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“Mr. President, we have your back!” Stepping forward to support the ACA

November 15, 2013
by Ron Manderscheid
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What is really important here?

We now are midway between Halloween and Thanksgiving. Should we be frightened? Thankful? Both? Neither? Clearly, a little fright is a good thing; it will motivate us to action. A little thanks also is good: Who would ever have thought five years ago that we would be implementing health reform now. But we must go beyond fright and thanks.  I am convinced by the dramatic events of the past month that we must step forward and support President Obama and Secretary Sebelius.

The President and the Secretary are working hard every day to sort out and address the technical problems, i.e., glitches, with www.healthcare.gov, the national enrollment site for thirty-six state health insurance Marketplaces, and the issues with individual market health insurance renewals. Our support is critical right now, so that the ever-present negative voices do not get an upper hand in this debate.

Several things must be said as we work with our respective communities:

The issues being addressed do not mean that the Affordable Care Act (ACA) is unnecessary. In fact, the glitches document that a tremendous number of people have interest in enrolling in health insurance through the state Marketplaces. More than 15 million unique people visited the federal site in the first 10 days of October, about 8 in 10 of whom are eligible to purchase insurance through the site. This amazing number far exceeds earlier expectations. It also is important to remember that individual market insurance renewals are an annual event controlled by state insurance commissioners and insurance companies, not just by ACA requirements.

The issues being addressed do not mean that the ACA is unimportant. In fact, we do need the ACA to provide health insurance coverage at a reasonable price to 39 million uninsured Americans, an exceptionally ambitious national agenda. By comparison, this agenda is more ambitious than that undertaken by President Franklin Roosevelt, when he began the implementation of the Social Security Act in 1935. In this process, it will be important to several million people that the individual insurance market offers health insurance with essential benefits, including mental health and substance use care offered at parity.

The issues being address do not mean that we should give up on the 11 million uninsured Americans with behavioral health conditions. In fact, quite the reverse is true. Our role is to work very hard to encourage these people not to give up before the issues are addressed. Help really is on the way!

President Obama and Secretary Sebelius have shown great courage in their response to these issues. They both have acknowledged them, and they both have made a commitment to the American people that they will be addressed. We could not ask for more.

Now, we need to show the same courage. We need to stand up for social justice—seeking equity for all—and we must oppose the voices of self-interest. We must argue strongly and loudly that all people be valued equally, and that the opportunity of good health be a right of all Americans. The ACA will promote these critical human goals.

In the longer run, just a few short years from now, the current uproar over these issues most likely will be viewed as a tempest in a teapot. Thus, we must not be distracted by it. Our essential agenda is far too important!


Ron Manderscheid

Exec. Dir., NACBHDD and NARMH

Ron Manderscheid



Ron Manderscheid, Ph.D., serves as the Executive Director of the National Association of County...

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