Today, the House of Representatives voted in favor of a measure that would repeal and replace the Affordable Care Act. The ACA, which ensures that anyone can receive affordable insurance coverage, regardless of preexisting medical conditions, is a critical protection for people in recovery. Republican representatives initially put forward a “replacement” bill in March, which would slash federal funding for healthcare and move back towards an individual payer system. This replacement, called the American Health Care Act (AHCA), specifically mentions the opioid crisis but makes no indication that people in need of treatment for addiction, alcoholism, substance abuse disorder, or any dual diagnosis, would be covered in the new plan.
The Trump Administration and Addiction
Since his campaign, Trump has spoken out many times about the addiction crisis in America. Trump created an “anti drug initiative” committee specifically dedicated to solving the crisis, and appointed New Jersey Governor Chris Christie, his former running mate, as its chairman. The administration has produced mixed messages since its inception: on the one hand, Trump regularly mentions the importance of treating addicts and helping people so they don’t “die in the street.” On the other, he takes action to slash life saving health coverage from the vulnerable population of people who struggle with substance abuse.
Although Trump’s words sound good, his actions, including his backing of and praise for the Republican measure to end the ACA, speak much more loudly. Without funding, government support and the state and federal levels, and legal protections for people with addiction, we will continue to die. Currently, the fatal overdose rate in the United States is one death every 15 minutes. Without access to treatment and related health issues, that rate can be expected to increase.
Why Does The ACA Matter?
Look at the Big Picture
The Affordable Care Act is important to people in recovery because we are in unique position to be affected by its changes. Addiction is a chronic illness that has many social, physical and psychological implications. Think about it: if you’re a middle class heroin addict, you’re not only dealing with the physical effects of getting sober, like withdrawal and detox. You will also need mental health care, probably from a therapist or certified drug counselor. All of that is covered by insurance you can access under the Affordable Care Act.
That means that treating addiction is expensive—prohibitively expensive, for many people. Also, if addiction is classed as a “preexisting condition,” no insurance company will accept addicts as customers. The ACA did away with preexisting conditions so that everyone, regardless of their healthcare needs, would have access to insurance. If that was taken away, who would be able to afford treatment costs out of pocket? Only the very wealthy, or the very lucky. State subsidized healthcare is, for many addicts, the only option they have for getting sober.
Addiction and Recovery Are Not Partisan Issues
Addiction, or substance use disorder, is a nuanced, complex disease that is a spectrum disorder. It has an extremely high rate of remission when treated. 50% or more of people who go into treatment programs for help with their addiction stay sober for a year or more, according to the Surgeon General’s report on addiction. Furthermore, every $1 spent on treatment, social services, and legal representation for someone trying to get sober nets $7 in return. Removing a critical bill that gives people with addiction the chance to be in that 50% is inhumane. Considering that less than 10% of people with addiction will ever seek treatment, this means that millions of Americans will continue to go untreated, unhelped, and unserved. It also means that our criminal justice systems, hospitals and health facilities, and nonprofit clinics will continue to be overwhelmed by addiction related cases.
Addiction does not discriminate. Neither should our legislature. A person’s political leaning does not determine whether or not they will develop substance use disorder. It doesn’t protect their kid from overdosing. Addiction and alcoholism affect all kinds of people, from all walks of life, of all colors, faiths, and origins. In fact, some of the communities hit hardest by the addiction crisis are deeply conservative and Republican. And yet, their representatives vote to remove life saving healthcare measures from the very people who put them into office.
The health care bill that would end the Affordable Care Act is faces uncertainty in the Senate. The measure passed in the House of Representatives by a very narrow measure of 217-213. Whether or not it is defeated may be a permanent, crushing blow to the recovery advocacy movement that aims to bring awareness and equal rights to people with addiction and their families.