« June 2012 Issue
New Opportunities for Addressing Substance Use Disorders
The passage of the Affordable Care Act (ACA) has opened new doors in addressing health needs that affect millions of Americans. One such issue is substance use disorders, which includes alcohol and drug addiction and related mental health issues. Nationwide, about 23 million Americans suffer from alcohol and drug addiction, but only a fraction get the treatment they need. In addition, another 68 million Americans engage in risky use of alcohol or drugs, setting the stage for potential dependence or addiction. And whether it is due to cost, stigma, or not knowing where to go for help, millions are going without the treatment they need to live healthy lives.
Research has shown that people with substance use disorders or a history of addiction are especially vulnerable in our health care system. Lack of consistent access to treatment, barriers due to cost or discrimination, and high rates of uninsurance can stand in the way of getting help. The cost in lives and in dollars is enormous. Fortunately, the ACA offers an incredible opportunity to improve care for people with substance use disorders and further integrate it into our existing health care delivery system.
The ACA will have a direct impact in a number of ways. First, the law raises the income threshold for Medicaid eligibility, a step that will dramatically increase the number of people who qualify for treatment of substance use disorders through their insurance coverage. Next, the ACA builds on the 2008 federal mental health parity law requiring insurers to cover mental health at the same level as physical health issues. Finally, the ACA creates a new pilot program in Medicaid to treat those who have multiple chronic conditions. Known as "health homes," these patient-centered systems of care are designed to address the complexities of chronic conditions. Patients must have two chronic diseases to qualify and substance use disorders are included on the list of conditions.
At Community Catalyst, we work at the federal and state levels to implement the Affordable Care Act provisions that affect those with substance use disorders, as well as with local advocates to improve coverage, access and treatment in their states. Our federal work focuses on implementation of the national health reform law, parity for substance use disorders, and protecting funding for the safety net and addiction programs. In two states, Georgia and Massachusetts, we are supporting advocates in major initiatives to make a significant difference in the lives of those struggling with substance use disorders and shape the health care system for the better.
Our partners in Georgia, Georgians for a Healthy Future and the Georgia Council on Substance Abuse, are working closely with the state's Medicaid Director on Medicaid issues that affect beneficiaries with substance use disorders. By partnering with and advising the state during the redesign of their Medicaid program, advocates will work to ensure that this vital program meets the needs of those dealing with substance use disorders. In Massachusetts, Health Care for All is focused on the state's payment reform bill, a unique opportunity to reform the delivery system in ways that will mean improved services, more affordable treatment, and better integrated care. Additionally, Health Law Advocates is pursuing a number of advocacy goals, including the enforcement of the federal law mental health and addiction treatment parity law.
The work of these advocates shows that whether change comes through modifying an existing program or by supporting legislative action, we can make strides toward improving care for people who have substance use disorders. The role of Community Catalyst is not only to support specific states like Georgia and Massachusetts but also to engage other state advocates in substance use disorders advocacy. We work to educate advocates about the ACA and to connect consumer health advocates with those who work on substance use disorders. Community Catalyst believes treatment should be readily available to all who need it. By pursuing policy change in Washington as well as in the states, we are moving closer to this goal.