One of our all-time favorite bloggers, Joe Paduda of Managed Care Matters, hosted the election edition of the Health Wonk Review on Friday, and it's full of great reads. Two of my favorites are from Tim Jost (Health Affairs Blog) and Maggie Mahar (Health Beat). Tim explains that the election was a win for healthcare reform, but that we still have a lot of work to do. And Maggie writes about our nation divided - between past and future rather than between whites and minorities.
Tim's article is an excellent primer on the implementation of healthcare reform, specifically in terms of the health benefits exchanges that need to be up and running by October 2013, when enrollment is scheduled to begin (health insurance effective dates wouldn't start until January 1, 2014, but people should be able to start enrolling next October). That's less than 11 months away, and there's still a lot of work to be done. Colorado has been working on its health insurance exchange for some time now, and has made a lot of progress so far. We're one of the states that has selected a benchmark plan for essential health benefits, and much of the groundwork for Colorado's exchange has already been done. But in addition to the nitty gritty logistics of setting up the exchanges, there are still plenty of legal and administrative bumps that will need to be ironed out. When the ACA was signed into law in early 2010, the implementation of exchanges and the majority of the law's "teeth" in 2014 seemed like a long way in the future. That is now just over a year away, with exchange enrollment beginning in less than a year. And there's still plenty of work to be done, especially in states that haven't made much progress on their exchange implementation yet. Tim's post is an excellent summary of where we stand now, and where we need to be a year down the road.
Maggie's description of our nation divided is a very insightful way of looking at the demographics of this election: A divide between past and future. Maggie describes the demographics where Romney got a majority as being "the people who ran this country in the 1980s" (white men and people over age 65). The new generation of Americans, and the multi-national mix of people who make up a good chunk of the electorate now, tends to be more progressive than the white men who were in power in the Reagan years. I would say that Maggie is correct in her summary, and I think that the general trend she's describing will likely continue in the years to come; the youngest group of new voters in 2016 will likely add another wave of progressive voters to the rosters. Hopefully Republicans and Democrats can find a way to work together and begin to rebuild our country, but with respect for the new majority, which looks a lot different than it did 30 years ago. This election - with the months and months of bitter, contentious debate that raged everywhere from dinner tables all the way to congress - was rough on our national unity, and the country needs time to heal and begin to bridge the divide that sometimes looks like the Grand Canyon. I'm hopeful that our lawmakers - and all the rest of us - will be able to start looking past differences and seeing similarities instead. As Tim pointed out, we have a lot of work to do in the next year on healthcare reform, and that's just one of the many challenges facing our country right now. None of it is going to get done well unless we start doing a better job of working together.