Over the past week, I, like many Americans, anxiously awaited the Supreme Court’s decision on the Affordable Healthcare Act (ACA). At last, Thursday morning, the news we had been waiting for arrived: the Court had voted to uphold the individual mandate. A few minutes later, more news flooded my inbox and flashed across my computer screen: the Court had ruled that the expansion of Medicaid is constitutional, though states could not be stripped of funds for refusing to comply with the expansion provisions. As the SCOTUS Blog put it on Twitter, “Bottom line from SCOTUS, Obama Administration wins. Challenge to ACA fails.”
I could not be more ecstatic about the Court’s decision. This is a momentous occasion, for it marks a major step towards achieving adequate healthcare for all Americans. It’s a big win for our country, and especially, for those struggling with addiction, their families, and those of us who are dedicated to substance abuse treatment.
As I’ve written in the past, the Affordable Healthcare Act will help the addiction and recovery community in several significant ways. In sum, it comes down to one word: CHOICE. Millions of previously uninsured Americans will now have healthcare coverage—and thanks to the Wellstone-Domenici Mental Health Parity Act, their substance abuse treatment coverage must be on par with the coverage they receive for other conditions. More Americans covered means more Americans will have a choice about where they receive their care. They’ll have a wider menu of options when selecting the treatment program that best suits their needs.
In addition to giving Americans more options when it comes to choosing a treatment program for substance abuse problems, the Affordable Care Act will provide more choices in terms of the types of care they desire. Up to this point, addiction treatment has been primarily focused on acute cases—those who have significant, long-term problems with Substance Abuse and Dependence. But Thursday’s ruling means that new types of services will be covered, including prevention and early interventions. This change will hopefully result in more medical providers screening for substance abuse, conducting brief interventions, and referring patients to treatment centers as necessary. The hope is that more people whose problems aren’t yet severe will find the help they need before addiction overtakes their lives.
At the end of the day, the Supreme Court’s decision is a victory for anyone in need of substance abuse treatment services. It’s also a win for their families; just as services such as family education are covered for chronic conditions like diabetes, so too will these services be funded for the loved ones of individuals coping with addiction. Additionally, since children may remain on their parents’ insurance until the age of 26, they will be covered for addiction services during the high-risk period of early adulthood.
Over the coming weeks and months, providers and insurers have a lot of work to do to evaluate the concrete implications of the Affordable Care Act. One critical task for providers will be to address the needs of new types of clients, such as those who are not critically ill. Given the expansion of patient choice, providers must also be even more focused on delivering the highest standard of care. I believe these are good challenges; we are prepared to meet them.
Thanks to clinical innovations, there have never been more addiction services available for the men, women, teens, and their families who need help. With Thursday’s ruling, we at last have a mechanism to bridge the tremendous gap between those who would benefit from prevention, early intervention, and other life-saving services—and those who receive them.
Deni Carise, Ph.D.
Chief Clinical Officer
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