Jul 13 2012
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Getting Ready to Implement the Affordable Care Act

On July 12, a standing room only crowd of local health leaders took part in a 2012 NACCHO Annual Meeting session on the implications of the recent favorable Supreme Court ruling on the Affordable Care Act (ACA). As the law faces continued uncertainty amid renewed legal challenges and the forthcoming national election, proponents were urged to continue educating stakeholders about the work of public health. Laura Hanen, who leads government and public affairs for NACCHO, advised that public health needs increasingly to have a seat at table in health policy decision making at the national, state and local level–or risk being on it.

Lillian Shirley, director of the Multnomah County (Oregon) Health Department and immediate past president of NACCHO,  urged health department leaders in attendance that in addition to being more vocal about the return on investment of  public health, they need be more forthright about the added value they can bring to local decision making  in areas such as demonstrating evidence, measuring and evaluating, spreading best practices, and collecting data that can inform policy decisions. “We have been invited to be part of the solution,” Shirley said. “We shouldn’t be shy about the skills we bring.”

During the question and answer period, many participants voiced confusion they were feeling in the early stages of the law’s implementation. One raised the question of whether to continue to focus on clinical services, an issue that many health departments are grappling with now amidst budget cuts and increased partnership with health systems. Another participant asked whether local health departments will have to address complaints from residents of the communities they serve if some parts of the law are not upheld, such as a requirement that many companies establish dedicated break rooms and break time for nursing mothers. Hanen said that the answers to such questions will in many cases be dictated by policies set at the local level, and advised health department leaders to continue to be assertive–but cautious at the same time. “We can’t predict [everything] at this point.”

>>View a list of resources compiled by the Robert Wood Johnson Foundation regarding the Supreme Court decision on the ACA.
>>Check out other outlets to follow with analysis of the decision.