The situation with healthcare reform is dire. It is estimated that as many as 18 million people could lose their health insurance if the Affordable Care Act is repealed. People struggling with substance use or addiction will be hit hard. If high risk health pools, which exist to provide insurance for people who are considered un-insurable, are re-established, it is almost certain that most addicts will find themselves unable to afford the kind of treatment they need. Even people who have been in recovery for decades could find themselves with limited access to healthcare, because addiction is considered a pre-existing condition.