With ACA Upheld, Attention Can Now Turn to Better Health Outcomes and Lower Costs

As historic Supreme Court rulings go, this one was like a roller coaster. There was great anticipation, even confusion—yes CNN, your error had my heart racing for a few minutes—but in the end a grand conclusion.

The Alliance for Children and Families and United Neighborhood Centers of America (UNCA) are delighted with the decision by the Supreme Court to uphold the Affordable Care Act. It is a great step forward in this country’s journey to achieve a far more efficient and effective health care delivery system and represents our country’s commitment to making sure that no one in America ever wants for access to health care.

Specifically, the Medicaid expansion offers the opportunity for Alliance and UNCA members to increase our strengths in being critical members of the healthcare team to serve individuals with complex healthcare issues whose social and behavioral needs often trump their medical needs.

My contention is that our nation cannot bend the cost curve of health care without recognizing that a small percentage of the population drive the majority of health care costs, and that their bio, psycho, and social needs make community-based nonprofit human service organizations, like those in our network, critical members of the team!

As the former secretary of the Washington State Department of Social and Health Services and of the governors’ health care cabinet, I have a really hard time understanding why a governor or legislature would not extend the expansion of Medicaid to the poor and uninsured. States are, in several ways, already paying for the populations that would now be covered by Medicaid. States pay through their social service delivery and corrections systems. These folks cost states and the insured through increased premiums, especially from frequent use of costly emergency rooms.

Right now we are paying for them, yet not getting very good results. As it now stands, the federal government will pay 100 percent of the Medicaid expansion costs, and after 2020 will pick up the cost at 90 percent! I truly hope that governors will make this decision based on a full analysis that looks beyond only their Medicaid budgets, and will see they can actually save money by having all persons insured.

So many governors talk about children’s education as being one of the highest priorities in their state, yet they lack sufficient funds to fund it well. Here’s a tip: The money you are lacking is now sitting in a very inefficient and ineffective health care delivery system and uninsured people are costing you dearly! Get busy reforming your healthcare delivery system and ensuring everyone is covered and you will bend the cost curve of health care and have the dollars for other priorities.

I look forward to continuing to work with health care insurers and providers to position our members as partners to improve health outcomes and control costs. We will also continue our work with members of this network to increase their knowledge about the health care delivery system and the rapid move away from fee-for-service care to managed care.

I believe that everyone must recognize the partnerships with our member organizations are going to be key to bending that cost curve and getting quality outcomes. Remember, only 10 percent of a person’s health is based on medical care, the rest involves the social and environmental factors of health, which positions our sector as being critical partners and experts in improving the effectiveness and efficiency of our healthcare delivery system.

Now that we have increased access and coverage, it is time to turn our attention to better health outcomes and lower costs. This can only be achieved when the full expertise of the nonprofit human services sector is brought to the table.

Let real health care reform begin—our people and national economy are depending on it!