This brief, which was developed with support from the Commonwealth Fund, examines the impact of the ACA on public mental health and substance use systems in three Midwestern states: Michigan and Indiana, both Medicaid expansion states, and Wisconsin, a non-expansion state.
Full Answer
What did the Affordable Care Act do for substance abuse?
Substance Abuse and the Affordable Care Act. The Affordable Care Act (ACA) put in place comprehensive health insurance reforms that will make health insurance available to many more people, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans.
What is the Affordable Care Act (ACA)?
The Affordable Care Act (ACA) put in place comprehensive health insurance reforms that will make health insurance available to many more people, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans.
How does the Affordable Care Act affect mental health?
Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans The Affordable Care Act will provide one of the largest expansions of mental health and substance use disorder coverage in a generation.
How does the Affordable Care Act affect SUD treatment?
AFFORDABLE CARE ACT The ACA has dramatically changed that picture. The ACA provides greater access to SUD treatment through major coverage expansions, regulatory changes requiring coverage of SUD treatments in existing insurance plans, and requirements for SUD treatments to be offered on par with medical and surgical procedures.
What is the most effective intervention for substance abuse?
CBT is often rated as the most effective approach to treatment with a drug and alcohol population.
What are 3 options for drug abuse treatment?
There are many options that have been successful in treating drug addiction, including:behavioral counseling.medication.medical devices and applications used to treat withdrawal symptoms or deliver skills training.evaluation and treatment for co-occurring mental health issues such as depression and anxiety.More items...•
What is a treatment plan for substance abuse?
A substance abuse treatment plan is an individualized, written document that details a client's goals and objectives, the steps need to achieve those, and a timeline for treatment. These plans are mutually agreed upon with the client and the clinician.
What does Samhsa stand for?
Substance Abuse and Mental Health Services AdministrationSAMHSA - Substance Abuse and Mental Health Services Administration.
What is treatment model?
The model proposes that the manner in which an individual views, appraises, or perceives events around himself/ herself is what dictates their subsequent emotional responses and behavioral choices.
What is the medical term for treatment using drugs?
Listen to pronunciation. (… THAYR-uh-pee) Treatment with any substance, other than food, that is used to prevent, diagnose, treat, or relieve symptoms of a disease or abnormal condition.
How do you implement a treatment plan?
Treatment plans usually follow a simple format and typically include the following information:The patient's personal information, psychological history and demographics.A diagnosis of the current mental health problem.High-priority treatment goals.Measurable objectives.A timeline for treatment progress.More items...•
What is the treatment plan?
Listen to pronunciation. (TREET-ment plan) A detailed plan with information about a patient's disease, the goal of treatment, the treatment options for the disease and possible side effects, and the expected length of treatment.
What is a treatment plan intervention?
Interventions are what you do to help the patient complete the objective. Interventions also are measurable and objective. There should be at least one intervention for every objective. If the patient does not complete the objective, then new interventions should be added to the plan.
What was the name of the federal agency that preceded the Substance Abuse and Mental Health Services Administration?
History and legal definition CSAP was established in 1992 from the previous Office of Substance Abuse Prevention by the law called the ADAMHA Reorganization Act.
Is SAMHSA part of HHS?
The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation and to improve the lives of individuals living with mental and substance use disorders, and ...
What has SAMHSA done?
What does SAMHSA do? SAMHSA provides leadership, supports programs and services, and devotes resources to helping the United States act on the knowledge that behavioral health is essential to health, prevention works, treatment is effective, and people recover.
What is the ACA?
The Affordable Care Act (ACA) put in place comprehensive health insurance reforms that will make health insurance available to many more people, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans.
What is the ACA expansion?
The ACA increases the number of people who will be eligible for health care under Medicaid in 2014, some of whom may need intervention and treatment services for substance use disorders.
Who determines substance abuse services?
The specific substance abuse services that will be covered are currently being determined by the Department of Health and Human Services, and will take into account evidence on what services allow individuals to get the treatment they need and help them with recovery.
Does ACA cover substance use disorders?
The ACA includes substance use disorders as one of the ten elements of essential health benefits . This means that all health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults starting in 2014 must include services for substance use disorders. By including these benefits in health insurance ...
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What percentage of small group insurances have substance abuse?
We estimate that about 95 percent of those with small group market coverage have substance abuse and mental health benefits. 4 Again, the federal parity law does not apply to small group plans.
What is the Affordable Care Act?
