Health Reform

Topic Summary

The Patient Protection and Affordable Care Act is the most comprehensive health reform legislation enacted by the United States in decades. Though focused on improving health care access and insurance coverage for millions of Americans, the Act also includes a number of preventive and community health provisions that could impact the practice of public health law.

Primary Legal Issues

Over the next five years, public health practitioners will be addressing questions such as:

• How will changes to health care access and coverage impact how state and local public health authorities protect vulnerable populations?
• What menu labeling standards will be applied to restaurant chains? 
• How will employers implement “reasonable break times” for nursing mothers?
• How will private and public insurers implement and inform their enrollees about provisions to enhance preventive and community health, including:
  • Requirements for private insurers to cover all recommended preventive care and vaccines without charging co-payments;
  • Requirements for Medicare to cover free annual physical examinations; and
  • Requirements for Medicaid to cover drugs and counseling to help pregnant women stop smoking?
• How will the Act’s “prevention and health fund” be allotted to state and local governments?
• How will Community Transformation Grants be used to support environmental, programmatic and policy changes to promote healthy living and reduce disparities?
• How will broad data collection requirements for federally funded entities be implemented to ensure reporting by race, ethnicity, gender, geographic location, socioeconomic status, primary language and disability?
• How will state and local governments respond to increased federal efforts to determine how to allocate and distribute health care and public health services?

Technical Assistance Capacity

Network attorneys are able to provide technical assistance and training on the above questions as well as broader issues related to health reform and public health. The Network has access to professionals who have worked with a variety of stakeholders to improve their understanding of laws affecting public health care delivery and access, outreach, quality and performance, wellness and prevention, and fraud and abuse. These professionals have provided national and state-based policy-makers and advocates with introductory and in-depth analysis and technical assistance as health reforms have been enacted and implemented. They are also participating in numerous technical advisory groups focusing on federal and state implementation of national health reform provisions. Staff members are also monitoring litigation currently underway to challenge national health reform in federal and state courts.

For legal technical assistance and support on health reform or any of the public health topics, please contact your region. Your region will connect you with the appropriate expert based on your request.

Resources

• The blog post, Supreme Court to Review ACA, discusses the November 2011 announcement that the Supreme Court will hear a challenge to the constitutionality of the Affordable Care Act.
• The webinar, Health Reform’s Impact on Comparative Effectiveness and Public Health Outcomes: Something Old Becomes New Again, investigates the question, 'how will the era of health reform impact public health outcomes?'
• The webinar, The ACA: What It Means for Local Health Departments, examines the challenges and opportunities of ACA implementation for local health departments.
• The issue brief, Applicability of Patient Protection and the ACA to Substance Use Disorder Treatment, and the blog post, Essential Coverage for Often Neglected Health Needs, provide information on how the PPACA may affect availability and accessibility of substance use disorder treatment services.
• The webinar, Public Health Provisions in the Affordable Care Act (ACA) (Part 1) (Part 2), and the chart, Public Health Provisions of the Patient Protection and Afforadable Care Act, examine the ACA’s limitations for public health and provides an overview of the litigation challenging the constitutionality of the individual mandate.
• The fact sheet, Health Care Reform and Nursing Mothers, provides information on Section 4207 in the ACA, which requires certain employers to provide both time and space for some employed nursing moms to pump.
• The blog post, Health Reform Litigation: An Update, discusses developments occuring before Novemeber 2010.