Illinois consumers who buy health insurance through the Obamacare exchange might get more coverage aimed at treating and preventing opioid addiction, starting in 2020, if the state has its way.
The Illinois Department of Insurance has applied to the federal government to add a handful of requirements, mostly dealing with opioid addiction treatment and prevention, to the list of what insurers on Illinois' exchange must cover.
The proposed changes come amid a scourge of opioid addiction. Last year in Illinois, 2,111 people died after overdosing on opioids, according to preliminary Illinois Department of Public Health data.
This year, more than 300,000 Illinois residents are covered by insurance plans purchased on the exchange. The state projects that exchange premiums could increase by 30 cents per person per month if the proposal is approved. Consumers who receive subsidies would likely see those subsidies also increase to cover the extra amount.
If the proposal is approved by the Centers for Medicare & Medicaid Services, insurers on the exchange would be required to, among other things:
_Cover prescriptions for the nasal spray form of naloxone, an antidote to opioid overdoses, when patients are prescribed certain dosages of opioids.
_Cover telepsychiatry for addiction and mental health issues, in which psychiatric services are delivered remotely, via phone, video or other technologies.
_Cover alternative therapies for chronic pain, such as certain pain relievers that can be applied to the skin.
_Limit coverage of opioid prescriptions for acute pain to seven days.
Illinois' proposal follows a Trump administration rule giving states flexibility to change the services they require exchange insurers to cover.
It's unclear how many other states have also applied for the flexibility, but Illinois says it is the first state to use the flexibility to address opioid addiction.
Colleen Miller, a spokeswoman for Blue Cross and Blue Shield of Illinois, declined to comment on the proposed changes. Insurers Cigna and Health Alliance Medical Plans did not respond to a request for comment.
Chelsea Laliberte, vice president for patient and family services at the Addiction Policy Forum, said the proposal is a step toward improving access to treatment for those struggling with opioid addiction. Laliberte lost her brother, Western Illinois University student Alex "Lali" Laliberte, in 2008 to an overdose of heroin and other drugs.
It can be difficult for patients to get the types of anti-addiction treatment they need for the amount of time they need it, she said.
"We know that treatment needs to be available when people need it for however long it takes for them to achieve their goals, just like any other medical condition," said Laliberte, who also is director of the forum's Addiction Resource Center in Arlington Heights.
The state expects to learn in the next few months if its proposal is approved.
