AURORA | Executives at a local drug and alcohol rehabilitation center are hopeful that more people will be able to get substance abuse and mental health treatment under their insurance plans as a result of President Barack Obama’s Affordable Care Act.
The Affordable Care Act, upheld by the Supreme Court earlier this month, requires that mental health and substance abuse treatment services are required benefits in all basic health insurance packages by 2014.
Arthur Schut, deputy director of Arapahoe House, which has two Aurora locations, said that’s significant. Currently, about 75 percent of the people who get comprehensive alcohol, drug and behavioral health services treatment at Arapahoe House’s 13 locations cannot afford to pay their health care costs, Schut said.
That equals to about 11,625 people out of the 15,500 individuals that Arapahoe House treats each year.
“We serve a large number of people who really don’t have the ability to pay either because they are underemployed or they’re working in a situation where they don’t have health benefits, so for us, it’s a distinct advantage that people have some kind of coverage,” Schut said.
The ACA requires all people buy health insurance or pay a penalty. Because of the ACA and the requirement that all basic health insurance plans cover substance abuse and mental health treatments, Arapahoe House officials expect to see an increase in the number of people with the ability to pay for treatment. That means the organization will save money by not having to use as many monetary donations to pay for an uninsured person’s treatments, and family members of people who need treatment won’t have to fork up cash out of their own pocket to pay for a person’s treatment.
Arapahoe House will be able to remain “fiscally healthy,” Schut said. “It reduces the burden on us,” he said.
Under Colorado law, insurance companies are currently required to offer coverage for care associated with some mental health problems, but not the full spectrum.
Treatment for mental disorders, including drug and alcohol dependency, are currently not included in small group insurance plans. However, state law does require that insurance companies cover treatment for mental illnesses like schizophrenia, bipolar disorder, obsessive compulsive disorder and panic disorder.
Schut said it makes sense for insurance coverage to exist for drug addicts and alcoholics who need treatment and rehabilitation because health care costs soar when a person has both a substance abuse problem and a health issue.
For example, he said, a person with a heart condition and a substance abuse problem will stay in the hospital twice as long as a person with only a heart condition.
“Those are the kinds of things that drive up health care costs” he said. “If you can address those things in the long run, you improve overall health outcomes, and when you improve overall health outcomes, you control costs,” Schut said.
Colorado currently ranks fifth in the nation for people age 12 and old needing but not receiving treatment, according to the Colorado Department of Behavioral Health.
For people who struggle with drug and alcohol addiction, the ACA’s requirements validate that substance abuse and mental health problems are diseases in the same way that cancer is a disease.
An Arapahoe House board member who wanted to remain anonymous said he has had to pay upwards of $40,000 out of pocket for his daughter’s alcoholism treatments because she doesn’t have a health insurance plan that will cover her care.
He hopes that in a couple of years when the ACA takes full effect, that his daughter will be able to afford a health insurance plan that will cover her treatment needs.
“I think it’s basic human nature to think that people have the ability to overcome addiction,” he said.
In some cases, he said, it’s easier to recover from addiction than others. In his daughter’s case, it’s an illness she’ll struggle with for the rest of her life.
“It’s difficult for people who haven’t witnessed the impact of alcoholism to be able to appreciate what it does to people and their families,” he said.
Reach reporter Sara Castellanos at 720-449-9036 or [email protected]