Document Type

Article

Publication Title

Utah Law Review

Abstract

Too many privately insured face substantial barriers and delays to getting timely and affordable substance use disorder (SUD) care when they need it, sometimes with terrible and irreversible consequences. Historically, private insurers have been reluctant to cover such services and have been glad to leave this responsibility to public systems like Medicaid. Laws like the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and the Affordable Care Act (ACA) were meant to make private insurance more generous, but these laws are underenforced and too weak to fully address the challenges of the opioid epidemic. When patients and the country need it most, private insurers are failing us is in both preventing and treating opioid addiction.

This Article considers why private insurers are contributing negatively to the opioid crisis and what we can do to hold them accountable in the future. Part I summarizes key provisions of the MHPAEA and the ACA, the two current laws that govern private insurers’ coverage of SUD services. Part II examines the current state of private insurance in the midst of the opioid epidemic. It finds that insurers are underperforming. One, private insurers are not equaling Medicaid and other government programs in tackling the opioid epidemic. Two, private insurers continue to place harmful impediments and restrictions on SUD services compared with other medical care. Lastly, Part III considers ways to make private insurers carry their weight in the future including recognizing private insurance’s role and responsibility in the opioid crisis, as well as state and federal legal reforms.

Publication Date

2019

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