For a sense of substance abuse treatment demand with new national essential health benefits, insurers should note the increase in services in states that enacted parity laws during the last decade.
Since 2000, more than half of U.S. states had enacted laws requiring private insurers to cover substance abuse treatment, and that corresponded with an uptick in treatment rates, Hefei Wen, an Emory University researcher, found in a study published in the Journal of the American Medical Association-Psychiatry.
A state implementation of any law mandating private coverage of substance abuse disorder (or SUD) was linked with a 9 percent increased treatment rate in all facilities and 15 percent in those accepting private insurance.
Estimating the impact of the Affordable Care Act's extension of behavioral and substance abuse treatment benefits to everyone, with Medicaid, group or individual policies, Wen wrote that there may be "an unparalleled growth of the SUD treatment rate in the public and private sectors." So much so that Wen and other researchers are wondering whether the nation's existing treatment centers, mostly speciality facilities, will be able to accommodate the new demand.
The ACA builds on a 2008 parity law that extended substance abuse treatment benefits only in group insurance nationally, and state laws range in their requirements and limits on the number of visits or prior authorizations health plans can use. In some states that already have parity laws, treatment rates could increase as the ACA replaces looser mandates with requirements for comprehensive benefits.
The Department of Health and Human Services estimates that about 25 percent of the nation's 48 million uninsured have some type of mental illness or substance abuse disorder in need of treatment, and of course lifelong drug and alcohol abuse can lead to cascading and costly health problems later in life and shorten life expectancy.
Insurers in several large states that have had limited mental health parity laws can probably expect to see an increase in demand for both behavioral and substance abuse treatment when the ACA's rules take effect in 2014, including in Florida, New Jersey, Ohio, Pennsylvania and Texas.
The behavioral health treatment industry is growing as well. The Bureau of Labor and Statistics projects a more than 20 percent growth rate through 2018 for mental health and substance abuse counselors. Behavioral health providers, primary care doctors and insurers will also have contend with potentially ambiguous and complex issues related to treatment for overeating and technology and internet addiction.