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The Ages and Stages of the ACA at 1-yr

Posted by Ricky Choi, MD, MPH, NPA Board Member April 4, 2011 at 1:57 PM

The Patient Protection and Affordable Care Act (ACA) turned one year old last month and as a pediatrician; I find it helpful to review its progress in developmental stages.  Just as a child learns to roll, crawl, and then walk, the ACA has made incredible strides this past year and its benefits will also continue to grow over the years ahead.

On March 23, 2010 the United States witnessed the birth of a new law that will eventually allow 35 million people to get affordable quality health insurance and for patients to get important protections from most of the worst practices of health insurance companies.  Witnessing the flaws in the health care system that leaves 16% of Americans uninsured, many had been dreaming for decades about this day. However, the pregnancy was difficult.  Some people expressed dissatisfaction with the likely changes it would bring to our lifestyle and questioned if we were financially prepared.

May 2010 was the first milestone when some Medicare recipients started to receive checks to help them pay for drug prescriptions.  The ACA baby could now roll and was on its way to sitting up.  As of September 23, children under 26 years of age could join their parents’ insurance plan and children with preexisting conditions could no longer be denied health insurance.  Starting this year, Medicare recipients can get free annual physicals and those in the “donut-hole” will get 50% discounts on brand-name Rx drugs.

The past milestones are setting the ground work for the ACA to walk independently on January 1, 2014, when most of the ACA’s provisions will enacted.  On that date people under 400% of the FPL will get subsidies from the government to help them buy affordable policies through state health insurance exchanges or become eligible for Medicaid.  Furthermore, the ACA allows the development of innovative models to improve the quality of care.  However, as with rearing any child, the ACA is a shared responsibility. Some vocal critics overlook the fact that the individual mandate makes possible popular provisions like banning the denial of insurance to those with preexisting conditions.

At my community health center in Oakland, the ACA is bringing life saving benefits.  Last year a staff member prayed daily that her uninsured young adult son would make it to the end of September without an accident or getting sick.  Several of our devoted doctors are able to stay working at the health center thanks to loan repayment programs offered in the ACA.  When fully implemented, the ACA will provide insurance to 5000 of our current uninsured patients through Medicaid expansion and bring many more newly insured people to our doors.  Increased funding for community health centers through the ACA will allow us to expand our operations such that we could double the number of people who benefit from our high quality services.

So, as we celebrate the ACA’s first birthday, we should celebrate the ways that this new addition has improved the lives of the Americans; and look with eager anticipation to the next stages of development. Raising a child is one of life’s most difficult challenges, but parents would agree that the benefits far out way the sacrifices.

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