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What Happens To Addiction Treatment In Indiana If Congress Repeals Obamacare?

Jake Harper/Side Effects
Many people suffereing from addiction use HIP 2.0 to pay for medications such as Suboxone, which helps control cravings for opioids.

Indiana’s new governor, Eric Holcomb, vowed to tackle the state’s drug addiction epidemic in his first State of the State address on Tuesday. But he has also said he supports Congress’s plans to repeal and replace Obamacare.

That could mean changes to or a loss of coverage for many Hoosiers battling addiction.

Scrapping the Affordable Care Act puts health coverage in question for roughly 11 million Americans who gained Medicaid coverage under the law, including 250,000 Hoosiers on the Healthy Indiana Plan, now known as HIP 2.0.

If the final Obamacare replacement plan doesn’t include ongoing support for the Medicaid expansion, the program could disappear — taking away addiction treatment for many people in the state. This concerns people working in the addiction treatment field.

Camila Arnaudo, a psychiatrist who treats addiction in Indianapolis, does not want her patients to lose their HIP 2.0 coverage. “It’s really scary that they could take it away,” says Arnaudo. “It’s definitely helping the very marginalized people I’m seeing.”

The number of deaths from drug overdoses has been going up over the last several years. In 2015, there were 1,245 drug overdose deaths in Indiana, according to the Centers for Disease Control and Prevention.

Governors in Indiana’s neighbor states of Ohio and Michigan have been vocal about their concerns surrounding ACA repeal, particularly when it comes to getting rid of Medicaid expansion.

But Holcomb has not spoken out publicly on the subject.

In a written statement sent to Side Effects Public Media, the office of Indiana Gov. Eric Holcomb says he supports the repeal and replacement of the Affordable Care Act, though he declined to provide specifics.

Holcomb’s office said that “Indiana needs the flexibility to maintain and improve this innovative and successful program.” But his office wouldn’t answer questions on what he would like Congress and the president to do to keep the program in place, nor would anyone in Holcomb's office agree to an interview on the subject of health care.

John Zody, chair of the Indiana Democratic Party, would like to see Holcomb advocate for the people utilizing HIP 2.0 coverage.

“He’s jumping on the bandwagon talking about how it needs to be repealed but not offering any solutions on how it would be replaced,” Zody says. “That’s unfortunately what we’re getting from Congress and the incoming Trump-Pence administration, so we all need to watch very carefully what happens because we need people to have health coverage.”

And addiction specialists say that’s especially true for those suffering from addiction, who often have co-occurring conditions. Arnaudo says getting addiction treatment for her patients was much harder before HIP 2.0.  

“Now, we’re able to do whatever we need to do,” she says. “Some of [my patients] have mentioned to me a fear of what will happen if it does go away.”

Jake Harper is an investigative reporter for Side Effects Public Media, and he is a co-host of the Sick podcast. He can be reached at