By Deven McGraw, Director, Health Privacy Project, Center for Democracy & Technology
The November elections are largely behind us, but speculation about what the elections could mean for the future of national health reform is mounting. A number of successful candidates promised to repeal health reform, and many pundits see health reform as vulnerable to at least some revision by the new Congress.
No one has a crystal ball, but understanding the recent history of health reform can help us put these conversations in perspective.
The Obama administration’s health reform efforts were enacted in two parts – not all in one contentious health reform bill. The first phase of health reform was passed quickly as part of the economic stimulus bill enacted in February 2009.The Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act of 2009, invested $20 billion in incentives to encourage doctors and hospitals to use health IT for the electronic exchange of patient health information in order to improve individual and population health. This incentive program will begin in 2011, and preparations to implement the program began shortly after the legislation was enacted. Several critical changes to our nation’s health data privacy and security laws critical to building the public’s trust in health IT were also included.
Electronic medical records and increased sharing of electronic health information among health care providers and between providers and patients was seen as key to improving health care quality and increasing efficiency. Although there was some debate about the details of the program, support for health IT and its important role in reforming the health care system was broad and bipartisan. When then-Senators Barack Obama and John McCain were campaigning for the presidency, both expressed support for health IT as a critical component of health reform.
The second phase of health reform was the Affordable Care Act, which was enacted in March 2010. The more controversial aspects of health reform, including a mandate that individuals must purchase insurance coverage, were part of this bill. When political pundits talk about potential threats to health reform in the new Congress, they are most likely referring to provisions in the Affordable Care Act.
We do not presently know whether provisions of the Affordable Care Act, which is the second component of health reform, will be repealed or modified. Bipartisan support for health IT, however, still appears strong. Because lawmakers may still revise how the health IT money is spent or how the privacy and security provisions are to be implemented, some uncertainty remains. Even so, the whole of health care reform is not necessarily in jeopardy.