Obamacare Explained: Drug Addiction Treatment

Benefits of the Affordable Care Act for Substance Abuse
November 4, 2013
Obamacare Facts: How They Affect Drug Addicts
November 7, 2013
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obamacare explainedMost people are having a hard time understanding Obamacare in general much less how it applies to drug addiction treatment. But for those who are dealing with substance abuse in themselves or their loved one it is important Obamacare is explained and also that the benefits and how it affects drug addiction treatment are understood. In today’s healthcare world, with Obamacare, drug addiction treatment is more accessible then it ever has been before. 

Here is Obamacare explained

  • Guaranteed issue prohibits insurers from denying coverage to individuals due to pre-existing conditions, and a partial community rating requires insurers to offer the same premium price to all applicants of the same age and geographical location without regard to gender or most pre-existing conditions (excluding tobacco use). 
  • Minimum standards for health insurance policies are established.
  • An individual mandate requires all individuals not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs (such as Tricare) to secure an approved private-insurance policy or pay a penalty, unless the applicable individual has a financial hardship or is a member of a recognized religious sect exempted by the Internal Revenue Service. The law includes subsidies to help people with low incomes comply with the mandate.
  • Health insurance exchanges will commence operation in every state. Each exchange will serve as an online marketplace where individuals and small businesses can compare policies and buy insurance (with a government subsidy if eligible). In the first year of operation, open enrollment on the exchanges runs from October 1, 2013 to March 31, 2014, and insurance plans purchased by December 15, 2013 will begin coverage on January 1, 2014. In subsequent years, open enrollment will start on October 15 and end on December 7.
  • Low-income individuals and families whose incomes are between 100% and 400% of the federal poverty level will receive federal help on a sliding scale if they purchase insurance via an exchange. Those from 133% to 150% of the poverty level will receive help that is 3% to 4% of income. In 2013, the federal help would apply for incomes up to $45,960 for an individual or $94,200 for a family of four; consumers can choose to receive their tax credits in advance, and the exchange will send the money directly to the insurer every month. Small businesses will also be eligible for federal aid.
  • Medicaid eligibility is expanded to include individuals and families with incomes up to 133% of the federal poverty level, including adults without disabilities and without dependent children. The law also provides for a 5% “income disregard”, making the effective income eligibility limit for Medicaid 138% of the poverty level. Furthermore, the State Children’s Health Insurance Program (CHIP) enrollment process is simplified. 
  • Reforms to the Medicare payment system are meant to promote greater efficiency in the healthcare delivery system by restructuring Medicare reimbursements from fee-for-service to bundled payments. Under the new payment system, a single payment is paid to a hospital and a physician group for a defined type of care (such as a hip replacement or surgery) rather than individual payments to individual service providers. 
  • Businesses who employ 50 or more people but do not offer health insurance to their full-time employees will pay a tax penalty if the government has subsidized a full-time employee’s healthcare through tax deductions or other means. This is commonly known as the employer mandate.

So what does these mean for drug addiction treatment? Well, it means that under Obamacare, drug addiction treatment HAS to be covered. Before Obamacare, it was optional whether or not insurance companies had to help with the treatment of drug addiction or alcoholism. Now, under Obamacare it is guaranteed and part of the normal standard of care that anyone who has a problem with alcohol or drugs gets help. 


If you have any more questions about Obamacare or drug addiction treatment please don’t hesitate to call us at Addiction Intervention Now Inc. today!