Thursday, June 24, 2010

Will the District lead again on health care reform?

As Legal Aid’s Jennifer Mezey discusses in her recent blog post on health care reform in DC, the District has long been a leader in health care reform.

Back in the day, experts and interested parties from the community and government came together to apply for funding from Robert Wood Johnson Foundation’s Covering Kids initiative to implement the federal State Children’s Health Insurance Program (SCHIP or CHIP).   DC Action for Children organized and managed the effort which relied on community-based partners to conduct outreach and enrollment and government partners to make important administrative changes.   The effort had a lot to work with, thanks to an early decision of the DC government to expand eligibility for health care access and insurance to 200% of poverty.   The District was an early adopter of this eligibility level.   The new limit meant that thousands of children, and all adults in the household, could now get health insurance.   Hundred of individuals and organizations worked for years to increase the number of children who had health care benefits and reduce barriers to access.

Today, the District is in a position to lead again.   As the city considers how it will implement the federal Patient Protection and Affordable Care Act (PPACA), it can either take a considered, deliberate, and inclusive approach, or not.   The former is the standard set by the CHIP experience and I, for one, am urging this approach.   I am not alone in supporting this tack.   Those with significantly more health policy and practice experience than I have put together a set of principles to guide the implementation of PPACA.   The principles are:

  • Principle 1:   The District should have a coordinated policy development and implementation plan allowing for all affected District agencies and critical stakeholders to provide input.
  • Principle 2:   The District should ensure that no one loses coverage as a result of health care reform implementation and that all individuals can access quality, affordable health care safely.
  • Principle 3:   The District should streamline its eligibility rules and processes for public insurance and the Exchange.
  • Principle 4:   Any money saved through the implementation of the PPACA should be reinvested into the health care system.

Presumably, there will be working groups, opportunities for public input, and more as the city moves to implement the federal health reform law.   Stay in touch with the council's Committee on Health and Legal Aid for updates.

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