Gabrielle de la Guéronnière from the Legal Action Center discussed opportunities for advocacy related to health care reform and parity laws. The Affordable Care Act expands coverage of addiction treatment and requires substance use disorder benefits be included in essential health benefit packages. Advocates need to ensure these laws are well implemented through commenting on upcoming regulations and educating policymakers. Ongoing advocacy is also needed to strengthen implementation of federal parity laws and protect safety net funding for addiction services.

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

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 childless adults

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: SUD/MH benefits required and must be provided at parity Extension to individual and small group plans 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

10. Continued challenges—fighting violations of both the letter and spirit of the law

11. Advocating for additional guidance at the federal level

12. Monitoring compliance and encouraging strong federal and state activity and response

13. Gathering information about plan compliance; filing complaints for violations of the law; aggregating information and sharing with the regulators

14. Templates and other resources by the Parity Implementation Coalition: www.mentalhealthparitywatch.org

15. Engaging our champions

17. We don’t yet know which services will be included in the SUD essential health benefit

18. Huge need for continued strong federal funding for prevention, treatment, recovery supports and research before the ACA is fully implemented and beyond

19. During this interim period before expansion has occurred

21. 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

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