ACA Upheld: Now What?

SCOTUS has upheld Obamacare as is. How will this affect availability of psychiatric and substance abuse treatment? I use a direct pay model with no insurance contracts, and I do not accept patients who have Medicare Part B with its absurd over-regulation. I regularly receive calls from prospective patients desperately looking for a psychiatrist who “accepts insurance.”

Will state plans continue to prevent patients from using their own money to buy drugs like buprenorphine? Will they continue to prevent them from using money-saving manufacturers coupons?

I believe some will use their own money to pay for psychiatric care and forego insurance altogether. Greater demand will continue to drive up prices for drugs in spite of onerous prior authorization requirements, setting up more barriers to treatment. Will regulators impose price controls on pharma thus discouraging development of new treatments?

Will more non-physicians and non-psychiatrist physicians provide care to psychiatric patients? Will more clinics close, unable to make ends meet? Will parity laws provide relief or hasten the demise of a system that can never work?

Would a national health plan or single payer system help?


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