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The U.S. Supreme Court’s decision to uphold the constitutionality of the Affordable Care Act (ACA) is extremely uplifting for the substance abuse field, according to A. Thomas McLellan, PhD, CEO of the Treatment Research Institute and former Deputy Director of the White House Office of National Drug Control Policy.

Dr. McLellan, who served on President Obama’s healthcare reform task force, notes the debates and research around the ACA produced two startling facts. “First, unaddressed substance use now costs mainstream healthcare upwards of $100 billion annually, particularly in areas such as ER and trauma care, but also in the treatment of virtually every chronic illness,” he said.

Dr. McLellan added that because of the severity and complexity of their conditions, the 23 million ‘addicted’ Americans are disproportionately costly – but it is the 40-45 million Americans with lower severity but still significant ‘harmful substance use disorders’ who comprise the largest burden of illness and cost to healthcare.

“The second realization produced in the ACA debates is that while there is provision to treat ‘addiction’ in specialty care programs (though clearly more coverage is needed) there had never been healthcare benefits or reimbursement options for those with ‘harmful substance use,’” he noted. “Thus, one of the historic aspects of ACA is the requirement that care services for the full range of substance use disorders be part of the ‘essential benefit design’ in all health plans.”

Dr. McLellan called this “the beginning of a new era in prevention, early intervention and office based care for patients who are not addicted – but whose drinking, smoking, and use of other substances is harming their health and compromising the effectiveness of the care they are receiving for other illnesses and conditions.”

The Supreme Court on Thursday largely upheld the constitutionality of the Obama Administration’s health care law. The mandate was upheld as a tax.


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