By Michael R. Fraser, PhD, CAE, Chief Executive Officer, AMCHP
The Affordable Care Act (ACA) was passed just three short years ago and was met with great fanfare by some and great chagrin by others. As we move toward full ACA implementation in 2014, we do indeed have cause to celebrate but also a great deal to think about as maternal and child health (MCH) leaders.
Clearly, a main goal of the ACA is to provide access to health insurance for all Americans – a goal shared by AMCHP and many, many partners. We know that access to care is an important part of reaching our vision of “healthy children, healthy families, healthy communities.” Clearly, we also want that care to be affordable, culturally competent, comprehensive and high quality.
With health care access “off the table” in a major way, we now have more space to talk about primary prevention. The ACA provides resources for public health and prevention activities; for example, the Public Health and Prevention Fund has supported a number of chronic disease prevention and health promotion activities in states and communities nationwide. The ACA also recognized the importance of evidence-based home visiting programs, authorizing $1.8 billion dollars over five years for the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program that many of you administer in your states. In my opinion, these are the only “new” dollars we are going to see in public health and maternal and child health for the foreseeable future and I am glad we have them to complement the ACA expansion of health care access.
With all that is positive about the ACA, I think we can all agree it certainly is not perfect. As mentioned above, there are concerns about the affordability and comprehensiveness of coverage, and details on how the expansion is going to work in the states are still being finalized. The prospect of expanding access to publically financed health care has raised questions about the need for programs like the Title V MCH Services Block Grant. In light of the ACA, AMCHP has played significant defense to help decision makers and partners understand that there remains an important, vital role for the Title V MCH Block Grant even with the ACA expansion of health care. Concerns about duplication, existing versus future gaps in services and the need for a focus on MCH overall were only on the horizon three years ago. Now, they are here.
At the three year mark, I think we do have cause to celebrate all the ACA has done, and will do, to improve our nation’s health. Moving forward it is important that we identify the many ways that Title V complements the work of the ACA and how your work in the states is still relevant and critical to strengthening and improving maternal and child health. While the third year anniversary of ACA is a milestone, the anniversary next year will be even more important as the law goes into full effect in 2014. AMCHP will continue to share how the ACA benefits state MCH programs and ways that you can leverage the ACA in your work as MCH leaders. Please let us know how we can help you moving forward and take advantage of the resources and tools that we have produced to date though our National Center on Health Reform Implementation and other programs.