By Barbara Thompson, Executive Director, NCADD Sacramento —

The Affordable Care Act requires states to implement a new system of healthcare delivery, expanding coverage for the underinsured and uninsured, and dramatically increasing the State’s Medi-Cal program.  Governor Brown recently announced that more guidelines are needed from the federal government to get the job done.  Citing that there will not be adequate time to discuss the many complex implementation issues still pending, the Governor has called for a special legislative session to take place in December or January.

ACA reforms are taking effect over a period of time beginning with passage in 2010 through full implementation in 2019.  Many of the law’s most important provisions will take effect in 2014, including the expansion of Medicaid coverage for people at or below 133 percent of the federal poverty level.  Before that time, California must have clarification on the services that will require coverage.

It is anticipated that the Act will have a significant impact on addiction care, including who will be covered by Medicaid, what treatment services will be reimbursed and at what rate.  Once fully implemented, the ACA will extend the reach of treatment by requiring both public and private health insurance plans to cover addiction care while moving addiction treatment into the scope of primary care.

Other Changes for Addiction Services:

  • Federally qualified health centers will be required to provide addiction care which will increase the number of addiction patients served.
  • The concept of “Medical Homes” under the Act is intended to address the long-standing practice of treating addiction outside the general medicine practice.
  • Medical schools are responding to the need for specialized training that will be required as new addiction medical residencies have been introduced.
  • Medical providers will have access to the entire medical profile of each patient as prevention and early intervention of chronic illnesses, such as addiction, is implemented.

As California works toward full compliance with the Affordable Care Act, AOD providers and other healthcare professionals should take advantage of the opportunity to work with elected officials during the Special Legislative session.  Input at this stage is crucial to developing a system to better serve Californians suffering from addiction, and the professionals who help make recovery possible.

Click here to view the Governor’s letter announcing the Special Legislative Session.