Table 1.
The Patient Protection and Affordable Care Act: implications for SUD treatment
| Relevant provisions | Implications for SUD treatment |
|---|---|
| Integrating behavioral health and primary care | • SUD treatments will be provided within the primary care setting. |
| • Reimbursement for treatment will be similar to other chronic diseases needing long-term management. | |
| Emphasizing prevention of substance abuse | • Preventive services for substance-related conditions will be covered (eg, routine screening of substance use and related problems, brief intervention, and referral to treatment). |
| Allowing individuals with a pre-existing condition to have insurance coverage | • Previously uninsured individuals (due to a pre-existing condition) will have insurance coverage for SUD treatment. |
| • Individuals who received SUD treatment in the public sector or from other specialty programs will receive SUD care in the mainstream health care system. | |
| Expanding medicaid | • It will bring coverage to a large number of new enrollees. |
| • Essential mental health and substance abuse services will be covered. | |
| Increasing eligibility of coverage for children up to age 26 under their parents’ plans | • Young adults – the group with an elevated rate of SUDs – will be covered for prevention services and treatment for SUDs. |
| Eliminating lifetime caps on essential benefits and supporting health care homes to coordinate care for individuals with chronic illnesses | • SUDs will be treated, managed, and monitored over a lifetime like other chronic illnesses. |