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Sister Carol Keehan
Sister Carol Keehan

Reform law is a starting point

A foundation to build on: Though changes are likely, health reform law fills a niche, fulfills promises


By Sister Carol Keehan
Posted: July 25, 2011 - 12:01 am ET
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For the Catholic Health Association and our members, the Patient Protection and Affordable Care Act is above all a promise. It is a promise to start repairing a broken healthcare system that leaves too many people on its periphery. It is a promise to protect individuals and families who are poor and vulnerable, making sure they never want for something as fundamental as healthcare. It is a promise to reduce costs and make healthcare smarter and more efficient.

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As we look to the future, fulfilling these important promises will not be easy or happen quickly but the Affordable Care Act is a solid foundation on which we can build. And people are receiving help and hope now. Already, it is illegal to reject a child for insurance coverage because of a pre-existing condition. Young adults can stay on their parents' health plan until the age of 26, and more than 600,000 have already done so, according to HHS.

Seniors, meanwhile, are getting new help with prescription drug costs. More than 4 million Medicare beneficiaries received a $250 rebate check last year to offset some of their out-of-pocket costs, and many others are receiving discounts on medication when they fall into the “doughnut hole” coverage gap, HHS has reported.

Small businesses, which we know are the engines of our economy, are already receiving tax credits of up to 35% of their annual health insurance premium costs. And preventive benefits for all age groups are being made available at no cost to the patient.

Many more improvements are coming as we move toward expanding coverage to at least 32 million currently uninsured people. As it stands, there are at least 50 million U.S. residents without health insurance. The long recession escalated this number as workers lost jobs and employers cut back on benefits in a difficult economy. Regardless of the reason for such widespread lack of meaningful insurance coverage, it is a national disgrace for a nation as wealthy as ours to tolerate it—and it would be equally disastrous to repeal or scale back the legislative progress we've made.

A long road—behind us and ahead

The CHA has been advocating for a healthcare system that serves everyone for several decades. Drawing on our concern for protecting life and those who are poor and vulnerable, we worked in 2007 to develop a set of principles for reforming the nation's healthcare system. The consensus document we developed with our hospitals and long-term-care providers, Our Vision For U.S. Health Care, spelled out principles for reform beginning with expansion of coverage to everyone in the nation.

We also called for a system that is oriented toward health and prevention, that is fairly financed with shared contributions from all stakeholders and that focuses on quality and safety. Many of these principles are reflected in the Affordable Care Act. And while the coverage offered by the law isn't complete or perfect, it is a serious and important step toward achieving the health system we need and deserve.

In many ways the hard work still lies ahead. First we need to make certain that the advances made possible by the law stay intact. Attacks on health reform continue to dominate blogs and cable TV but are rarely honest or accurate. Catholic healthcare will be among the many groups working to educate the American public about what the law really does, how it represents real progress and how it is helping real people.

Over the coming years, we will also closely monitor implementation of the law to ensure that it aligns with our expectations, values and emerging realities on the ground. And most important of all, we will make sure that it serves the American people well.

Hospitals, too, will have to change as new models of financing and care delivery—including accountable care organizations—offer new opportunities for collaboration and cost savings.

Every detail matters, and for the future healthcare system to be strong, all the elements need careful attention. The state exchanges, for instance, are expected to provide a coverage source to 16.6 million Americans. Making sure this works includes helping determine how the exchanges are designed, maintained and explained. Similarly, we will need vigorous enrollment efforts to make sure that people eligible for various coverage options are aware of and sign up for them.

At the same time, it will be critical that we protect the Medicare and Medicaid programs, which have successfully provided care to poor and elderly persons since the 1960s but are now under duress because of a growing national debt. Cutting our deficit spending is a high priority, but it must not be done at the expense of vulnerable families and healthy communities.

Many Catholic values are also American values, especially equality, justice and the common good. The Affordable Care Act is the foundation of a promise to care for each other, to build strong environments for our children and future generations, and to more wisely manage our precious resources.

The work is far from over, and the Affordable Care Act will no doubt change and evolve over time as we learn what works and what needs to be adjusted or updated. In the meantime, the reform law and all those working to implement it will help the entire healthcare industry fulfill the promises we have made to our families and our communities.

Sister Carol Keehan is president and CEO of the Catholic Health Association.



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