With provisions in the Patient Protection and Affordable Care Act (PPACA) set to take effect over the next four years, grantmakers and advocacy groups have been developing activities to address the early stages of health care reform implementation. To support philanthropy’s response to this sweeping and unprecedented legislation, Grantmakers In Health (GIH) has released Implementing Health Care Reform: Funders and Advocates Respond to the Challenge, a report based on over 40 interviews with national and state grantmakers and advocacy organizations about their initial work around implementation.
Funders and advocates have identified public education and laying the groundwork for implementation as critical issues to address over the next year. They are creating strategies to explain the PPACA in ways that the public can understand and to target groups who might benefit from early provisions. Grantmakers and advocacy groups are also trying to determine how to support and inform state governments as they develop new laws, regulations, and expansions of current programs. The political climate, lack of government capacity, and gaps in policy expertise are considered the main challenges to overcome.
Despite the numerous challenges and complexities the PPACA brings forth, there are opportunities for funders and advocates to not only support implementation efforts while advancing their own missions and objectives, but also coordinate with one another to accomplish the law’s intent. Irrespective of whether a foundation has been involved with health care reform activities in the past, the post-enactment period presents new opportunities to engage, including supporting public education, advocacy, policy research, and program innovation and reform; partnering with government; and convening. Advocates identified priority areas going forward: creating blueprints at the national and state levels, communications and public education, engaging new allies, and establishing a multifaceted enrollment infrastructure. With implementation of the PPACA occurring in all 50 states, coordination among national, state, and local groups is essential and could stretch limited resources, avoid duplicative efforts, and inform decisionmaking so that it is relevant to local needs.
To help grantmakers considering implementation activities, the report also offers several recommendations, including understanding the lay of the land before making any decisions about strategy or grantees, identifying state leadership on an issue-by-issue basis, maintaining and increasing funding for advocacy, and engaging a broad range of stakeholders and constituents.
Implementing Health Care Reform: Funders and Advocates Respond to the Challenge, made possible through support from The Nathan Cummings Foundation and Public Welfare Foundation, is part of a series of GIH products and programs designed to keep funders advised about health reform implementation and informed about the work of their colleagues. GIH will continue to monitor foundation activities and provide updates as implementation unfolds.