Alcohol exclusion laws (AELs) that allow health insurers to deny coverage of injuries sustained while individuals are intoxicated remain on the books in 18 states, despite evidence showing that these laws prevent people from receiving treatment for alcohol use disorder.
Systematic legal analysis using the Alcohol Policy Information System to identify states in 2023 that explicitly allow AELs, prohibit insurers’ use of alcohol exclusion (AE), or have no AE allowance or prohibition.
18 states still have AELs, a decrease from 37 in 2004.
The first AELs were passed in 1951 and the most recent were passed in 1988.
15 states have passed laws that explicitly prohibit AE provisions. No state has outlawed AE provisions since 2009.
The remaining 17 states have no clear laws on AE, including five that repealed their AELs but adopted no specific prohibition on AE.
“By continuing to permit the exclusion of health coverage for intoxicated injury, these laws preserve the outdated notion that adverse consequences of alcohol use should be viewed as evidence of a lack of willpower and immorality for which an individual is exclusively liable,” the authors write.
The study was conducted by Sunday Azagba, PhD, Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, and funded by the National Institute on Alcohol Abuse and Alcoholism. It was published online September 19, 2023.
This study focuses on alcohol exclusion laws pertaining only to health insurance and represents an analysis of state laws as of 2023.
Study authors report no relevant financial relationships.
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