Is ObamaCare Parity Deja Vu All Over Again?

Red State/Blue State

It is indeed true that ObamaCare does in principal mandate a destruction of the two tiered system that has carved out a separate and highly underprivileged fiefdom for addictions and mental health, by requiring that health plans offered at auction in the various state insurance exchanges give care on a par with med surg. And the extent that the above is likely to become reality for the average person will depend on whether or not the governments of states they live in embrace ObamaCare or whether they oppose it. So far only about 15 states have taken steps to set up the required state exchanges that will be needed when the health law becomes fully operative. The health exchanges are supposed to open Oct. 1 for purchase of plans that go into effect Jan 1.  A rule of thumb in this highly complex map is that the more hard core Republican a state is the more they are objecting to the vast expansion of the Medicaid rolls required – for example, Indiana is proposing only that there be an expansion of its Healthy Indiana Plan – and the more liberal and Democratic a state is the more they are embracing ObamaCare. And then there are the inevitable technical problems, of course, which mean that even Republican states that were inclined to be cooperative, like Idaho and New Mexico, have applied to the Feds for extensions.

Cash Starve

With health insurance being an information rich type of product, it is absolutely critical that consumers get the help they need to understand the transition to ObamaCare – help to understand what is a VERY complex financial instrument – and, thus, make the bridge to a new healthcare environment as smooth an experience as possible. But in an example of how the law’s opponents are operating to try and kill it – essentially the Republican controlled house, which wields the power of the purse – only $54 million, out of a total healthcare spend of about $2.5 TRILLION annually, has been allocated to fund the “patient navigators” who will man call centers to guide consumers. This is a classic example of how Congress “cash starves” programs they don’t want to succeed, with the starving of the “navigator” role – which could easily be funded in the billions and still not be enough so critical is it – in and of itself enough to quash the public’s perception of any success for ObamaCare.

Polarization and Uncertainty

The bottom line is that to assume that 68 million additional people will suddenly have access to addiction treatment because the first draft of ObamaCare mandates it, as recent press reports have claimed, is ridiculously naïf. Currently about 3M to 4M people a year get some kind of substantial addiction treatment, and it seems logical to perhaps hope for a pretty big increase in demand over the next few years, but not the wall of money and people some have predicted. And with the Obama Administration pushing a switch toward doctor’s offices, combined with meds, over traditional treatment – especially residential – it is unclear exactly the level of benefits for addictions that will eventually shake out as becoming the standard minimum of care. There has never been a major piece of legislation like ObamaCare that has not undergone substantial revision as improvements and changes that are needed become obvious over time. But with the current polarization of Congress, with Democrats scared to reopen debate on a bill they just barely managed to get passed and Republicans refusing to discuss any changes that don’t fully kill the legislation, ObamaCare might just become for everyone what parity turned out to be for us in the addiction treatment industry ….a big paper tiger.

POST YOUR COMMENTS BELOW … start a debate!