Mar 5 2014
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The Affordable Care Act Bolsters Disaster Readiness

Nicole Lurie, MD, MSPH, is the assistant secretary for preparedness and response at the U.S. Department of Health and Human Services (HHS), and Kacey Wulff, MPH, is special assistant to the assistant secretary, at HHS. An alumna of the Robert Wood Johnson Foundation Clinical Scholars program, Lurie is the co-author of “The U.S. Emergency Care System: Meeting Everyday Acute Care Needs While Being Ready for Disasters,” published in the December 2013 issue of Health Affairs, which focused on the future of emergency medicine. This is part of a series of posts  featuring RWJF Scholars who authored articles in the issue.

Nicole Lurie, MD, MSPH Nicole Lurie

As we approach the Affordable Care Act’s March 31 enrollment deadline, data is starting to emerge about how these reforms are making care more accessible, cost less, and, ultimately, Americans healthier. As these reforms take effect, and make our day-to-day health care system stronger, they also result in strengthening communities across the country to become more resilient and disaster-ready.

The gaps that inspired and propelled health reform like untreated chronic conditions and mental illness, and health disparities plague our health care system every single day. During a crisis, like a hurricane, earthquake, or attack, these issues can become magnified. As a result, the ability for individuals and communities to prepare, respond, and recover successfully is intrinsically linked to the strength of the underlying health care system.

Kacey Wulff, MPH Kacey Wulff

The Affordable Care Act expands mental health and substance use disorder benefits and federal parity protections for 60 million Americans. As a result, many Americans who previously have not had coverage for mental health care will have greater access to this and other important aspects of health care. This will help to make the tools that support recovery from injuries sustained during disasters, whether illness, injury, or trauma, more accessible.

This boost in preparedness is important for responding to disasters big and small: the biggest indicator of how a person or community will fare during a disaster is how they were doing before the crisis struck. While health insurance doesn’t guarantee that you will be healthier, it does make health much more likely. 

The opening of the Marketplaces, combined with consumer protections against being denied coverage, or charged more, for preexisting conditions, means that millions who could previously either not access or afford insurance now have options. Approximately 4 million Americans have already enrolled through the Federally Facilitated Marketplace and State-Based Marketplaces.

As a result, millions of Americans have access to health care services, including preventive care. Many will have this access for the first time. Expanded access helps more people to have better daily management of a chronic condition, and means that during a disaster it’s more likely that an individual can control the condition on their own and less likely they’ll have to resort to a trip to a badly stressed emergency room.

This is good for the person, and good for the community.

Read a description of Lurie's 2011 remarks at the  2011 Public Health Systems and Services Research Keeneland Conference.

Tags: Clinical Scholars, Emergency Care, Emergency Preparedness and Response, Voices from the Field