1. Shaping Our Future:
Updates and Opportunities for the
Field
Gabrielle de la Guéronnière Legal Action
Center
2011 NCADD Advocacy Day
September 8, 2011

2. Legal Action Center
 Advocacy for people with addiction
histories, criminal records, and HIV/AIDS
 Thirty-five year history of policy analysis and
advocacy
 Federal policy work
 Advocating for the expansion of services and
resources for people with addiction
histories, criminal records, and HIV/AIDS
 Fighting discrimination: eliminating legal and
policy barriers in place for people with addiction
histories and criminal records

3. Parity and Health Care Reform:
A Time of Tremendous Opportunity
 Greater understanding of addiction as
preventable, treatable chronic health condition
 Federal parity statute and regulations (MHPAEA) are
now in effect for all covered plans
 Dramatic expansion of coverage of addiction
treatment
 SUD and MH benefits must be included in the
ACA’s essential health benefit package; these
benefits must be offered:
 By private insurance plans participating in the
health insurance exchanges
 Individual and small group plans, States can
allow large employers to participate in the
exchanges in 2017
 For newly-eligible Medicaid enrollees, including

4. Parity and Health Care Reform: A Time
of Tremendous Opportunity (cont’d)
 All plans in the exchange must adhere to the
provisions of the federal parity law
 SUD and MH benefits provided to the Medicaid
expansion population also must comply with
parity
 Building on the federal parity law:
o SUD/MH benefits required and must be
provided at parity
o Extension to individual and small group
plans
o Requirement for SUD and MH benefits for
the Medicaid expansion population

5. Parity and Health Care Reform: A Time
of Tremendous Opportunity (cont’d)
 Inclusion of addiction in integrated
care initiatives
 Health homes and accountable care
organizations
 Inclusion of substance use
prevention in chronic disease
prevention initiatives
 Identification of the addiction service
workforce as part of the health
workforce

6. Huge Opportunities But Miles to
Go…
 The success of these laws depends on
decisions that will be made in the
coming days, months and years
 Decisions in Washington and by state and
local policy-makers around the country
 There is a critical need for our field
to educate and advocate to ensure
these laws are well implemented for
the people we serve

7. ACA implementation:
Our Advocacy on Benefit Design
 Huge opportunity to expand coverage
for and access to care
 SUD/MH benefits required by not
defined in the ACA
 Key next steps in the process to define
the SUD/MH essential health benefit:
 Institute of Medicine—report due by
the end of the month
 Proposed regulations on the essential
health benefit (possibly) released by
HHS by the end of the year
 Various opportunities for public
comment

8. ACA implementation:
Our Advocacy on Benefit Design (cont’d)
 Advocacy of the national SUD and MH groups:
the Coalition for Whole Health
 Crafting a comprehensive SUD and MH benefit
 Coalition for Whole Health Essential Health
Benefits Recommendations paper; continued
need for broad organizational sign-on
 www.lac.org; National Health Care Reform link
 Using the paper with other education and
advocacy tools with decision-makers in the
Administration and to engage our allies in
Congress
 Parallel advocacy process needed in
the states

9. Our Advocacy on
Parity Implementation
 Interrelationship with ACA advocacy—opportunity for
huge expansions in coverage by private insurance
 Continued challenges—fighting violations of both the
letter and spirit of the law
 Advocating for additional guidance at the federal level
 Monitoring compliance and encouraging strong
federal and state activity and response
 Gathering information about plan compliance; filing
complaints for violations of the law; aggregating
information and sharing with the regulators
 Templates and other resources by the Parity
Implementation Coalition:
www.mentalhealthparitywatch.org
 Engaging our champions
 Continued tremendous need for education

10. Protecting Safety Net Funding
 Recognition that ACA coverage provisions do not
go into effect until 2014
 We don’t yet know which services will be included
in the SUD essential health benefit
 Huge need for continued strong federal funding
for prevention, treatment, recovery supports and
research before the ACA is fully implemented and
beyond
 During this interim period before expansion has
occurred
 Through implementation of the ACA to cover the
services not included and the people who remain
uncovered or underinsured

11. Our Advocacy on Strong Safety Net
Funding
 Advocacy by the national drug and alcohol
community
 Fighting for highest possible funding for
SAMHSA and the continuum
 Huge need for a continued push from
around the country with Congress and the
Obama Administration; www.lac.org
 Need to ensure our system of care is
strong now and beyond

12. Our Advocacy: Now More Important Than
Ever
 Continued outreach and education—
within and outside of our field
 Connecting our work in Washington with
implementation efforts around the
country
 Speaking with one cohesive voice
 Finding the best ways to engage our
champions
 Advocating for the strongest possible
SUD benefit through the ACA
 Protecting safety net programming
 Monitoring implementation and
informing our federal partners about
successes and non-compliance

13. Gabrielle de la Guéronnière
gdelagueronniere@lac-dc.org
202-544-5478 (phone) 202-544-5712 (fax)
www.lac.org
www.hirenetwork.org