With a decision expected any day from the U.S. 5th Circuit Court in a lawsuit to repeal the Affordable Care Act (ACA), people with substance use disorders and their advocates need to prepare to fight to preserve life-saving treatment.

The lawsuit, brought by Texas Attorney General Ken Paxton and supported by the Trump administration, would roll back the clock to a time when millions of people were denied coverage for problematic use of drugs or alcohol. People with substance use disorders and their advocates need to raise their voices to let the courts, their state attorneys general, and the country know just how harmful this outcome would be.

Here are some examples:

  • The lawsuit threatens millions of people’s health coverage, access to health services, and protections for pre-existing conditions. Through the ACA, millions of people secured health insurance that covered their care for substance use disorders, as the law barred insurers from using a person’s health status to determine their eligibility and premiums. The ACA also improved access to treatment for all types of substance use disorders – not just opioids – and increased access to prevention and early intervention services that young people need to thrive.
  •  If the ACA is repealed, people with substance use disorders and mental illness who gained coverage through the law will face more limited availability of evidenced-based Medication-Assisted Treatment (MAT) for addiction. MAT is a “gold standard” treatment that decreases the recurrence of symptoms and enables people to be more productive.
  • Repeal of the ACA would also eliminate access to insurance coverage for young adults with substance use disorders under age 27, who are now on their parents’ insurance plans.
  • The repeal would worsen disparities in access to addiction services in communities of color, which have already been harmed by the ineffective “War on Drugs.” Research shows that the unmet need for addiction treatment is worse for African-American and Latinx populations than for white populations.
  • The repeal would reverse coverage gains made in communities of color through the ACA and has the potential to perpetuate structural and systemic racism in health care. Structural racism such as discriminatory practices and policies that affect employment, education, health and environment, places young people of color at higher risk of experiencing trauma and of misusing substances to cope with that trauma.
  • ACA repeal also would limit access to substance use prevention and early intervention services for young people of color. This lawsuit jeopardizes the expansion of substance use prevention services that are often financed through health insurance plans tied to the ACA. These services provide young people with the support they need to prevent substance use disorders.

To adequately address substance use disorders, our nation needs broader health coverage and better access to comprehensive services, not just crisis care for drug overdoses and vaping deaths.  

We have to continue to raise our voices, protest this sabotage of the ACA, and activate our communities to support the ACA and oppose this lawsuit. Take action by contacting your state’s Attorney General and using the substance use talking points we created to assist you in your advocacy efforts. You can also check out our collection of state-specific fact sheets for more information on how the Texas v. United States case could affect consumers in your state. To learn more about the history of the case, please review our timeline and explainer video.

We must do what we can to avoid turning back the clock to a time when masses of people were denied coverage for problematic use of drugs or alcohol. What will you do?