Robert Reich Explains


The Effects of the Repeal of Obamacare on Addiction Treatment Costs

The early part of 2010 witnessed the rolling out of new healthcare policies by the Obama administration. These policies were formulated to offer accessible and affordable health insurance cover to those Americans who were previously uninsured.

The Journal of Substance Abuse Treatment reported that the Affordable Care Act (ACA) or Obamacare had helped offer insurance cover to over 5 million individuals suffering from mental health and addiction problems.

One of the greatest benefits of the Affordable Care Act for addiction patients was that it covered the costs of rehab. Also, mental health and substance abuse disorders were listed as one of the ten EHBs or Essential Health Benefits that required coverage under the ACA health insurance system. In other words, the health insurance plans which met the guidelines of Obamacare for minimal coverage had to include insurance for addiction treatment.

Widespread concern over withdrawal of coverage

With the Congress working to withdraw the ACA, those with mental health disorders and addiction problems, along with their treatment providers and families, are worried about how patients will manage to maintain sobriety and good mental health in the absence of insurance cover.

The Substance Abuse and Mental Health Services Administration reports that almost 30 percent of the individuals who received coverage under the Medicaid expansion plan had some mental disorder (schizophrenia, anxiety) or substance abuse problem (alcohol, opioids).

Between 2015 and 2016, there was a 30 percent increase in the Medicaid expenditure on prescriptions for treating opioid abuse. New Hampshire, Kentucky, Ohio, and Massachusetts were among the states that reported the highest death rates due to opioid overdose in 2015.

Reduction in Medicaid Costs and No Tax Credits

The Better Care Reconciliation Act will cut down on the Medicaid federal funding and withdraw Medicaid expansion which offered coverage to nearly 11 million low-income citizens. In addition to this, it would also cause a fundamental restructuring of the program and transform Medicaid from an open benefit to something which allows limited spending only.

The repeal of the ACA without any replacement would be an extremely reckless decision. It is likely to have a very damaging effect on people with addiction and related disorders. Even a partial repeal of the Affordable Care Act would end up eliminating tax benefits which would minimize premiums for nearly 85 percent of the people who purchase insurance coverage on the state and federal exchanges. The majority of the people receiving tax benefits pay under $100 per month towards insurance. These people have minimal out-of-pocket expenses which make coverage affordable for them.

The benefit cuts were confirmed by the House of Republicans in a meeting last week. Republicans who form a part of the committee claim that the transformation would provide additional flexibility to states with regards to coverage decisions. They believe that states would not stop providing mental health and addiction coverage to recipients of Medicaid if required.

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