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Does Medicaid Help with Rehab Costs?

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Like many government-sponsored programs, Medicaid is lagging behind in the war to fight substance use in this country. Medicaid is government insurance designed to help our poorest citizens receive healthcare. But Modern Healthcare reports that Congress has their eye on cutting these programs and one of the safety nets for people suffering from all kinds of diseases – including the disease of addiction.

This article discusses the role of Medicaid in addiction treatment for a wide swath of opioid users in the U.S. What challenges does the program face in multiple states? And what do changes in Medicaid coverage mean for those suffering from addiction?

Drug Rehab Costs and Medicaid as a Safety Net

Like everything else in healthcare, drug rehab costs are skyrocketing. The Kaiser Family Foundation (KFF) says that in 2015 alone there were more than two million people addicted to opioid prescription medication and another half a million addicted to heroin. Between 2000 and 2014, hospital inpatient stays for opioid addiction increased by 64%. Emergency rooms have been inundated, with ER visits increasing during this same time by 99%.

Medicaid has traditionally handled a portion of this country’s drug rehab costs. Under the Affordable Care Act (ACA), or Obamacare as it has been commonly called, 32 American states expanded coverage in 2017 to cover adults making less than $17,000 a year, according to KFF. A KFF Fact Sheet says “A central goal of the Affordable Care Act is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and the Health Insurance Marketplaces.”


Today, Medicaid for addiction treatment covers nearly four of every 10 people struggling with opioid addiction, according to KFF. Opioid addiction is so prevalent now that KFF says more than half of the states have increased Medicaid access to naloxone, a drug that reverses overdoses and prevents death.

But over the past year, Congress has had their sights set on cutting this funding to our most vulnerable populations, according to Modern Healthcare. That’s probably because Medicaid is the largest reimbursement provider for substance abuse treatment in the United States, paying for around $7.1 billion of the country’s $33.9 billion drug treatment costs. But these statistics do nothing for what Modern Healthcare says are the 441,000 adults with opioid addiction that are currently uninsured. Legislators in Ohio and Pennsylvania, two of the states that have had the highest drug rehab costs in the nation, are calling on Congress to halt their efforts to tear down the Medicaid safety net. One Pennsylvania state rep said, “If the (Medicaid) expansion goes away, people with drug and alcohol addiction will show up at hospital ERs, go back on the street, and end up tragically dead or in jail.”

What is the answer to the Congressional mandate to lower drug rehab costs? How can Americans ensure that substance abuse treatment will be reimbursed? The answer for most is private insurance. While drug rehab costs continue to escalate and with Congress clamoring to cut Medicaid, private insurance remains the best way to seek help from Washington State addiction treatment professionals. To learn more about admissions, call now.