Insurance Receipt and Readiness for Opportunities under the Affordable Care Act: A National Survey of Treatment Providers for Substance Use Disorders

This study measures the readiness of substance use disorder (SUD) treatment to use opportunities under the Affordable Care Act by examining Medicaid and private insurance acceptance between 2011 and 2013, as well as center characteristics associated with acceptance. Data for this study were from a random sample of SUD treatment centers in the United States. Interviews were conducted on site and face to face, with administrative and clinical directors. We employed logistic regression analyses to examine Medicaid acceptance and private insurance acceptance. We found that 59% of centers accepted Medicaid and 55% accepted private insurance. Accredited centers were more likely to accept Medicaid. A 12-step orientation and greater reliance on female clients were negatively associated with Medicaid acceptance. Larger centers and centers with a greater percentage of counselors with advanced degrees had greater odds of accepting private insurance. Centers that offered residential treatment had lower odds of accepting either Medicaid or private insurance. For private insurance acceptance, having a specific track for homeless patients lowered the odds of acceptance, as did having a greater percentage of Hispanic clients. Newly insured individuals under the ACA may have difficulty finding a program that accepts insurance. Future research should examine effects of Medicaid expansion on SUD treatment delivery.