After Republicans failed to rally the support needed to repeal the Affordable Care Act (ACA) and replace it with the American Health Care Act (AHCA), it seems that, for now, millions of people in recovery will keep their access to health insurance. Republicans withdrew their bill to “replace and repeal” just before the House of Representatives’ vote.
The AHCA failed in part because of the massive outpouring of phone calls, emails, and protests as Americans attempted to keep healthcare access. Recovery advocates scrutinized the bill, as well as the ways that Trump’s administration has spoken—or remained silent—on how they’ll address the American drug epidemic.
We Dodged A Deadly Bullet
The AHCA would have made significant cuts in healthcare for people with addiction in need of treatment. The bill, which Republicans referred to as “Trumpcare,” would have cut mental health care and substance abuse treatment for 1.3 million people. That type of care is among the ‘essential benefits’ states are required to provide under the ACA’s expansion of Medicaid. Low income people with substance abuse issues would be hit particularly hard by this cut, since Medicare provides health-care coverage to those who can’t afford it. Although Trump has spoken about the importance of “helping everyone” and keeping people from “dying in the street,” his bill’s language did not align with his promises.
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.
For Addicts, It’s About More Than Healthcare
Active addiction sets you up to need more services than someone who has a different chronic illness like heart disease or diabetes. To go back to the example of the middle class heroin addict, there’s more to the story than the physical and mental difficulties of active addiction. Depending on the severity of your addiction, you may be on your way to losing your job, your home, and custody of your children. You may have legal issues as a result of your addiction. That means you will need social services, such as housing, employment and job search help, and a public defender to represent you in court. You might be given food stamps so that you can feed yourself and your family. You may need to connect with a recovery mentor, or find a support group. If you are prescribed medication to help with your recovery—whether it’s an antidepressant or methadone—you may get those from a free clinic. All of those services are paid for by the state—and they are all services that are potentially on the chopping block.
Trumpcare is Dead. Now What?
As we move forward and continue defending the Affordable Healthcare Act, it’s important to protect other addiction related services as well. These services, though they may not be needed by everyone, are often the difference between recovery and relapse for addicts. Getting sober while you’re homeless, broke, hungry, and afraid is nearly impossible. Addicts need treatment, yes, but they also need help in other areas. The good news is, most addicts don’t need those services long term. Just like everyone else, they want to become self supporting, productive, and self reliant. One year of food stamps is a small investment in someone, considering how much we contribute to society in recovery.
It’s critical that the recovery community continues to advocate for policy changes that directly affect addicts. Addiction is a mental illness, yes—but the problems created by active addiction don’t go away simply because an addict gets sober. Treating addiction is a start, but there’s a bigger picture to take into account as well. Healthcare, access to mental health and treatment services, social services, community support, and changes in how drug offenses are tried in court are all critical to ending the drug epidemic in America. Statistically, it’s worth it: for every $1 spent on helping someone get sober, we save $7 in our criminal justice budgets. That’s $7 that could be spent on hiring more teachers, building better schools, upgrading roads and highways, building new libraries, and other community improvements.
Addiction affects everyone, not just the person with the drug problem. By keeping the Affordable Care Act in place, we ensure that 1.3 million people will still have access to life-saving treatment for drug and alcohol addiction. (That’s as many people as the entire population of San Diego, California!) Mental health care and substance abuse treatment are critical for addicts. If the Trump administration truly wants to solve America’s addiction problem, they may have to look beyond making cuts to programs that are proven to save lives.