The Affordable Care Act contained several provisions that significantly increased access to SUD services. While earlier efforts by Congress to repeal Obamacare failed, there are several efforts underway to dismantle the program. Below is a current summary of what is at stake:
- Senate tax reform proposal proposes to double the standard deduction, likely shifting millions of taxpayers who currently itemize to taking the standard deduction. An analysis of this provision estimates that charities could see a staggering loss of up to $13.1 billion in contributions annually, directly impacting non-profit SUD service providers.
- Proposed reductions in the Senate tax reform bill to the income threshold after which medical expenses can be deducted would impact the financial futures of millions of Americans living with costly and chronic conditions like mental illness or addiction.
- The Senate tax reform bill proposes to eliminate the individual insurance mandate. This provision is foundational to the Affordable Care Act because it spreads the risk thereby lowering health insurance premiums. It also funds comprehensive coverage in insurance plans to include necessary services like mental health and addiction treatment.
- President Trump has directed the Centers for Medicare and Medicaid Services (CMS) to change the rules on how the Essential Health Benefits (EHB) for marketplace insurance plans are administered. The proposed changes would allow states to choose less comprehensive coverage for mental health and substance use service.