Insurance coverage does not currently meet addiction treatment needs. Addiction is now defined as a chronic relapsing brain disease that requires monitoring and treatment throughout a patient's life. Furthermore, Federal parity laws require that insurance providers cover mental health care at the same level they provide for physical health care. However, there are legacy loopholes that allow insurers to deny coverage of treatments and certain medications, including buprenorphine, a medication used in opioid addiction treatment that decreases withdrawal symptoms and drug cravings, that have been proven to help.
This means that people whose insurance covered the prescription opioids that wrecked their lives, may not have insurance coverage for the treatment and medications that can help them successfully navigate through recovery. It’s a recognized problem that is going to take new laws, and enforcement of those laws to change.
Many say the industry will undergo a complete change over the next decade. The congressional investigations into rehab marketing and Google’s new ad certification program for treatment providers will help clear away some of the corruption that is mitigating advancements in care.
Right now, there simply isn’t enough regulation to prevent insurance money and the drugs it covers, from getting into the wrong hands. As regulations tighten, the industry will change. However, medical and professional recovery experts and representatives of the insurance industry will have to work together to identify the treatment methods that are the most effective and how they should be covered.
But, up until recently, there has been little research into the effectiveness of the Affordable Care Act though experts are aware of coverage barriers state to state. They just don’t have a clear picture of how these barriers are affecting coverage of addiction medications or limiting treatment options. Even though medication-assisted treatment was listed as an essential health benefit, coverage isn’t being provided to all who need it.
Hopefully, recovery professionals will continue to bang the gong for long-term diverse treatment options, researchers will continue to analyze how those options work, and lawmakers will continue to identify areas within the industry that need to be rebuilt with a solid legal foundation. If they do, changes are sure to come to the insurance industry too.