Medicaid Law That Limits Available Beds Impedes Addiction Treatment

Major obstacles remain to expanded treatment for addiction through the Medicaid program, according to USA Today. Although the Affordable Care Act (ACA) requires treatment be offered to people who are newly insured through insurance exchanges or Medicaid, experts say a federal law is limiting available beds nationwide.

A federal restriction does not allow drug treatment centers with more than 16 beds to bill Medicaid for residential services provided to low-income adults. The law was meant to prevent Medicaid dollars from funding private mental institutions that warehoused patients, according to the article. The result is that addiction treatment centers are turning away new Medicaid patients who are entitled to treatment under the ACA.

“We don’t have enough capacity right now,” Becky Vaughn, Executive Director of State Associations of Addiction Services in Washington, told the newspaper. “The unintended consequence is that you are discriminating against an adult who needs help,” said Elizabeth Stanley-Salazar, a Vice President at the Phoenix House. “We don’t do that for any other illness or disease.”

Toby Douglas, Director of California’s Health Care Services Department, said only 10 percent of the available inpatient beds in the state are in facilities that meet the federal government’s restrictions. Most treatment for substance abuse in Colorado is provided in centers with more than 16 beds, according to Arthur Schut, Chief Executive Officer of Arapahoe House. “Everyone is in agreement about how dumb this is,” he said. “It doesn’t work economically, and it doesn’t work for the people seeking treatment.”

The federal government does not plan to change the law, according to Suzanne Fields, a senior adviser on health care financing for the Substance Abuse and Mental Health Services Administration. She said the federal government is looking at alternatives, such as treating patients under programs already paid for with other federal funds.