Health reform is one year old

April 15, 2011

CHA president and chief executive officer

We have just celebrated the one year anniversary of the passage of the Patient Protection and Affordable Care Act. This was a long-sought goal of Catholic health care and many others. It has long been a concern that the United States was the only industrialized country that did not cover health care for everyone, and since our economic downturn, the number of uninsured has risen to over 50 million.

CHA members played a major role in getting this legislation developed and passed. Together several years ago, we set goals for our vision for health care reform in the United States. Leading these goals was a respect for life at all stages, with particular attention to those who are vulnerable. Throughout the debate, we made it clear that we were willing to compromise on our preferences, but we would never compromise on our principles. We also emphasized the importance of conscience protection as the bill progressed.

Now we must implement the bill, and it is especially challenging to implement a bill of this magnitude in an economic recovery mode, especially with employment being the last segment of the economy to recover. The last time we implemented a major health care change was in the midst of the "Great Society" when our economic situation was much stronger.

However, the bill is rapidly being implemented. Most of the achievements to date have helped those who were insured but challenged not only to maintain their insurance, but to have it truly cover them. Some of the wonderful changes implemented already include: adult children up to 26 can stay on their parents' policies, children cannot be denied coverage any longer for preexisting conditions, there is no lifetime limit on benefits, preventive services can be obtained without a co-pay, there is more freedom of choice to select a primary care physician, insurance companies must prove fraud before cancelling a policy and senior citizens are rapidly having the "donut hole" in their prescription coverage closed. These are wonderful changes and are a great help to so many working families and senior citizens.

CHA especially looks forward to the help for 32 million of the uninsured through the Medicaid expansion and the state exchanges in 2014. Unfortunately, the Medicaid expansion is experiencing some real challenges given the economic environment and the states' requirement to have balanced budgets. Expanding Medicaid is expected to help an additional 16 million Americans get health coverage. It is also intended to improve the reimbursement to physicians for primary care, and the new Medicaid recipients will be 100 percent covered with federal funds for the first three years. Our members are fully engaged with their states to preserve the Medicaid gains.

The exchanges are a very exciting part of the new bill, and there is a great deal of work going on throughout the country. It is expected that 16.6 million Americans who do not have coverage now will get it through the exchanges. Small employers will be able to purchase insurance through large pools rather than the notoriously expensive small market for insurance. There are planning grants in almost every state to prepare for the exchanges, and the possibility of significant flexibility to experiment and develop best practices is included in that. Since Congress must buy a plan from the exchanges, the "essential benefits" included in these are expected to be sufficient.

The tremendous challenge for enrollment and reenrollment in the exchanges is daunting. CHA's Michael Rodgers and I went to a meeting of Enroll America and met with the team that is responsible for developing the programming for this. The quality and the scope of the team's understanding were very impressive. Their commitment is to easy and rapid enrollment and reenrollment. There is a commitment to an extraordinarily rapid turnaround on enrollment, and it is clear that these advances can be extended to other programs such as Medicaid.

We have a special responsibility to help implement the reform act well and to achieve the promise of the bill. We have been working with many groups to do this. Getting good information out is an essential first step. Unfortunately, the misinformation and distortion is frightening so many people. CHA is increasing its efforts to help our ministries identify accurate resources to help their communities understand the bill. Some good websites are and Our Washington Update and our website will also be very helpful. Other resources will be developed and shared with our members.

We have an opportunity to help those we serve achieve a great deal from this bill. It is unprecedented, and CHA will do everything it can to help our members help their communities achieve the promise of this bill.


Copyright © 2011 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2011 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.