By Michael R. Fraser, PhD, CAE
This March, we recognized the second anniversary of the landmark Patient Protection and Affordable Care Act (ACA). I must admit we do so with both excitement and trepidation: everything related to the ACA is a political hot potato – controversial and potentially divisive. As a nonpartisan organization, AMCHP represents members and state programs with varying attitudes towards the ACA and its implementation and we strive to respect both sides in the debate, pro and con. In this issue of Pulse, we present the impact of the ACA on maternal and child health (MCH) programs from an objective perspective recognizing that 26 of our 59 state and territorial members work in states where their attorneys general are suing the federal government to block the ACA. Like many of our members, we also have to walk a fine line between optimism and caution regarding a piece of legislation that clearly has huge benefits for the most vulnerable of our citizens, but also huge changes to state Medicaid, MCH and other health programs.
I suppose the easy way out would have been to ignore the topic completely but you know how I feel about taking the easy way out. Indeed, we ignore the implementation of the ACA at our peril: regardless of your opinions toward it, or your states’, it is the law of the land with important implications for state maternal and child health programs and the work of our partners. For that reason alone, it is important that we spend some time thinking about what we have learned over the past two years from the debate around the ACA and all that means for MCH leaders nationwide.
The ACA has truly become a flashpoint for more than just attitudes toward health care. A recent Kaiser Family Foundation poll (Feb/Mar 2012) found that of the 40 percent of Americans surveyed with an unfavorable view of the ACA, 38 percent said their unfavorable view is more about a "general feelings about the direction the country is going and what’s going on in Washington right now." Only 27 percent of those who have an unfavorable view of the ACA said that their opinion was based on what they knew about the health reform law. Thirty-two percent of those with an unfavorable view said that their unfavorable opinion was based on both their opinions about the law and their general feeling about the direction the country is going and what’s going on in Washington, DC. Hence, at least within the general public, among those with an unfavorable opinion of the law, much of that is due to an unfavorable opinion about Washington, DC in general – interesting.
The fate of the ACA is currently in the hands of the Supreme Court, which began hearing oral arguments in the suit. Will we be celebrating the third anniversary of the ACA next year, or going back to the health reform drawing board once again? We should know soon. In the meantime, AMCHP will continue to provide updates to members on this important topic and share information and analysis about how the ACA can be used to address state MCH needs and priorities.