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07Jun

Report: Uncovering Coverage Gaps: A Review of Addiction Benefits in ACA Plans

By: The National Center on Addiction and Substance Abuse

NEW YORK, N.Y., June 7, 2016 – The National Center on Addiction and Substance Abuse is pleased to share our latest report, Uncovering Coverage Gaps: A Review of Addiction Benefits in ACA Plans, which reveals that across the U.S., insurance plans are not covering the necessary treatments for people with addiction.

Historically, insurance coverage for addiction has been insufficient. The Affordable Care Act (ACA) aims to address this by designating substance use disorder services as a mandated benefit that must be provided at parity, meaning equal or comparable to medical and surgical benefits. But the ACA does not identify which addiction benefits should be covered. Instead, each state chooses an Essential Health Benefits (EHB) benchmark plan to dictate the benefits ACA plans sold in that state must cover.

We conducted a comprehensive review of the addiction benefits offered in each state’s 2017 EHB benchmark plan and found major gaps in coverage. The findings are disheartening.

  • None of the plans provide comprehensive coverage for addiction by covering the full array of critical benefits without harmful treatment limitations.
  • Over two-thirds of the plans contain ACA violations.
  • Eighteen percent of the plans do not comply with parity requirements.

When people cannot access effective treatment, it can lead to disability or premature death, and a range of other costly health and social consequences. Conversely, effective treatment has been shown to not only save lives, but also to reduce health care costs and decrease drug-related crimes. The report calls on states and insurers to revise their plans to comply with the law and cover the full range of effective addiction treatments, so that people with addiction can receive the same insurance benefits as those with other chronic diseases.

We invite you to download the report and share it widely with your colleagues and partners. It can also be found on our website at: www.centeronaddiction.org/addiction-research/reports. If you have any questions about the report, please do not hesitate to contact Lindsey Vuolo, JD, MPH, Associate Director of Health Law and Policy and lead author of the report, at lvuolo@centeronaddiction.org.

About The National Center on Addiction and Substance Abuse

We are a national nonprofit research and policy organization focused on improving the understanding, prevention and treatment of substance use and addiction. Founded in 1992 by former U.S. Secretary of Health, Education, and Welfare, Joseph A. Califano, Jr., our interdisciplinary experts collaborate with others to promote effective policies and practices. We conduct and synthesize research, inform and guide the public, evaluate and improve health care, and analyze and recommend policies on substance use and addiction. For more information, visit

www.centeronaddiction.org.

Source
The National Center on Addiction and Substance Abuse
Teaser/Summary
The National Center on Addiction and Substance Abuse is pleased to share our latest report, Uncovering Coverage Gaps: A Review of Addiction Benefits in ACA Plans, which reveals that across the U.S., insurance plans are not covering the necessary treatments for people with addiction.