The Affordable Care Act (ACA), or Obamacare has been a hotly contested topic since its inception. President Trump has pledged to rid the country of Obamacare. He has also made it a point to stem the flow of illegal drugs and to address the opioid crisis. These two, competing and related issues may be hard to reconcile.
Many people agree that the ACA needs to be repealed. Certainly, people who are already struggling financially shouldn’t have to pay an absurd fine…or any fine….for not having insurance. The government fine system is an outrage to millions of families. The cost of Obamacare plans is also anything but affordable, with the cheapest being around $200 a month.
However, the ACA does have some good provisions that can be salvaged. One includes the expansion of Medicaid for drug dependency programs.
Affordable Care Repeal – An Overview
According to the NY Times and federal health officials, in the past, a third of private insurance plans sold on the individual market did not cover addiction treatment. Programs that did imposed strict limits. Medicaid covered little besides inpatient detox. Now, more health care providers are offering and getting reimbursed for outpatient counseling and medications like Suboxone and Vivitrol, which have been shown to reduce the potential for relapse.
The NY Times also said that in Kentucky about 11,000 people were receiving addiction treatment through Medicaid by mid-2016. This was up from 1,500 people in early 2014.In New Hampshire, more than 10,000 people have received addiction treatment through the Medicaid expansion. It allowed smaller treatment centers in the state to bill insurance, hire more people, and take more clients.
Senator Jeanne Shaheen (D, NH), said, “We’re just beginning to implement these exchanges in a way that people know about them.” She said it made no sense to get rid of them. In contrast, NH also has seen a sharp rise in overdose deaths from 2013-2016 and still ranks amongst the highest in the nation.
Affordable Care Repeal – Programs that Could Suffer
The ACA repeal could impact the 21st Century Cures Act, which passed in December. It provided $1 billion nationwide over two years to expand drug treatment. This is all money states need and will budget for programs. They could stand to lose it under the new administration.
Some other programs are those that are licensed to prescribe medication-assisted treatment. Many programs have expanded under the ACA and there are also state-funded programs which specialize in areas like homelessness and pregnant women, or other vulnerable populations.
People who use these programs, as well as other intensive outpatient services, or inpatient treatment, all could lose coverage for insurance if the Medicaid expansion is revoked.
If the Affordable Care Act is repealed, many addiction treatment providers and specialists stand to lose millions in funding. In some places, the Medicaid expansion revenue accounts for a third or more of their annual budgets.