Over the last 18 months, the Patient Protection and Affordable Care Act (ACA) has been praised, vilified, promoted and distorted. Yet last week, the law was upheld by the Roberts Court as constitutional, clearing the path for transforming our health and long‐term care system into one that works for all Americans, young and old alike. This decision lays the groundwork for a better approach to care — a needed change for individuals today who live with chronic health conditions and functional needs and for the onslaught of aging boomers who will need care in the future.
Upholding the ACA has several positive effects, two in particular for older Americans and their families. First, the law bolsters Medicare by changing its focus from high volume of services to high quality and value of care. This will maintain the solvency of Medicare so that this very popular backbone of providing health care to older and disabled Americans will remain for years to come. The ACA also tackles the biggest weaknesses in Medicare today, which are the lack of coordination among providers and the lack of communication between providers, patients and families. Given Medicare’s strength in shaping the total health care marketplace, this positive movement toward care coordination has the potential to reverberate across all payers and providers.
Second, the law also sets in motion key improvements to transform the current systems of care that provide long-term supports for people with functional challenges so they can live with dignity, choice, and independence. This comes in the form of new opportunities for states to increase the availability of community-based services so people with disabilities have care choices other than nursing homes. It also sets a framework for creating new financial tools and care options to plan for the future needs that 70% of people over 65 will face.
In an election year, the political debate will no doubt continue at a fevered pitch. However, the ACA has already touched millions of Americans in a positive way. It is now time to focus on its robust and effective implementation so that we can all benefit from a care delivery system that puts people, families, and their care needs first.