As Congress and the Trump Administration consider legislation to replace the Affordable Care Act, they would do well to keep in mind one facet of this law which is providing immense help to as many as 114,000 Pennsylvanians, according to Medicaid and a Harvard Medical School study.
These people are getting coverage for substance abuse treatment, including many affected by the nation’s opioid addiction crisis. Gov. Tom Wolf has led the battle to provide much needed help for Pennsylvanians caught in the opioid abuse trap. The opioid and heroin abuse problem tragically took the lives of 3,500 people in our state in 2015.
The governor’s expansion of Medicaid under the ACA has provided access to treatment for 63,000 Pennsylvanians who need drug and alcohol treatment. In addition, about 439,000 of our citizens signed up for health insurance through the ACA’s individual market last year. That is private coverage so we don’t know exactly how many of these people are getting mental health or substance abuse treatment.
However, the Harvard Medical School study estimates 51,000 Pennsylvanians are getting substance abuse treatment through the ACA’s individual health market. This coverage exists because the ACA said mental health and substance abuse treatment is an “essential health benefit” and must be provided “in parity” with medical coverage — that is, in the same way as medical coverage.
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Prior to the ACA, this was often not the case. While Pennsylvania legislators passed a law nearly a decade ago that required certain coverage for mental health and substance use disorder treatment for some group plans, the ACA extended mental health and substance use treatment options to all individual and group plans, which is the 25 percent of all health coverage in the state that is within the state insurance regulators’ jurisdiction. The fact is, prior to the ACA, many Pennsylvanians simply did not have access to mental health and substance abuse coverage, if they had insurance at all.
Stripping away this vital safety net in the midst of the current heroin and opioid crisis would be a cruel act for the tens of thousands of our citizens benefiting from treatment and their loved ones, just when Governor Wolf and the Pennsylvania legislature have committed resources to help.
Under the governor’s leadership, legislators approved $20.4 million to establish 45 treatment centers around the state for heroin and opioid addiction in 2016. Wolf has also worked with state and local law enforcement and other first responders to make Naloxone, an overdose reversal drug, widely available, and this has saved lives.
Repealing and replacing Obamacare may be a convenient political slogan. But such an action by Congress and the Trump administration, without careful thought and understanding of the consequences, would have real, potentially devastating impacts on many people across our state. I urge our elected leaders in Washington to think long and hard before repealing the ACA about what its replacement will look like, and how they will provide coverage for our fellow citizens who need mental health and substance abuse treatment.
Teresa Miller is the Pennsylvania Insurance Commissioner.