Addiction, Treatment and Recovery

When it comes to health insurance, persons with the disease of addiction to alcohol and/or other drugs are often – make that usually – treated as second-class citizens in this country. Talk about a bad news/bad news scenario. Persons with the disease of addiction either discover that their health insurance policy simply doesn’t cover their primary disease at all – or is blatantly discriminatory vis-à-vis what it does cover. Some insurance companies and the policies they write talk a decent game. But they don’t deliver. When you read the fine print, lo and behold, you discover that the copays are higher for persons seeking treatment for addiction to alcohol and/or other drugs than is the case with persons suffering from other diseases.

When it comes to addiction, deductibles are often higher than is the case with other diseases. The number of treatment days covered by insurance is severely limited. There are restrictive visit limits, as well as lower annual and lifetime caps. No other fatal disease is treated with such disdain by insurers, who impose such strict limitations. Now, a bill pending in Congress would eliminate discriminatory barriers to care and provide coverage for families and individuals needing treatment for addiction.

The Help Expand Access to Recovery and Treatment Act (“HEART” – H.R. 2256/S. 1138) does not mandate that health plans offer addiction treatment. That’s the red herring that insurance companies have used to fight similar proposed legislation in the past. What the new bill does mandate is that if a substance abuse benefit is offered, health plans must offer it on a par with other diseases covered under the plan. No more second-class citizenship! Men and women with the disease of alcoholism and other drug dependency who are seeking help should not be discriminated against.

The fight for fairness has been hobbled in the past by three factors: (1) with a few notable and brave exceptions, we have not had public advocates for our cause on Capital Hill; (2) we simply have not been able to rally the grass roots in the way that, say, advocates of treatment for cancer or diabetes have, and (3) an ugly stigma still attaches to the disease of alcoholism and drug addiction. We like to think informed and educated persons don’t buy into the “weak morals” versus disease argument. Sadly, I’m afraid, many informed and educated persons – including many members of Congress – do appear to subscribe to the “weak morals” bias.

How can you help? By communicating your support for H.R. 2256/S. 1138 to your elected member of the House and/or Senate. We need to make sure that in the new Congress, we’re not sitting out the political game on the sidelines. We need to be suited-up players. Treatment for this disease desperately needs to be put on the nation’s agenda. At the end of the day, all we’re really asking for is fairness.

Related posts:

1. U.S. Representative Jim Ramstad Announces New Congressional Recovery Caucus in Betty Ford Center Address