ACA Changes Expected to Result in Less Treatment Access

(Summer 2017) According to a study conducted by the Johns Hopkins Bloomberg School of Public Health, the number of individuals with mental health and substance abuse disorders covered by insurance increased in 2014 due to greater access provided by the Affordable Care Act (ACA). Efforts of the Trump Administration, to strip away the ACA would negate any forward momentum experienced and could be particularly damaging to the fight against the U.S. opioid epidemic, warned Michael Botticelli, former director of the White House Office of National Drug Control Policy. The ACA’s repeal, according to a health economist at Harvard Medical School, may terminate coverage for 1.8 million people who have been treated for mental health or addiction issues, reduce expenditures in these areas by $5.5 billion, and lift a mandate that Medicaid cover addiction and mental health treatment in states that elected to enlarge the federal health care plan.

Medicaid currently insures a large majority of individuals who would be impacted by the ACA’s rollback. In its place, the Trump administration has proposed issuing block grants to the states, allowing each state to implement its own Medicaid system. Some experts believe the block grants will come with lower funding, which would, in turn, result in fewer benefits. Close to 1.3 million Americans currently access treatment for addiction and mental health conditions through Medicaid’s expansion.

The new Trump strategy would also permit the states that took advantage of a wider Medicaid safety net to choose whether or not to incorporate mental health and addiction treatment as of 2020. States that could opt out of these benefits are some of the ones mired most in the opioid epidemic, such as Ohio, West Virginia and Kentucky.

With the proposed changes announced, 19 state attorneys general are now speaking out. The group recently sent a letter to President Trump and congressional Republicans demanding that any substitution for the ACA address drug treatment satisfactorily. The letter goes on to warn of the drug crisis’ severity, which disrupts communities across the country and is currently responsible for the unprecedented rate of overdoses.

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