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The Progress & Future Challenges of the ACA

Today’s guest blog was written by Peter Long, President and CEO of the Blue Shield of California Foundation. The Foundation works to improve the lives of Californians, particularly under-served populations, by making health care accessible, effective, and affordable for all Californians, and by ending domestic violence

On the two-year anniversary of the Patient Protection and Affordable Care Act (ACA) being signed into law, it is clearer than ever that health reform is not self-implementing. A tremendous amount of progress has been made on implementation nationally and here in California, but a lot of hard work still remains. It is important to remember that many people are tirelessly working on the front lines to make sure that all Californians have access to quality, affordable care.

I recently attended the Health Symposium, a gathering of 350 community health center leaders from Los Angeles, Orange and San Diego counties, to talk about the state and national policy environment and the path to becoming a successful health center of the future. I was impressed by the engagement of these leaders to improve their quality of care, patient experience and financial strength. No one questioned whether these improvements needed to be made; instead they focused on how they would accomplish them in such a short period of time. As community health centers prepare for significant coverage expansions through Medi-Cal and the California Health Benefit Exchange in 2014, today they are seeing new and more complex patients because of the expansion of Medi-Cal managed care for seniors and persons with disabilities and the Low Income Health Program (LIHP) population. At the same time, they are working to achieve meaningful use of their electronic health records and forming new partnerships with counties, hospitals and other types of providers. With less than two years until full implementation, questions remain about whether health centers and other health providers serving low-income Californians will be able to handle the primary care needs of the newly-insured populations using existing care models. Their sincerity and desire to meet the challenge, however, are unquestioned.

Two of the people leading the state’s work implementing ACA are Peter Lee, Executive Director of the California Health Benefits Exchange, and Toby Douglas, Director of the California Department of Health Care Services. In recent presentations, Peter and Toby outlined the critical path from today to the successful implementation of ACA on January 1, 2014. I was struck by their clear articulation of the ultimate goal in human terms, their thoughtful analysis of the tough policy choices that lie ahead, and the massive and unpredictable challenges in the external environment. Within the polarized political climate surrounding the ACA and the constrained state budget, both were focused on achieving better health outcomes, reducing costs, and improving people’s care experiences. While their enthusiasm is gratifying, the road ahead is truly daunting and the path to success is narrow.

Blue Shield of California Foundation is proud to partner with ITUP and other individuals and institutions that have taken on the difficult work of implementing reform to ensure access to health care for the most vulnerable Californians. As you read insightful commentaries from ACA’s proponents and opponents, digest new policy reports and survey results and wait with anticipation for the Supreme Court’s proceedings next week, remember that over 370,000 low-income Californians now have health coverage because of the implementation of the LIHPs. At the end of the day, these efforts are fundamentally about improving health care and health outcomes for individuals, families and communities across the state and the nation.

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