Barbara Ballad, President of the National Black Caucus of State Legislators and State Representative of Kansas House of Representatives, spoke on the use of unconventional strategies in order to implement the Affordable Healthcare Act.

The National Black Caucus of State Legislators (NBCSL) has always taken its commitment to the disadvantaged, the disenfranchised, and the poorest among us very seriously. We remain acutely aware of the health disparities and the lack of equal access to health care in this country. Therefore, as state legislators, we look upon the Affordable Care Act (ACA) as our greatest opportunity, and our biggest challenge, to addressing the health needs of our constituents and ensuring health equity.

While the U.S. Supreme Court ruling of June 2012 upheld the Affordable Care Act, it struck down the Medicaid Expansion provision, creating a gap in coverage for the exact citizens we at NBCSL are committed to serving. Medicaid expansion would have required states to expand Medicaid to those persons whose incomes are up to 133 percent of federal poverty guidelines, or risk losing their entire Medicaid funding. It was estimated that this expansion would have provided coverage for 17 million more people by 2022.

It is now up to the states to decide whether or not they will include Medicaid Expansion in their Medicaid legislation. To do so will provide the states with very attractive federal funding, but it will still require us to make a sizable commitment of state resources. That is why it so critical that we, as state legislators, look at our health care delivery systems.

One method of healthcare delivery and cost savings is the creation of Accountable Care Organizations (ACOs). Introduced through the ACA, ACOs are a group of hospitals and physicians that will work together to coordinate care for the patients they serve. In July, the U.S. Department of Health and Human Services announced its approval of 154 ACOs to work with an estimated 2.4 million Medicare patients across the nation.

For these reforms to work, however, our medical schools must produce more primary care physicians to keep up with an increased demand for health care services. That is why the National Black Caucus of State Legislators is looking at resource that already exists, our Historically Black Colleges and Universities’ (HBCUs) medical schools. These schools are renowned for producing socially responsible physicians, who become primary care physicians, willing to provide care in undeserved areas. Along with private sector innovators, HBCU Medical Schools also provide innovative solutions to tackling health disparities in the U.S., such as conducting clinical trials that specifically target minorities. It is up to us to ensure our health insurance exchanges, Medicaid and Medicare, make these innovations available to everyone, regardless of their income. What good does it do to develop effective, new medicines if they are out of reach for the people who stand to benefit the most?

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