A newborn boy places a stone on his father’s grave as friends and family gather to mark the first anniversary of his death from a heroin overdose. A recent federal study shows that between 2011 and 2021, more than 321,000 children across the United States lost a parent to a drug overdose. (Photo: John Moore/Getty Images.)
If individual insurance subsidies expire at the end of the year, it would not only harm millions of people, including Ohioans who rely on them to treat conditions such as high blood pressure and pneumonia. It will also exclude thousands of people from treatment for opioid operate disorder and escalate overdose deaths, the CEO of a treatment company said Tuesday.
Much of the federal government has been shut down since Oct. 1 as Republicans in Congress resist calls to extend subsidies for insurance purchased on marketplaces created by the Affordable Care Act. The subsidies will expire on December 31, and recruitment for next year will start in two weeks.
Amid the uncertainty, six states have already published insurance prices for next year on the markets. U.S. Sen. Raphael Warnock, D-Ga., posted an insurance quote received by a constituent in X: – Axios reported. Covering it cost $307 a month with the subsidy, it would cost $906 a month without it.
In Ohio, where about 583,000 people are insured on the exchanges, insurance companies have proposed raising prices by as much as 40%. It is unclear whether these proposals take into account the possible loss of subsidies.
The health nonprofit KFF estimates that, on average, insurance will cost more than twice for 24 million Americans if subsidies expire.
It won’t just escalate the number of uninsured Americans, said Cooper Zelnick, CEO Groups. It will put treatment out of reach for hundreds of thousands of Americans suffering from opioid operate disorder.
The company has 20,000 patients in 12 states, including Ohio. Instead of billing insurers or Medicaid for services such as doctor visits or drug tests, Groups are paid based on outcomes resulting from “whole-of-the-box” services.
That makes it the largest “value-based” opioid treatment provider in the country, Zellnick said.
For many, those outcomes will be at risk if ACA insurance subsidies expire, he said.
“Every week across the country, we serve 1,500 people covered by the ACA exchanges who will no longer be able to afford insurance once the subsidies expire,” he said. “We believe that a significant portion of these individuals will unfairly be ineligible for Medicaid and will be ineligible for employer-sponsored insurance.”
For people in recovery to be able to obtain insurance through the exchanges, they have most likely managed to scrape together enough to hold down one or more jobs. If insurance is no longer available, they will face the stress of not having health insurance for themselves and their families, while also missing out on treatment for addiction.
For every person who stops using drugs, this means more children growing up in the chaos and neglect of drug-addicted parents, more people in jails and prisons, more unpaid visits to the emergency room, and more absenteeism from work.
There are also people who simply won’t be here. ACA health subsidies were implemented in 2021. They are credited with helping lower the rate of uninsured people in the United States to lowest level ever of 8% According to the US Department of Health and Human Services in the first quarter of 2022.
Meanwhile, the number of overdose deaths fell from 111,451 in the 12 months ending August 2023 to 73,690 According to the US Centers for Disease Control and Prevention for the period ending last April. That’s a merciful drop of more than a third.
Zelnick said the decline can be partially attributed to treatment funded by ACA and Medicaid subsidies. The expiration of ACA subsidies would easily lead to the loss of insurance and treatment for half a million Americans addicted to opioids, he said.
“We massively celebrated overdose deaths dropping by 10%, 15%, 20%,” Zelnick said. “This will save 10,000, 15,000 or 20,000 lives. If 500,000 people lose access to care, you could easily see a world where overdose deaths return to levels not seen since 2022 or 2023.”
Zelnick said the widespread loss of insurance is even more critical than access to treatment, which will make people in recovery lose hope.
“Addiction treatment is a necessary but not sufficient condition for success,” he said. “It’s not that treatment gives you a meaningful life. It’s that treatment gives you the opportunity to build a meaningful life. It takes work. It takes care of your family. It involves participating in your community.”
“The person we’re talking about has been through hell. He’s been through treatment. He’s got a job and is supporting his family. If suddenly he doesn’t get his medication, he gets sick, he can’t go to work, and he loses that job. When you lose that job, you lose hope. And when you lose hope, going on day after day seems futile.”
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