The Affordable Care Act: Better Coverage for Mental Health and Substance Use Disorders. The Affordable Care Act and its implementing regulations, building on the Mental Health Parity and Addiction Equity Act, will expand coverage of mental health and substance use disorder benefits and federal parity protections in three distinct ways: (1) ...
How many Americans lack health insurance?
In addition, 47.5 million Americans lack health insurance coverage altogether, 5 and 25 percent of uninsured adults have a mental health condition or substance use disorder ...
How many Americans are covered by non grandfathered insurance?
Under this approach, 7.1 million Americans currently covered in ...
What drugs are covered by ACA?
There is one therapeutic category for substance use disorder medications and four classes. The classes include: Alcohol medications, including acamprosate, naltrexone, disulfiram.
What percentage of plans violate the ACA?
50 percent of plans violate the requirement for tobacco cessation coverage. 45 percent of plans violate the requirement for coverage of prescription drugs to treat addiction. 11 plans lack enough detail to evaluate compliance with the ACA’s requirements. Two plans violate the ban on lifetime dollar limits on benefits.
What percentage of insurance plans do not cover opioids?
100 percent of the plans lack sufficient coverage for prescription drugs to treat opioid addiction. 64 percent of the plans require prior authorization for a range of services. 60 percent of the plans lack sufficient coverage for tobacco cessation.
What percentage of the plans lack sufficient coverage for prescription drugs to treat opioid addiction?
One plan violates the requirement for coverage of substance use disorder services. 100 percent of the plans lack sufficient coverage for prescription drugs to treat opioid addiction. 64 percent of the plans require prior authorization for a range of services.
What is the goal of the CASA?
Their goal was to determine if the plans met ACA requirements for substance use disorder benefits, complied with parity requirements, provided adequate care for addiction treatment and provided enough information for evaluation.
How many ACA plans have overly restrictive treatment limitations?
Nine plans have overly restrictive treatment limitations. Four plans have excessively high cost sharing requirements. Vuolo said the states should review and revise their benchmark plans to comply with ACA requirements and ensure the plans comprehensively cover substance use disorder treatments without limitations.
Does the Affordable Care Act cover prescription drugs?
In doing so, the plans: Have to cover preventative services and prescription drugs. Cannot impose lifetime or annual dollar limits.
How many states have implemented the Affordable Care Act?
Implementation of the Affordable Care Act has varied across states (Exhibit 5). In this section, we identify the decisions that all 50 states and the District of Columbia have made in implementing the law’s three major com-ponents—the market reforms, the establishment of new marketplaces, and Medicaid expansion. We found that nearly all states will require or encourage compliance with the market reforms, every state will have a mar-ketplace, and more than half of states will expand their Medicaid programs.
How does the Affordable Care Act affect health insurance?
The Affordable Care Act has the potential to increase access to private and public health insurance for mil-lions of Americans primarily through three mecha-nisms: 1) implementing new market reforms that set minimum standards for coverage; 2) establishing new health insurance marketplaces, also known as individual exchanges and Small Business Health Options Program (SHOP) exchanges; and 3) expanding Medicaid eligi-bility to adults with incomes up to 138 percent of the federal poverty level ($15,856 for an individual and $32,499 for a family of four) (Exhibit 1) . This report examines the status of state implementation of each of these reforms in all 50 states and the District of Columbia as of November 1, 2013.
What are the components of the Affordable Care Act?
Because states are the primary implementers of these requirements, this report examines the status of state action on the three major components of health reform—the mar-ket reforms, the establishment of health insurance marketplaces, and Medicaid expansion. The analysis finds that nearly all states will require or encourage compliance with the market reforms, every state will have a marketplace, and more than half the states will expand their Medicaid programs. The analysis also shows that federal regulators have stepped in where states have been unable or unwilling to take action. These findings suggest that regulators will continue to help ensure consumers receive the benefits of the law—regardless of the state they live in—but raise questions about how this variation might affect consumers as state insurance markets undergo significant transition in 2014.
Both Sides of The ACA
Positive Aspects of The ACA Affecting Substance Abuse Treatment
- There are still many positive aspects of the ACA that will help to affect substance abuse treatment. They are: 1. “The new system covers more services for more people.” 2. It states that “patients are entitled to mental health and substance abuse treatment without arbitrary or discriminatory limitations.” 3. It keeps providers from denying coverage...
Negative Aspects of The ACA Affecting Substance Abuse Treatment
- Some of the negative aspects of the ACA and its policies are: 1. Providers who cover more patients and do not see “a corresponding increase in their overall earnings” may decide not too take on more Medicare or Medicaid patients. These providers could “determine the government reimbursement rates to be too low” which is why they will not want to take on patients like these…