How Obamacare Affects Addicts & Alcoholics

The Patient Protection and Affordable Care Act, more commonly known as “Obamacare”, was recently brought before the Supreme Court of the United States of America to be judged on its constitutionality. Though we will not know the results of this landmark case until June, by all accounts, it appears the court will rule that the landmark bill is unconstitutional, and will not stand as it is currently written. If you are someone who is recovering from an addiction, and do not believe this news affects you, think again.


The main reason the law was, reportedly, deemed to be unconstitutional has to do with a provision in the bill referring to an individual mandate. Basically, this part of the law would require all Americans to purchase health insurance by the year 2014. If they do not buy health insurance by that time, they will be fined. Opponents of the bill, mostly Republicans, have cried that this is a wild overreach of governmental powers and is blatantly unconstitutional. The question is, should anyone in recovery even care? They absolutely should.


The Affordable Care Act (ACA) includes several provisions that make addiction prevention and treatment much more accessible and affordable to American citizens. Some proponents of the bill claim that there are provisions that are purposefully kept under-the-radar, by those who champion the law, because they believe if it became common knowledge that the bill was good for addicts there may be a public outcry. It is impossible to know if this is true or not. Frankly, you would be hard pressed to find any American who could detail what the ACA means or what specific provisions it has in it. However, that does not mean the outcome of this landmark case will not affect the daily lives of everyone living in this country, especially those who battle addictions.


There are four ways that the ACA would have a direct impact on those struggling with addictions. The main one has to do with what is called health care parity. Essentially, this means that health insurance plans would be required to provide equal benefits for mental health and addiction as for other health related issues. Without the ACA, it will be very difficult for individuals with addictions to find affordable health care that included mental health coverage.

Extended Coverage

Second, the ACA allows parents to keep their children on their health insurance plans until the age of 26. Most people who develop addictions do so in their teens or early twenties. By allowing individuals to stay on their parent’s health insurance until this age there is a much greater chance they will be able to receive care to treat their addiction before they become uninsured, and therefore unable to afford essential care.

Pre-existing Conditions

Third, the new law bans health insurance companies from denying coverage to those with pre-existing health conditions. Currently, it is very difficult for those recovering from an addiction to get insurance, even if they have been sober for years. If the ACA is deemed unconstitutional, as it seems it soon will be, it will become increasingly difficult, if not impossible, for people who are in recovery to find affordable health insurance.


Last, the ACA has crucial elements that are aimed to help stop people from developing addictions in the first place. A program known as Screening Brief Intervention and Referral to Treatment (SBIRT) is geared towards stopping substance abuse before it can destroy a person’s life. Studies show that SBIRT is actually very effective. A 2009 article in the journal Drug and Alcohol Dependence, for example, found an almost 68% reduction in illicit drug use over a six month period among individuals who had received SBIRT services.  In addition to significantly reducing illegal drug use, SBIRT also reduced individual’s alcohol consumption. Among people who began the program as heavy drinkers, the rate of heavy alcohol use was almost 40% lower after being on the program for six months. However, many insurance companies do not make the fact that it is available readily known. The ACA fixes this problem by categorizing the program as a mandated, preventative benefit. This means that people with Medicaid and insurance plans will be guaranteed this program, should they want or need it, in their coverage.

Proponents of this bill claim that the Patient Protection and Affordable Care Act, as currently written, would greatly benefit the lives of those who are dealing with addictions to drugs or alcohol. They say it would immediately improve, for every single American citizen, the quality, affordability, and accessibility to health care that is specifically targeted to those with addictions. However, with the Supreme Court seemingly set to strike the individual mandate provision, if not the entire law, we could be looking at a system that puts quality and affordable health care out of the reach of those in recovery. Regardless of your political ideology, it is important to stay educated on the potential changes that this historic bill might have for those struggling with addiction.

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