Will Insured Addicts Overwhelm the System?

By Chrisanne Grise 04/16/13

Millions of addicts will soon become eligible for health insurance, but the system may not be able to treat them all.

Will there be enough to go around? Photo via

Right now, only about 10% of the 23 million Americans with alcohol or drug problems receive treatment, in part because about a quarter of them are uninsured. But this could soon change. When new health care laws kick in this January, 3 to 5 million people with addiction problems will finally become eligible for insurance coverage. The new law designates addiction treatment as an “essential health benefit” for many plans, provides subsidies for private coverage, and encourages states to expand their Medicaid programs to more working poor individuals. "This is probably the most profound change we've had in drug policy ever," says Michael Botticelli, deputy director of the Office of National Drug Control Policy. "We know one of the most significant reasons for the treatment gap is folks who don't have insurance or who have an inadequate coverage package for substance use disorders."

Still, experts warn that this overhaul may not go as smoothly as planned. Depending on how many states decide to expand their Medicaid programs, the number of people seeking treatment could double, according to the Associated Press. And this surge in new patients could potentially overwhelm the system. "There is no illness currently being treated that will be more affected by the Affordable Care Act than addiction," says Tom McLellan, CEO of the nonprofit Treatment Research Institute and President Barack Obama's former deputy drug czar. "That's because we have a system of treatment that was built for a time when they didn't understand that addiction was an illness." Treatment facilities in two-thirds of the states are already close to or at capacity, so wait lists could reach months or longer. In fact, many rehab centers have been shrinking instead of growing in recent years, due to government budget cuts. "Advocates just get so excited,” says Josh Archambault of the Pioneer Institute, a nonpartisan public policy research center in Boston, “but at some point, reality is going to hit and they'll find it's not all it was cracked up to be."

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Chrisanne Grise is a multimedia journalist specializing in health/fitness, lifestyle, travel, bridal, and music. Her work has appeared in print and online for publications such as Martha Stewart Weddings, Parents, FitnessMagazine, Fisher Price, Bridal Guide, Scholastic's Choices, AbsolutePunk.net, Chorus.fm, and more. She is the Senior Editor at The New York Times Upfront. Follow her on Linkedin and Twitter.