Medicaid might overwhelm drug treatment centers
Ryan Scott Ottney
PDT Staff Writer
An Associated Press analysis of government data concluded that the number of people seeking treatment could double from current levels, depending on how many states expand their Medicaid programs and how many addicts pursue the new opportunity.
Ed Hughes, executive director of The Counseling Center in Portsmouth, called this “a good problem to have.” He said Medicaid expansion in Ohio would extend coverage to 5,000 people in Scioto County, and The Counseling Center expects to pick up about 500 new drug treatment patients.
It has been 60 years since doctors concluded that addiction was a disease that could be treated, but today the condition still dwells on the fringes of the medical community. Only one cent of every health care dollar in the United States goes to addiction, and few alcoholics and drug addicts get care. One huge barrier, say many experts, has been a lack of health insurance. But that barrier crumbles in less than a year. In a major break with the past, 3 million to 5 million people with drug and alcohol problems — from homeless drug addicts to working mothers who drink too much — suddenly will become eligible for insurance coverage under the new health care overhaul.
Many with substance problems are waiting eagerly for January, when the new insurance will become available. The new demand could swamp the system before even half of the newly insured show up at the door, causing waiting lists of months or longer.
“It’s the chance to clean up and not use anymore, so I could live a stable life,” said Ashley Lore, 30, of Portsmouth told the Associated Press.
Lore was jailed and lost custody of her 4-year-old daughter as a result of her heroin addiction.
“If I get into treatment, I get visitation to my daughter back. And I get her back after I complete treatment,” she said.
The AP found that those seeking a new chance at sobriety may be surprised by the reality behind the promise. The system for treating substance abuse — now largely publicly funded and run by counselors with limited medical training — is small and already full to overflowing in many places. In more than two-thirds of the states, clinics are already at or near capacity.
Only about 10 percent of the 23 million Americans with alcohol or drug problems receive treatment, according to the National Survey on Drug Use and Health. Shame and stigma are part of the reason, but about a quarter of them have no insurance. Today, those without insurance include many lower- and middle-income people who don’t get the benefit from an employer, don’t qualify for Medicaid or Medicare, and can’t afford their own policies. The new law will provide subsidies to help many buy private coverage.
“It would be challenge, but it would be a challenge that we would love to try and meet,” Hughes said. “We have struggled for the whole 30 years that I have worked in this field to provide services to people who are uninsured or under-insured, and the opportunity to have that number of people with access to treatment would be a real blessing for them and for our community. Because what we are seeing is, not only would they be able to access drug and alcohol treatment, but they could access other health care as well. Our community ranks 88 out of 88 counties in terms of poor health care indicators and our workforce is very sick and has drug addiction problems. If we are going to make progress on an economic front, we are going to have to have a healthier workforce.”
The government is also pressing states to expand their Medicaid programs to include more working poor people. If 20 states expand Medicaid programs - roughly the number now planning to do so - 3.8 million more addicted patients would get insurance, the AP analysis found.
Gov. John Kasich supports Medicaid expansion in Ohio, but has been stymied by the Ohio Senate who have dropped the plan from the proposed state budget. Senate President Keith Faber said Wednesday that he’s pushing for changes to the Medicaid program instead of the wide-ranging expansion plan.
Ryan Scott Ottney can be reached at 740-353-3101, ext. 287, or email@example.com. For breaking news, follow Ryan on Twitter @PDTWriter. The Associated Press contributed to this story.
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