The Patient Protection and Affordable Care Act, often referred to simply as the ACA or Obamacare, was signed into law on March 23, 2010. The ACA is intended to expand access to health insurance coverage for millions of uninsured Americans by expanding eligibility for Medicaid and developing health insurance marketplaces where uninsured persons may be eligible for subsidies to make private health plans more affordable. While expanding access to health insurance is a big part of the ACA, there are many other purposes of the law, including provisions intended to reform the health care delivery system to produce better patient outcomes at lower cost.
AOTA was very active in the legislative process leading up to the passage and signing of the ACA, working to achieve victories such as inclusion of rehabilitation and habilitation in the essential health benefits package. AOTA has also been monitorting the regulatory process at the federal and state levels as the ACA has been implemented, and has been advocating for occupational therapy practitioners and consumers. The dynamic environment created by health care reform creates opportunities, but vigilant monitoring of implementation activities and carefully executed advocacy efforts are necessary to ensure occupational therapy is valued and protected in the future.
Please also see the Health Care Reform Implementation page on AOTA's website at: http://www.aota.org/Advocacy-Policy/Health-Care-Reform.aspx
Long-term care didn't get much attention during the debate leading up to passage of the ACA. However, there was a program created by the ACA to address the growing demand for long-term care services that is expected as the population ages. It was called the Community Living Assistance Services and Supports Act or CLASS Act. The CLASS Act created a voluntary long-term care insurance program, but federal officials determined it could not be implemented in a self-sustaining fashion as was intended. As a result, Congress repealed the CLASS Act and created a Commission on Long-Term Care to "...develop a plan for the establishment, implementation, and financing of a comprehensive, coordinated, and high-quality system that ensures the availability of long-term services and supports for individuals in need of such services and supports...." The Commission released its recommendations last week.
While implementation of the ACA is dominating much of the health care policy landscape these days, long-term care will inevitably become a prominent issue in the near future as efforts to keep the aging population out of institutional care settings becomes increasingly necessary to control Medicare and Medicaid spending. Indeed, apart from the issue of government spending, AARP reports 9 out of 10 individuals would prefer to stay in their homes and communities as they age. This creates increased opportunities for occupational therapy professionals in the areas of fall prevention, home modification, driving and community mobility, caregiver training, and others areas of practice. AOTA policy staff will continue to monitor the Commission's activities as they may be developed into proposed legislation.