Improved Substance Abuse Coverage under the Affordable Care Act

Starting in 2014, under the Affordable Care Act (ACA), Americans will suddenly enjoy greater coverage for substance abuse and mental health treatments.

How Does the ACA Increase Access to Substance Abuse Treatment?

Under this new legislation:

• Substance abuse and mental health treatments become one of ten ‘essential health benefits’ - no matter what plan you’re covered under, you’ll have coverage.

• The act mandates mental health and substance abuse treatment parity - this means you’ll receive treatment for mental health and substance abuse issues that is equal in scope to the treatments offered for physical health complaints.

• The number of Americans who’ll have at least minimal insurance coverage should increase dramatically.

Essential Health Benefits

As of January 1st 2014, any insurance plan you buy into must offer coverage for 10 essential services and treatments - substance abuse and mental health services being one of these essentials.

So no matter what plan you buy, you will have coverage for substance abuse and mental health services.

Mandated Parity

Under new parity regulations, insurance plans must offer benefits that are equivalent in nature to benefits provided for general medical and surgical treatments.

Parity laws will cover all non-grandfathered individual and small-group plans.

Increased Coverage - Increased Access to Substance Abuse Services

According to the Department of Health and Human Services, under the provisions of the act:

• By 2022, 27 million currently uninsured Americans will receive health coverage.
• By 2020, 62.5 million Americans will enjoy increased substance abuse and mental health coverage, including 32.1 million who’ll have coverage for these conditions for the first time.

An estimated 25% of those currently without coverage have a mental illness or substance use disorder in need of treatment, so from this subset alone, the ACA should provide needed treatment to almost 7 million Americans living with mental illness or a substance use disorder.¹