Kady Williams: In name of 'access,' new law cuts 'coverage'

GRAND FORKS -- I have some grave concerns about the state of mental health and addiction treatment in North Dakota. I have spent most of my nursing career working with individuals with mental health and substance use disorders. I have seen the de...

GRAND FORKS -- I have some grave concerns about the state of mental health and addiction treatment in North Dakota.

I have spent most of my nursing career working with individuals with mental health and substance use disorders. I have seen the devastation of addiction, and I have witnessed the benefits of effective addiction treatment.

Understanding the problems addiction and mental health issues can cause, I was not surprised to learn that Altru Health System and Grand Forks community agencies identified access to mental health services a priority for improvement.

Addiction is one of the leading causes of death and disability in the United States. As our state population has grown, so has the number of individuals requiring addiction treatment. And not only has the total grown, but also the number of adolescents and young adults requiring treatment has grown, too.

In addition to alcohol and marijuana, various forms of synthetic marijuana, prescription drugs, heroin and methamphetamine are reported as the drugs of choice.


Unfortunately, this increase in demand for addiction and mental health service comes at the same time as the implementation of the Affordable Care Act. As a result, Blue Cross Blue Shield of North Dakota is decreasing the availability of mental health and addiction coverage for most individuals.

Blue Cross Blue Shield of North Dakota announced Oct. 1 that coverage for residential care, which is necessary for many individuals to achieve and maintain sobriety, would not be available as part of its existing coverage or part of the coverage available from the Affordable Care Act insurance exchanges.

The new "light" addiction and mental health plans contain the minimum mandated by the Affordable Care Act, but do not maintain the coverage levels provided in the past or the coverage needed by many individuals seeking addiction and mental health services.

For Herald readers who are breathing a sigh of relief because they have a grandfathered plan, not so fast. The full range of benefits available in the past no longer will be available after Jan. 1.

Residential treatment is a cost-effective way of giving individuals an environment conducive to recovery, an environment in which patients can experience sobriety, achieve mental and emotional stability and develop and practice the skills necessary to return to their community.

Effectiveness of addiction treatment has been rigorously studied by the American Society of Addiction Medicine, and it has the most widely accepted criteria used to determine the level of care most appropriate to meet individual patient needs.

But without insurance coverage for these levels of care, only the wealthiest of our population will be able to access the full continuum of services.

Wasn't the purpose of the Affordable Care Act to make sure that all Americans have equal access to affordable healthcare?


Make no mistake, limiting the ability to get addiction treatment in the appropriate setting will not only impact those vulnerable to the effects of addiction, but also will increase the social costs of addiction as well. Expect those additional costs to be borne by state treatment programs subsidized by the taxpayer.

In short, not only will taxpayers in many cases subsidize the premiums for insurance policies from the health care exchanges, they'll also end up subsidizing the cost of treatment

All Americans should have access to affordable health care. But the cuts being made to mental health and addiction coverage by Blue Cross Blue Shield of North Dakota as a result of the Affordable Care Act is a step backward for many people.

As consumers and tax payers, we deserve more. After all, having insurance coverage isn't the same as having access to medical care. Please don't give us one without the other.

Williams is a student in the psychiatric nurse practitioner program at UND.

Related Topics: HEALTH
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