--by Lisa Kaplan Howe, NH Voices for Health
Last week’s election brought significant change to our State House and Congress. Various polls reveal that the economy and jobs far outranked health care in what motivated voter decisions. Regardless, the new composition of our State House and Congress will impact efforts to implement the Affordable Care Act (ACA) moving forward. Ultimately, it’s unlikely public support will be mustered to take away new rights or cost savings realized by implementation of the law. But the new political landscape does mean that supporters of reform need to turn their efforts to defending the ACA and advancing implementation of the law.
From a federal perspective: The promised efforts to repeal reform law in full will meet certain death in the Senate and would also be vetoed by President Obama. More modest efforts to challenge, overturn or defund individual provisions of the law and ACA regulations are more worrisome though they too will face the same hurdles. Oversight hearings and inquiries are also likely forthcoming from Congress. While slowing progress on implementation, such hearings could help to educate the public about the details of the ACA – and better understanding of exactly what’s in the law has been shown to build public support for it.
The state is also playing a critical role in implementation and has already made significant strides under the leadership of Governor Lynch and Commissioners Toumpas and Sevigny. With the Governor’s reelection, the Executive Department’s commitment to using opportunities under the ACA to advance and accelerate needed reforms to New Hampshire’s health care system continues. Those efforts, however, are likely to face challenges from the state legislature and Executive Council - including obstacles to accepting ACA grant funding - challenges that will have more weight with the new veto-proof majority in the legislature. Legislation challenging the ACA more broadly has already been proposed, though it’s important to bear in mind that as a federal law, the ACA trumps state law.
We should expect challenges to the law federally and here in New Hampshire. But we should also take note that poll after poll proves that support for reform jumps when people understand the specific provisions included. Public support is likely to rise even more significantly as people experience the benefits of reform. Lastly, and quite simply, repeal would be costly since the independent Congressional Budget Office found that the ACA will reduce the federal deficit.
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