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Medicaid Boost Could Help Millions of Addicts

Expansion of the insurance program could provide substance-abuse treatment for 2.6 million uninsured alcoholics and addicts, experts say.

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By Hunter R. Slaton

11/14/12

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The nonprofit advocacy group Faces and Voices of Recovery hosted a webinar yesterday, outlining coming changes to the American health-care landscape as a result of Medicaid's expansion. This is part of the Patient Protection and Affordable Care Act—aka Obamacare. Under the law, in states that choose to participate (as per a Supreme Court ruling this summer), Medicaid eligibility will be extended to everyone under 65 years of age with income at or below 133% of the federal poverty level (FPL). At present that's $14,404 a year for an individual and $29,327 for a family of four. According to Suzanne Fields, senior advisor on health care financing for SAMHSA (the Substance Abuse and Mental Health Services Administration), "The key point from my piece of the conversation is that the Medicaid expansion will provide benefits to mental-health and substance-abuse clientele."

Who are these people? According to Fields, there are currently 37.9 million uninsured individuals who make less than 400% of the FPL. Eleven million of them, or 29%, have a behavioral health problem. Seven percent of this subset have a serious mental illness; 14.9% suffer from "serious psychological distress"; and 14.2%, or 2.6 million people, have a substance-use disorder. These 2.6 million previously uninsured alcoholics and addicts—73% of whom are male, 34% aged 18–34, and 79% white or hispanic—now will be eligible for substance-abuse treatment benefits. As Fields pointed out, structures are already in place to make this happen: "There are several vehicles by which Medicaid can cover substance-abuse programs, and those vehicles exist today." Yet another important aspect of the Medicaid expansion, she added, is "the inclusion of both mental health and substance abuse as essential benefits."

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