The Real Stories of the Affordable Care Act

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Affordable Care Act

The ancient greek symbol for medicine Caducei with a health cross.The Affordable Care Act may still be generating plenty of headlines on Capitol Hill and in state legislatures, but the real stories are somewhere else entirely.  These stories of the new health care law are in the thousands of communities across the country where advocates are preparing for the October 1 opening of the Health Insurance Marketplace.

This past week I worked out of ACF’s regional offices in Kansas City and Chicago. Few waking hours passed without mention of the ACA and the opportunities it brings to the struggling Americans our programs serve.

From those who receive energy assistance and child care subsidies, to non-custodial parents paying child support, ACF works with millions of people who will be newly eligible for Medicaid or for reduced-cost insurance.  Many of them are among our nation’s 44 million uninsured, and countless dedicated grantees, activists and state agencies are doing everything they can to reach them.

Here are a few of the stories I heard:

  • In Columbus, a Community Action Agency operates a mobile health unit whose users are 100 percent uninsured. Come Oct. 1, they will talk to all of their patients about the Marketplace and help them apply for health insurance.
  • In Kansas City, a staff person from the Local Investment Commission (LINC), addressed a group gathered for a child support enforcement meeting.  “The Affordable care Act is the most significant policy reform of our generation,” he said. “And I feel very free to discuss this everywhere and in every way I can.” His remark, met with chuckles in the room, was in reference to a Missouri law that forbids state employees from helping the federal government in any way as it implements the new health care law. 
  • That Missouri law also meant that the ACF table at the recent Missouri State Fair got an unusual amount of health care questions, since state agencies had to refer people to us. Other non-profits there have increased their outreach efforts in response to the state law.
  • Of our nation’s top 10 cities with the highest proportion of low-income residents, HHS’s region five, based in Chicago, is home to four of them:  Detroit, Michigan; Cleveland and Cincinnati, Ohio; and Milwaukee, Wisconsin. The HHS regional office is working closely with ACF and other HHS divisions to make sure that we’re doing everything we can to connect residents of these cities with health insurance.
  • The state of Minnesota just posted this video, which describes its creative and humorous plans for outreach and promotion of the Health Insurance Marketplace.
  • At the Community Action Partnership (CAP) national conference in Chicago, a group of Community Action Agency leaders met to discuss Marketplace outreach strategies and what softwares to use to track their outreach and measure its impact. They are not only willing to go door-to-door to reach the uninsured, they also want to be sure that those they talk to ultimately get insurance and, most importantly, medical care. And they will track this progress.
  • In Michigan last week, the state legislature narrowly passed Medicaid expansion, becoming the 25th state to expand eligibility requirements for Medicaid. The state expects about 470,000 additional people to receive coverage through the program. (Check out this video explaining Medicaid expansion.)  This news was met with a roar of applause from those gathered for the CAP meeting in Chicago.

I could list many more examples of grassroots efforts to implement the Affordable Care Act, but you get the idea. Those who work every day with Americans who are struggling to achieve financial security, those who seek out and hold tight to every inch of safety net they can create or find –  are focused on the Affordable Care Act.

This work will not likely make headlines. But it will make this historic shift in public policy work for the American people.


Marrianne McMullen is the Deputy Assistant Secretary for External Affairs for the Administration for Children and Families.

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