Health Reform: One Year Later
By Michael R. Fraser, PhD CAE
When our staff team met to plan the 2011 editorial calendar and decided that the March issue of Pulse would mark the one year anniversary of the Patient Protection and Affordable Care Act, or what we know as “ACA,” we had no idea the future would look like this! Efforts to stop, repeal and/or defund ACA seemed like idle threats a year ago. On the first anniversary of the most significant health legislation to be adopted by Congress in my lifetime I must admit I thought we would be well past celebration and well into implementation. I had no idea, however, that we would also be well into active defense of this important landmark in improving the health of America’s women, children, and families.
Indeed, the celebration is over and we are into implementation. AMCHP has stood up our National Center for Health Reform Implementation to provide resources, analysis and support to state MCH programs looking to better understand the options and challenges of ACA. We have reviewed and read three rounds of guidance for the new home visitation program and are anxious to see that program developed in the states among many other new or expanded programs in ACA. We have already heard about the ways that our Medicaid colleagues and partners are moving ACA forward. The investments in adolescent health will greatly contribute to current and future health outcomes. And most importantly we have heard from families about the many ways that ACA has made their lives better even in the first 12 months of its implementation. Regulations are phasing in, programs are getting started, and there is a lot to celebrate.
But, the future of ACA implementation is uncertain. At the AMCHP Conference a few weeks ago we engaged in important dialogues about states’ abilities to implement provisions of ACA in the face of legal challenges and political barriers. Last week in Congress, the House approved a Continuing Resolution for FY 2011 that withheld funding for ACA implementation in addition to cutting funding to the Title V MCH Block Grant and other federal programs. The Senate starts its deliberations on the House proposal this coming week. It will be an interesting compromise and no one knows what the future will bring. Failure to compromise could result in a government shutdown. Would we have predicted this a year ago? I didn’t.
In the face of uncertainty what’s an MCH leader to do? Go with what we know. As the budget process unfolds and the political process continues our only choice is to proceed as we can with implementation and show the impact of the work we are doing. While some states will not be able to move forward right now with full implementation of ACA, it is still law and its provisions remain vital to improving maternal and child health. AMCHP will continue to share information with you on the status of ACA, and other legislative issues of import to MCH programs. We ask you to please keep us informed of what you are doing in your state and community and what you are learning in the process of ACA implementation.