Community Health Centers Reconsidered: Addiction Treatment in an Era of Health Care Reform

President Barack Obama’s signature on the SCOTUS-upheld Affordable Care Act

The Supreme Court’s affirmation of the Affordable Care Act (popularly known as the ACA or “Obamacare”) two weeks ago was a landmark decision, bringing the United States closer to achieving—as supporters say down here in Georgia—health care for y’all.

Across the country, “health care” today means more than primary care. The passage of the Wellstone-Domenici Mental Health and Addiction Equity Act in 2008 established parity for mental health and addiction treatment, which means that private insurance providers are required to fund these services in much the same way that they cover care for more traditional physical ailments. Thanks to this precedent, more health care coverage should mean increased access to mental health and addiction services.

In a recent article in Health Affairs, behavioral scientist David Mechanic argued that the ACA, along with the now-endangered Medicaid expansion, has the capability to “begin to fulfill the many unmet promises of community mental health care.” To meet the increased demand for behavioral health services, the Obama administration’s planned implementation of the ACA will continue to boost federal support for Community Health Centers that integrate mental health, crisis support or substance abuse treatment into their suite of services. Given this expensive (and still controversial) plan, it’s worth re-examining the large-scale social project we might be reviving. What are the “unmet promises of community care”?

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