Affordable Care Act and Treatment

In just a few months, an estimated 32 billion Americans will have the opportunity to have health insurance coverage. This is a huge deal for those who have been (or have ever gone) without it. The Patient Protection and Affordable Care Act, more commonly referred to as Obamacare, was signed into law in March 2010 and now, as we round out 2013, Americans will finally have a piece of the health insurance pie.

The Scope of Reformed Health Insurance

affordable care actUnder the Affordable Care Act (ACA), not only will this large chunk of Americans have the chance to enroll for coverage beginning in January 2014, but they will also have a wider range of coverage than they would have had prior. The key features of the law encompass more than just availability of insurance coverage.

The law also includes provisions on cost, care and preventative strategies. Here are a few, as reported by the U.S. Department of Health and Human Services:

  • Preventative care at no cost to the individual
  • Tax credits for small businesses
  • Protections against fraud
  • Discounts on prescriptions for senior citizens
  • Allowance of those with pre-existing conditions to be covered
  • Guarantees an individual’s right to appeal should the insurance company deny payment
  • Keeps young adults covered up to 26 years of age
  • Allows individual choice of doctors
  • Reviews any premium increases
  • The majority of health care premium dollars must be spent on health care

Of course, there are still many other provisions that are included in the bill, even though some, like abortion, are hotly debated. Encompassed in the Affordable Care Act are some services termed “essential health benefits” that comprise several sectors of healthcare, one of them being substance abuse.

Here is the list of covered services:

  • Ambulatory patient services (also known as outpatient services)
  • Prescription medications
  • Emergency care and visits
  • Hospitalization
  • Mental and behavioral health services (including substance abuse care)
  • Rehabilitation and habilitation
  • Preventative care and wellness services
  • Pediatrics
  • Laboratory services
  • Women’s health (including maternity and newborn care services)

The Affordable Care Act and Substance Abuse

girl in need of substance abuse careThe Affordable Care Act works to expand the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA), a law that states that coverage for substance abuse and mental health treatment should be equal to that of other medical care. The law didn’t necessarily require insurers to cover mental health treatment but, if plans did cover these areas, the coverage must be on par with care for other conditions and it must not restrict that coverage to individuals.

The new provisions are a welcome sight to those recovering from substance abuse and also for those who are currently battling with abuse or addiction. Previously, many plans did not offer coverage for this type of health care. The Partnership at Drugfree.org notes that an estimated 2.3 million Americans currently receive substance abuse treatment in any form. That could mean outpatient or inpatient services, counseling groups or assistance with detoxification. That seemingly large number only accounts for around one percent of the population who need help for substance addictionWhen you look at it from a broader angle to include mental health services, approximately 26 percent of the nearly 58 million people who suffer from mental health disorders or substance abuse actually get treatment. Imagine the number of people who could utilize and be helped by these services.

Fortunately, under Obamacare, individuals who are in need of substance abuse and/or behavioral health services will now have access to it. Even if the services are not used by the individual, the insurance company must make them available. Not only will preventative care be provided, you can expect some other services to be covered as well, such as:

  • Visits to physicians
  • Visits to clinics and hospitals
  • Screening
  • Intervention approaches
  • Assessments and evaluations
  • Medications
  • Family counseling
  • Testing for drugs and alcohol
  • Testing used for monitoring purposes
  • Smoking cessation methods

Financial cost has been a huge barrier for people getting the proper care they need. Some are not insured and others simply can’t afford to pay for treatment. The Affordable Care Act will now make it possible for those desperately needing treatment for substance abuse to finally get the services they need.

Getting Help at The Oaks at La Paloma

If you’ve been needing care for alcohol or substance abuse, the Affordable Care Act could be just what you’ve been waiting for. Don’t let the financial cost of substance abuse treatment prevent you from getting the help you need. At The Oaks at La Paloma, we have counselors standing by 24/7 waiting to take your call. You can consult with one of our staff in a free one-on-one phone consultation to discover what available treatments we offer and how our services can help you. If you need to discuss finances or treatment, we’re here to answer your questions.