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6th March
written by Lisa Stand

At the end of March 2012, the Supreme Court will hear oral arguments in the challenge against the Patient Protection and Affordable Care Act. Every Tuesday in the month of March, the Alliance will blog about the impact the ACA has had and can have on preventing and ending chronic homelessness.

March marks the second anniversary of passage of the Affordable Care Act. This national legislation is changing the way communities take care of their most vulnerable residents. For people working to end chronic homelessness, it’s a good time to take note of some important milestones.

At the end of this month, the ACA is going before the Supreme Court. The nine Justices will hear oral arguments for three days about a host of issues raised by ACA opponents. After oral arguments, it could be some time – several months at least – before we know how the highest court in the land decides about upholding this historic piece of health care legislation.

Whatever happens, there is no denying that the Affordable Care Act has been helping people. In its first two years, the ACA has made the most progress in the private sector – making insurance more accessible for people with pre-existing conditions, and young people who age out of family policies.

For low-income populations, there is some good news but still a long way to go. The Affordable Care Act channeled millions more dollars to community health centers, which directly serve 20 million people who otherwise cannot access health care services. There are more than 1,100 such sites across the country today, including 208 projects that specifically serve one million homeless people every year. The ACA gives CHCs a critical role to play in rebuilding a health care system that puts people first. With expanded funding, the safety net has greater reach, with new centers and training programs for community health workers.

For chronically homeless people, the ACA’s biggest promises are still unfolding. Millions of poor and low-income adults still lack access to essential health care services, and many are denied Medicaid even though they have serious and disabling illnesses. The health care safety net remains fragmented and difficult to navigate. From Washington, it’s sometimes easy to think these problems are solved; that’s because we are only seeing federal agencies and states prepare for changes that are yet to come in a meaningful way for people who desperately need them.

But, help is on the way. Medicaid programs in states like Missouri, New York, and Rhode Island are moving ahead with new “health homes.” Health homes dedicate more Medicaid funding to the task of coordinating services and helping people achieve their highest potential for health and independence. (We’ll look more closely at health homes in a blog later in the month.) Other pilot programs are under way to find the best practices, tried-and-true approaches to integrating primary and behavioral health care services. More and more, health care experts are recognizing that housing can be part of the solution. Just last week, the Corporation for Supportive Housing announced $2.8 million in awards to 4 communities that are building out integrated models, capturing cost efficiencies while improving health outcomes.

Finally, Medicaid is getting ready to expand eligibility for basic health benefits, covering as many as 16 million more low-income people – who are uninsured and have not been eligible in the past. This part of the ACA is set to take effect in 2014. It is one of several key aspects that ACA opponents are challenging in the Supreme Court. Meanwhile, advocates are influencing implementation at the federal and state levels. The main task is to see that essential health benefits truly deliver on the promise of access to needed health services for all.

The Alliance will be blogging on the ACA throughout the month of March and paying close attention to the impending Supreme Court case challenges provisions of the health care reform law. For more information about homelessness and health, visit our website. We’ll be featuring these and related resources in later blogs.

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