While millions more Americans now have health insurance that covers addiction treatment, many facilities do not have the capacity to take on new clients, according to a new report.

The Affordable Care Act (ACA) greatly expanded the number of Americans who receive coverage for addiction treatment, Marketplace reports. Spending on addiction treatment is expected to almost double by 2020.

Christina Andrews of the University of South Carolina, who authored the report, says half of addiction treatment programs in the United States do not meet basic insurance company requirements. As of 2012, an estimated 63 percent of programs did not have the technological capabilities needed to communicate with doctors and hospitals, she reported in Health Affairs.

“The reality is it’s going to take years. And we have people right now who have great need,” she said.

Andrews conducted a national survey to examine how state governmental organizations charged with overseeing addiction treatment programs are helping the programs respond to new requirements under the ACA.

She found most of the organizations provide little assistance to addiction treatment programs. “Most agencies are helping programs develop collaborations with other health service programs. However, fewer than half reported providing help in modernizing systems to support insurance participation, and only one in three provided assistance with enrollment outreach,” she wrote.

The report concludes, “In the absence of technical assistance, it is unlikely that addiction treatment programs will fully realize the ACA’s promise to improve access to and quality of addiction treatment.”