsured and not financially able to pay for treatment out of pocket, will, ideally, now seek appropriate care under an Affordable Care Act insurance plan. Further, when someone presents the early signs and symptoms of addiction, he or she can seek services right away, preventing the progression of substance abuse to full-blown addiction that is then much more difficult to overcome.
Perceived Goals and Benefits
Overall, the ACA hopes to reduce the number of cases of overdose deaths, high medical and legal costs endured by uninsured and untreated drug addicts and alcoholics, and the total number of addicts living without treatment. As our country treats those in need of immediate services, and then has addiction treatment covered like any other illness, there is no reason for anyone to progress to the point of addiction.
Gradually our health care system can address everything that a person is going through. A doctor can spot the signs of mental illness, substance abuse, eating disorder, and the co-occurrence of multiple disorders (dual diagnosis) and refer that patient for applicable services right away.
Reduce Addiction Stigma
The stigma of addiction will also gradually diminish. The shame that currently surround alcohol and drug abuse, and mental illness, can be reduced to a view more similar to diabetes and cancer, and can eventually be seen as a preventable disease that we can all help one another identify and take action on upfront rather than once the disease has taken over an individual’s life.
Limitations of the Affordable Care Act
At first, the market will be flooded with new patients seeking services. How will current treatment centers help everyone who needs help? The ACA does not seem to explain how the new influx of rehab clients will be handled. Of course centers will do the best they can to accommodate, but there are only so many people one place can treat each day, week, and month.
What type of addiction treatment will truly be offered and covered to those insured through the ACA? Will addicts and alcoholics be able to enroll in an inpatient substance abuse program with enough insurance coverage so they are not paying much out of pocket?
What other limitations do you think will be a part of the addiction coverage under the Affordable Care Act?
Healthcare in the United States is changing. The ACA is a step in the right direction!
Learn more about the treatment offered at Sovereign Health by watching this testimonial:
Blog post by: Marissa Maldonado