What the Supreme Court Ruling on the Affordable Care Act Means for Addiction Professionals.

On July 28th, the Supreme Court largely upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA).  In a 5 to 4 decision written by Chief Justice John G. Roberts, the court ruled the insurance provision of the PPACA is a legitimate use of the governmental power of taxation and not an unconstitutional mandate.

What the Health Care Law Means for the Addiction Profession
The Patient Protection and Affordable Care Act (PPACA), signed into law by President Obama in March 2010, improves coverage for and access to health care for substance use disorders by expanding health insurance coverage to 32 million Americans in 2014, largely through state health  insurance Exchanges for individuals and small businesses, and through an expansion of Medicaid for low-income individuals and families. The PPACA requires the plans in the exchanges, as well as Medicaid expansion plans, to cover a set of essential health benefits that include mental health and substance use disorder [MH/SUD] services, including behavioral health treatment. In other words, under the law, services such as screening, early intervention, treatment and recovery support for patients with substance use disorders will be provided in the same manner and in the same primary care settings as services for any other illness. The change will bring needed help to many as it also increases awareness that drug dependence is a chronic, treatable disease.

NAADAC, along with other addiction groups, is working to ensure the full inclusion of substance use disorder services within the Essential Health Benefits package that will be offered under the PPACA.

In 2010, over 23.1 million Americans age 12 and older needed treatment for a substance use disorder, and yet only 2.3 million – one in ten – received care at a specialty treatment center. Many of those who do not receive, but could benefit from, treatment do not have health insurance or other means to pay for it. By helping more people get the care they need, the PPACA, when fully implemented in 2014, will go a long way toward closing the treatment gap.

Features of the ACA that benefit those in need of treatment for substance use disorders include:

• Broader Coverage for Americans with Substance Use Disorders - Of the 32 million currently uninsured Americans who will receive health insurance under the new law, about 5 million meet medical diagnostic criteria for a substance use disorder. These Americans will receive insurance coverage to help pay for substance use treatment.
• No Denial of Coverage for Pre-Existing Conditions - Insurers are no longer able to deny coverage based on pre-existing medical conditions, such as substance use disorders.
• Plans Must Cover Substance Use Disorders - Individuals and small businesses will have access to affordable coverage through a new competitive private health insurance market through state-based Health Insurance Exchanges.  Plans offered through the Exchanges are required to cover mental health and substance use disorder services and must meet the parity requirements of the Wellstone-Domenici Mental Health Parity Act of 2008.
• Greater Access to Treatment through Medicaid - In 2014, Medicaid eligibility will be expanded for families or individuals with incomes up to 133 percent of Federal poverty guidelines. Many newly eligible beneficiaries will receive substance use services.  Participation in Medicaid will help more patients gain access to traditional healthcare benefits, such as medications and behavioral therapies in the treatment of addiction.

Addiction will not disappear on its own. NAADAC looks to Congress and the Administration to lead our nation into a 21st century that is healthy, clean and safe. Addiction counselors, working with Congress and other policymakers, are optimistic that together we can create a healthier and a safer America.

For assistance or more information, contact Chris Campbell, Director of Government Relations at 800.548.0497, ext. 129, or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .  Also, be sure to check out the NAADAC Advocacy website at www.naadac.org/advocacy.