Substance Abuse and the Affordable Care Act

The Affordable Care Act (ACA) put in place comprehensive health insurance reforms that will make health insurance available to many more people, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans.

The ACA includes substance use disorders as one of the ten elements of essential health benefits. This means that all health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults starting in 2014 must include services for substance use disorders.

By including these benefits in health insurance packages, more health care providers can offer and be reimbursed for these services, resulting in more individuals having access to treatment. The specific substance abuse services that will be covered are currently being determined by the Department of Health and Human Services, and will take into account evidence on what services allow individuals to get the treatment they need and help them with recovery.

Additional Resources:

Expanding the Public Health Workforce

The ACA increases the number of people who will be eligible for health care under Medicaid in 2014, some of whom may need intervention and treatment services for substance use disorders. To fill this service gap, training from medical and non-medical professionals currently working in the field, as well as new groups of behavioral health specialists to fill new jobs is needed.

Additional Resources:

AHRQ Webpage

Electronic Health Records

Individual patient Electronic Health Records (EHRs) as part of health information computer systems gives health care providers the ability to address substance use disorders in primary care settings. With this information, health care providers will be able to accurately document a patient’s complete medical history. Under development are EHRs with privacy features that allow for the integration of substance use disorder treatment records into an individual’s EHR. Certified EHR systems will allow for the exchange of substance use information between medical professionals when appropriate, and with patient consent.