***Although the Affordable Care Act (ACA) was not designed with the opioid epidemic in mind, it provides valuable tools for expanding access to medication treatment: major health insurance coverage expansions through Medicaid and the establishment of state health insurance marketplaces, inclusion of addiction treatment as an essential health benefit that existing insurance plans must cover, and requirements that benefits for treatment of opioid use disorder be provided at parity with coverage of medical and surgical procedures. The dramatic rise in opioid use disorders has prompted many states to take a hard look at deficiencies in their current systems of treatment and to leverage opportunities presented by the ACA for addressing them.
Yet the future of the ACA is precarious at best. President Donald Trump has professed his intention to repeal the law, with the support of a Republican-dominated Congress. Through Medicaid expansion and state health insurance marketplaces, the ACA has extended health insurance coverage to at least 20 million Americans who would otherwise have been uninsured.
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