Health Care Reform a Year Later: Reflecting on a Journey Started -- Not Completed

Every journey worth taking must start with a single step. Like most major changes to our society, changing health care will surely be a painfully incremental process, rolled out in phases.
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One year after the historic passage of health care reform, I have to ask myself, "How does it feel?"

Bitter... because not enough has been done? Unhappy... because it wasn't everything I was hoping for? Angry... because there is still so much criticism from the right aimed at the very legislation that -- had it been around just a couple of years earlier -- could have saved my brother Eric's life?

There is only one word for the way I feel, and that word is "grateful." Nothing will ever relieve the pain I have felt since losing my only sibling, Eric, who passed away in 2009 after a lengthy battle to get the insurance coverage he needed for a heart transplant. But, after a year of fighting for health care reform in his name, and another year of guarded optimism in the wake of its passage, I remain profoundly grateful. I am grateful that -- even if flawed in various ways -- the Affordable Care Act was passed into law and can now serve as a stepping stone to bigger and better things ahead. I am grateful that so many others like my brother -- so-called "uninsurables" with pre-existing conditions -- now have an option for at least some insurance coverage through the new Pre-Existing Condition Insurance Program (PCIP). I am grateful that the new health care law is working to make Medicare stronger and more secure for all beneficiaries, and that you can no longer lose your insurance because you get sick. I am grateful that young adults can stay on their parents policy until they are 26, allowing them more time to get their lives in order before having to figure it out on their own.

I am grateful for the hope that, by the time I have children, this country will be well on its way to giving every American proper access to health care.

Despite the shortcomings that partisan warfare has left in the Affordable Care Act, it is a start and we are still a few years away from the implementation of major provisions within it. Truth be told, we must consider just how long it took to end up with what we know as "Social Security" today. When introduced in 1935, the program actually excluded Latinos, African Americans and immigrants. If you got sick or became disabled, you became ineligible for Social Security benefits. If that same legislation was proposed today, we would all laugh. It took us seven decades to build on that very legislation to get to where we are now, and -- like Medicare's evolution since its enactment in 1965 -- it remains a valued social program that has profoundly altered the lives of senior citizens and middle-class families for decades.

A year after its passage, few would argue that Americans remain as confused and divided as ever over what the new health care law means to them. And that should be no surprise, given the historic levels of rhetoric which served to obscure the actual components of an already lengthy bill. Depending on what side you are on, reform was sold as one of two wildly divergent things -- either the life-saving, cost-cutting dream of universal coverage or a budget-inflating, big government nightmare. In reality, it is almost certainly neither. And with federal officials and agencies rushing to implement facets of the new law on one end of the spectrum and conservatives orchestrating court challenges and political maneuvers to overturn it on the other end, it is almost impossible to predict what the future holds.

But I am still grateful.

Every journey worth taking must start with a single step. Like most major changes to our society, changing health care will surely be a painfully incremental process, rolled out in phases. There really is no finish line. But as this law's benefits continue to kick-in, I am almost certain that stronger public support will follow.

As it reaches its first birthday, health care reform has had little time to build credible quantitative data on its effects so far. More of that will come in 2011, supplementing growing anecdotal support for provisions that have already been implemented. Nearly 4 million people with Medicare who reached the program's Part D coverage gap, the so-called "Medicare donut hole", have received a one-time, tax-free $250 rebate check. Today, the law helps many young people -- ages 19 and under -- who previously could not get insurance because of a pre-existing medical condition. And a report from the Commonwealth Fund indicates that, when fully implemented in 2014, the Affordable Care Act will bring much needed relief - nearly all of the 52 million working-age adults who were without health insurance for a time in 2010 will be covered.

It was too late for my brother, but it's still not too late for people like Sean Semon. Sean is a young man in Las Vegas suffering from a similar heart condition to the one that took my brother. He is a patient for whom we are now advocating and is someone who will hopefully benefit from the PCIP options enacted as part of health care reform. Or for Emily Schlicting, who suffers from a rare and chronic auto-immune disease and, because of the Affordable Care Act, can now remain on her parents plan while she finishes college. Or for my dear friend undergoing chemotherapy who - because insurers are now banned from lifetime caps on policies - cannot be denied lifesaving treatment because she has hit a coverage ceiling.

We can agree that the Affordable Care Act is far from perfect. But I'm deeply thankful that our country finally made an overdue step toward equitable health care. It's important for those who supported the passage of health care reform to remember that the goal of equal and affordable access to health care is still several more steps away. To get there, our newly passed law must withstand all objections, criticisms and challenges -- fair or unfair -- or must be improved to become better. We must defend our new health care rights as vigorously as we fought to earn them, and then work to strengthen them further.

A lot of progress has been made in a year. But for many people, more progress is sorely needed. Remaining active in supporting stronger health care rights, and the patients who need them most, is critical to our future as a nation, as a society and as individuals. For more information on health care reform, organ donation or helping those in need, like Sean Semon, visit the Eric De La Cruz Hope For Hearts Foundation at

Saving a life starts with a heart. And saving many lives -- with the implementation and improvement of health care reform -- will take patience.

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