TrumpCare’s fatal flaw — making addiction coverage a choice

Freedom — and the right to make choices — is woven into America’s DNA. But one of those choices might become life and death for millions of Americans.

Although our current healthcare system is far from perfect, for 91 percent of Americans today who have some form of health insurance, that coverage is fairly comprehensive across unpredictable needs people may have.

As a result of the 2008 Mental Health and Addiction Equity Act and The Affordable Care Act, signed by presidents George W. Bush and Barack Obama respectively, millions now have health coverage that includes substance use disorder treatment services as required benefits – which only seems right in the midst of the most devastating drug epidemic in American history.

{mosads}But that coverage could change dramatically if the U.S. Senate moves forward with the House version of The American Health Care Act proposal, supported by the Trump Administration. Last week, the nonpartisan Congressional Budget Office predicted one in six Americans will have to choose to buy a health insurance policy with coverage for substance use disorders costing thousands of dollars more than other plans that will be available on the market.

Perhaps one can make the argument there is sufficient “fear” for individuals to choose to purchase emergency room or cancer coverage. One can surely imagine a family planning to have a child purchasing maternity coverage, or a person with chronic back pain purchasing surgical coverage. But who expects addiction to cross their doorstep?

● “I [Jim] never expected my son, Austin, to become addicted. The thought never crossed my mind. There was nothing in my family’s life that would have led me to believe I would need that kind of insurance.”

● “My [Greg’s] parents didn’t expect me to become addicted, because they never had a problem with substance use themselves. How could they possibly know that when their boy turned 17 they would need insurance that ultimately saved my life?”

● With only one in ten of the more than 20 million Americans currently suffering from a substance use disorder ever getting treatment, why would anyone think they need this kind of insurance coverage, especially if it is thousands of dollars more expensive?

Most people probably don’t think they will cause a car accident. But what if we allowed people who operate motor vehicles not to carry insurance that would pay their liability in an accident they caused — or offered them the “opportunity” to do so only after they caused an accident? It is no different with addiction. 

In a country where one in seven people will experience a substance use disorder, virtually no one ever thinks they will be impacted. Worse, it is absurd to make the argument that people with an illness of the brain—that so often tells them they don’t have a problem—will ever choose to buy coverage (even if they can afford it) for an illness they don’t think they have. And, so, those people continue to suffer — as does all of society.

The notion of forcing families to choose to pay more for addiction treatment coverage will have catastrophic effects on a country with an already burgeoning opioid epidemic. 

Kentucky, Tennessee, Ohio, Nevada, Arizona, Colorado, Louisiana, and West Virginia — states crushed by the weight of opioid deaths — could see double or triple the number of overdose deaths if people from those states have no access to treatment for addiction.

The Surgeon General’s history-making report, Facing Addiction In America, released last November, confirms that addiction impacts as many people in America as diabetes, and one and a half times as many as all cancers combined. The consequences of untreated addiction costs our economy $442 billion a year – twice what we spend on diabetes. 

The report shows that every dollar spent on substance use disorder treatment saves $4 in healthcare costs and $7 in criminal justice costs. There are very few (if any) other investments in healthcare with this type of return on investment to the budget and, importantly, to the public safety concerns of communities.

What our senators — most of whom have been outspoken on solving the opioid crisis — must do in the coming weeks is make a fiscally (to say nothing of humanely) prudent decision: ensure that addiction remains a covered and accessible benefit in any health proposal moving forward.

Eliminating this coverage will force states and communities to pay dramatically in increased emergency room visits, lost productivity in the workplace, increased prison populations, and greater death rates. No other untreated health issue has the enormous public safety costs associated with it that addiction does.

We have known this for more than a decade. Ten years ago Congress went through a bi-partisan debate — including Congressional Budget Office Scoring — on The Mental Health Parity and Addiction Equity Act.

In a hearing in 2007, former Republican Congressman Jim Ramstad said, “we have all the empirical data in the world to show that increasing access to treatment is not only the right thing to do, but it is a cost-effective thing to do. We have got the proof, the empirical data, including all the actuarial studies, to prove that equity for mental health and addiction treatment will save billions of dollars nationally, while not raising anyone’s premiums more than one-half of one percent.”

If we allow addiction treatment to become a future purchasing choice for millions of Americans, what we believe might be a moderate savings in insurance premiums up front will ultimately cost all of us many times more in devastating, unintended economic consequences — to say nothing of the incalculable human toll.

We must impress upon our senators the critical need to maintain required coverage for substance use disorders under any future health reform.

It saves money and lives.

To do anything less creates a scenario for disaster in both financial and human terms. And that is not part of America’s DNA

Jim Hood is the co-founder and CEO of Facing Addiction: Jim lost his oldest son to addiction in 2012. An accomplished executive with many years of experience on Madison Avenue, Wall Street, as a consultant, and an entrepreneur, Jim left his business career to work with others to find a solution to the addiction crisis in our country.

Greg Williams is the co-Founder and executive vice president of Facing Addiction. Greg is a person in long-term recovery from addiction, and filmmaker behind the award winning documentary, “The Anonymous People,” which is a large spark behind this entire effort.

The views expressed by contributors are their own and are not the views of The Hill.