Hard work ahead on the Affordable Care Act

Added February 11th, 2011 by Jan Hudson

Jan Hudson

I recently returned from Health Action 2011, Families USA’s annual conference where I experienced a renewed appreciation for the good that will come with full implementation of the Affordable Care Act (ACA). It won’t be easy, and there are many hurdles to overcome.

The conference included many highlights, such as presentations by U.S. Rep. Nancy Pelosi, Don Berwick, (director of the federal agency that will oversee much of the implementation of the Affordable Care Act), and of course, the address by President Obama.

President Obama reminded us of all the good that had already occurred because of the Affordable Care Act and how much more is to come. He spoke of the increased power, greater freedom and stronger control over their health care that Americans have experienced since the law was signed just 10 months ago.

He also expressed concern about the current efforts to repeal and/or undermine implementation of the law. While he agrees the law is not perfect and is willing to consider modifications to make it better, he is not willing to abandon this historic law and start over. In response to those who call the law a “job killer,” he noted that the economy has not only grown since the law was signed, but that small businesses, many for the first time, have been able to offer health care coverage to their employees because of the tax credits.

The most compelling presentation for me, however, was given by Dr. Gail Christopher, Vice President for programs at the W.K. Kellogg Foundation. To be successful and effective in implementing the Affordable Care Act, she told us we must change our fundamental beliefs and hearts. We must acknowledge and work to heal the legacy and cumulative impact of discrimination, racism and inequality. The law, while containing many non-discrimination clauses, will not be effective without changes in our beliefs and behaviors. We have not moved to a post-racial America in spite of our dramatically changing demographics. By 2050, one in two will be a person of color. We must, as a nation, come to grips with this fact.

In her remarks, Dr. Christopher told the story of a young black woman, who had lost her first child (not uncommon), and who upon arrival at the hospital in labor to deliver her second, was shoved off into a corner and left unattended after a brief examination. When her doctor arrived at the hospital, he was furious and demanded to know why she had not been prepared for delivery. The attending resident responded simply that she was black and he assumed on Medicaid. That young woman was Gail Christopher!!

I thought about Gail Christopher’s story as I attended a workshop on the Affordable Care Act benefits for women. I know about the great provisions that have already been implemented and those still coming. What I had not yet focused on were the gender and racial disparities in our current system and the degree to which those issues can be addressed and improved with full implementation of the law.

Access to and stability of coverage through the exchanges, with their subsidies and protections, will be very important to women who may have unstable incomes, sometimes leading to gaps in coverage. The law requires preventive services to be provided without cost sharing. This provision will enable women of all ages to obtain the care and services they need without financial hardship. In addition, women and small businesses with predominantly female employees will no longer be surcharged by insurance companies based on their gender, and insurance companies will be required to provide maternity benefits as part of the essential benefits package. Pre-existing conditions will no longer keep women out of coverage through insurance company denials or unaffordable premiums.

The Affordable Care Act has the potential to benefit millions and millions of individuals, families, and small businesses. Implementation should proceed without the distraction of attempts to repeal the law (both the House and Senate have had failed attempts) or efforts to undermine its implementation. A call to your U.S. Senator and Representative to affirm ACA implementation is in order.

– Jan Hudson