Skip to content Skip to navigation

CalTAF proposes amendment mandating coverage for substance abuse treatment

February 21, 2012
by News release
| Reprints

The California Treatment Advocacy Foundation (CalTAF) has voiced support for pending legislation concerning the treatment and diagnosis of mental illnesses and called on state legislators to add an amendment to protect those in need of alcohol and drug rehabilitation.

AB 154, authored by Assemblyman Jim Beall (D-San Jose), recently passed the California State Assembly and is currently under review by the State Senate. That bill broadens the mental health services covered by private insurance plans. The amendment proposed by CalTAF would specifically expand the measure to protect those individuals who have been prescribed substance abuse treatment by their physicians but who have been denied care by their health insurance carrier.

"The passage of this bill is critically important as it will help people get access to the care they need as prescribed by their physician," said Phillip Greer, executive director of CalTAF. "For far too long health insurance companies have imposed barriers that reduce access to much-needed chemical dependency treatment. When this happens, the health and wellness of whole families are jeopardized and the unnecessary costs to society ripple across California's communities, schools, businesses and healthcare delivery system."

The amendment proposed by CalTAF would be modeled after Pennsylvania's Drug and Alcohol Insurance Law (Pennsylvania Act 106 of 1989) which requires most group health insurance plans to include coverage for addiction treatment. The only prerequisite is certification and referral by a licensed physician or a licensed psychologist. The Act also requires most group health policies to include mandated minimum benefits for treatment of alcohol and drug addiction.

Alcohol and drug abuse costs combined are the costliest health problems in California. Current estimates for the cost of drug abuse in California are approximately $4 billion and last year alone approximately 200,000 patients were admitted to treatment programs receiving state funding. "By requiring that health insurance providers make available this treatment -- treatment already included in most policies -- costs to the state decrease and successful treatment increases," says Greer.

The irony in all this, according to Greer, is that most health insurance policies written in California already contain some provisions for substance abuse treatment. "The Wellstone Dominici Equity Act was passed by Congress in 2008 to try to protect consumers," said Greer, "but insurers continue to impose unreasonable deductibles and co-payments or impose care guidelines which keep patients from receiving treatment at the level of intensity or for an amount of time that is universally accepted as necessary. That is why this new legislation is so important."

The California Addiction Treatment Advocacy Foundation is dedicated to improving access to effective and affordable chemical dependency treatment throughout the state. Created in 2011 by a group of concerned California-based providers, CalTAF believes that through insurance reform, either voluntary or mandated, barriers to care can be eliminated, thus making it easier for individuals to get access to the treatment and professionals they need.

Further information on the work of CalTAF may be obtained at www.caltaf.org

Topics