The substance abuse community in Illinois is hopeful the Quinn Administration has gotten it right, aligning the Affordable Care Act with existing policy with a 40-year-old anti-warehousing law. The longstanding law prohibited Medicaid reimbursement for residential substance abuse treatment in facilities with more than 16 beds. But with implementation of the ACA, many more patients are considered Medicaid-eligible. In the short term, the state has agreed to forego the Medicaid match for those people, says Sara Howe, chief executive of the Illinois Alcoholism and Drug Dependence Association.
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"It's a tale of two federal laws in conflict with each other creating havoc across the country and an ineffective Congress unwilling to fix the problem," says Howe. "The Affordable Care Act authorizes residential treatment in the benefits package, but the bill's architects failed to reconcile it with the older law.” Howe says the old law was designed to prevent the mentally ill from being kept in large facilities indefinitely. She says that’s not a concern when it comes to addiction treatment; the providers want the patients out in a few weeks.