The wait is over. The Affordable Care Act (ACA), Medicaid expansion, health insurance exchanges—these are some of the important things that now can come pouring out of the federal government, and addiction treatment policy experts who spoke with Addiction Professional on the morning after the election were looking forward to the wheels finally starting to move.
“The time for people putting their head in the sand about health reform is over,” says Chuck Ingoglia, vice president for public policy for the National Council for Community Behavioral Healthcare. With President Obama’s re-election and with Democrats maintaining a majority in the Senate, the repeal of healthcare reform that Republican presidential challenger Mitt Romney had promised if elected is not going to happen.
“There was a lot of ‘hurry up and wait’ for the election,” says Robert Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD). “All of the hemming and hawing that everyone had to do over the ACA—this is why,” he says. “It shows how hard it is to navigate.”
But now that the election is over, several agenda items will start falling into place quickly. Next week is the deadline by which states have to declare whether they will establish an insurance exchange; some had been holding back until the election, says Ingoglia. Now they will have to decide to establish their own exchange or a federal partnership exchange. In either case, the federal Department of Health and Human Services (HHS) has required that substance abuse and mental health treatment be covered by the exchange, in which people who earn too much money to qualify for Medicaid but do not have coverage elsewhere can purchase insurance.
Likewise, many states have been waiting for the election results to decide whether they will expand Medicaid, covering single men and people up to 133 to138% percent of the federal poverty level. Some states have indicated that they would like to expand it but only up to 100 percent of poverty, giving higher-income people the chance to purchase subsidized insurance on the state exchange.
“We’ll see more policy making now in terms of both the Medicaid expansion and insurance exchanges,” says Ingoglia.