In early January of 2017, by a final vote of 51-48, the Senate approved a budget resolution that can potentially result in a massive overhaul of the Affordable Care Act that was set in place during the Obama administration. While this does not mean that Obamacare has been entirely repealed yet, it does mean that wheels have been set in motion, and changes are going to be made. For those of us in recovery and even in active addiction, this could bring about a huge shift in our ability to access drug and alcohol treatment. Many people who suffer from addiction are of low income and have minimal insurance coverage. A majority of the population in treatment today consists of people between the ages of 18 and 27, who are still using their parents’ insurance plans. Also, a high number of those in treatment suffer from co-existing or pre-existing medical and mental illness. These are all areas that President Trump stated he wanted to overhaul, and, if he is successful, it will create a huge block for a large majority of those seeking help for drug and alcohol addictions. What is Actually Happening? If the intended process known as budget reconciliation, or more precisely, a closer inspection of how government spends taxes, is used, it could be good news for those concerned with insurance cutoff ages or for those needing coverage for pre-existing conditions, as the repeal would be unable to penetrate these areas of the law. On the other hand, the requirement for people to have healthcare coverage is an area that could be repealed, as it is enforced through a billion dollar tax system. While there has been much speculation about what the president plans to actually repeal and replace, he has been adamant about pulling everything that the Obama Administration had worked to put into effect. While the new president claims that the repeal/replace would happen “probably the same day – could be the same hour,” some Republican senators disagree that such a massive overhaul could take place in such a short amount of time, as there would be nothing to “replace” the current plan with. As for the American people, in an NPR poll released in January, 38 percent of people felt that the Affordable Care Act (ACA) should be strengthened or expanded, while 31 percent felt that is should be repealed and replaced. Regardless of which side you take, if you are covered under ACA, there are definitely changes coming your way. Treatment Access In regards to drug and alcohol treatment, the Affordable Care Act provides coverage similar to private insurance plans. The program also expands funds and treatment options for those who are covered by Medicare and Medicaid. ACA also provides benefits for patients who require dual diagnosis treatment if the patient struggles with depression or eating disorders. Affordability If the Affordable Care Act is abolished, many people will lose quality drug and alcohol treatment. The problem being that long-term treatment is just too expensive for most people to afford. This could result in a massive increase in deaths by overdose, suicide, and addiction-related health issues. Along with simply being in a treatment center, separated from drugs and alcohol, the reformation of ACA would mean that addicts would lose access to medications for any present mental illnesses, the inability to be professionally treated, the loss of therapy and counseling, the loss of access to detoxes, and frankly, a lower chance of success. For most people, treatment is an essential first step in the recovery process, separating from the addiction before entering a 12-step or other programs. Those who do enter treatment have a much higher chance for recovery and continued sobriety. Quality The remaining issue with changing the Affordable Care Act is that the quality of drug and alcohol treatment centers that are available would probably decrease. Treatment costs are so high that most of their profits are only really brought in via insurance plans, which is why most treatment centers will accept insurance as payment. If centers can no longer charge insurance, chances are, many will be forced to close their doors. This would potentially shut down non-profit facilities, as well as many hospitalize detox centers and shortly after, IOP’s. One of the best parts of getting sober today is the massive network of licensed treatment centers to choose from that provide people all over the country with a nearby treatment option. If many of these were to close, it would be likely that the ones that remained would have to resort to only self-pay options (which only a very small percentage could afford) or to other… maybe not so savory measures, i.e, the deed to the car or house. Obviously, this is speculation, but if the country continues on in the way it is going, it seems a likely option. Now to be fair, none of this has happened as of yet, and things could possibly change. Until the Senate finally sits down to make the revisions or repeals to the Affordable Care Act, drug and alcohol treatment will remain the forerunner for the first step in recovery for drunks and addicts. Losing the ACA could be detrimental for many, but let’s cross our fingers that whatever the government replaces the plan with, will keep the well-being of the people in mind. Getting Help at Wayside House If you are a woman struggling with addiction and mental health issues, Wayside House can help. We offer a women-only program and provide a safe, supportive environment to recover in. We have outstanding treatments and therapies that are often only found in more expensive programs. We offer inpatient rehab with various therapies, relapse prevention education, outpatient, and aftercare, as well as programs for medical professionals and veterans. Contact Wayside House at 561-278-0055 to learn more.