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Tuesday, July 15, 2014

Obscure Rule Limits Treatment Bed Numbers

One of the key components of the Affordable Care Act (ACA) is to expand coverage in order for thousands of people to become eligible for substance abuse treatment labeling it an “essential health benefit,” but an obscure law nearly 50 years old is blocking many people on the road to recovery, according to the New York Times.

The ACA has given states the ability to expand Medicaid coverage to people with low incomes and so far 26 states have done so, the article points out. However, in order for a treatment center to qualify for accepting Medicaid the facility needs to have fewer than 16 beds. While more people are finding they have coverage for substance use disorder treatment every day, the reality is that finding a bed will prove extremely challenging due to the high demand for treatment. The 16 bed rule was intended to prevent Medicaid funds from covering treatment in state psychiatric hospitals, facilities that were far more common when it was passed in 1965.

“The federal government basically said to the states, ‘We’re not going to pay for your institutional care,’" Becky Vaughn, Executive Director of the State Associations of Addiction Services, told the newspaper. “Addiction services never should have been wrapped into that because we are not long term.”

Congress could act to change the rule which would help thousands get the treatment that they need and the coverage that they constitutionally deserve, but it seems unlikely at this point because nobody in Congress wants to get near health care issues any time soon.

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