1. 1 Health Care Reform-- Report Back from CDC Consultation on 10/7/10 James Watt October 19, 2010

2. 2 Patient Protection and Affordable Care Act (“ACA”) Federal law signed in 2010 Modeled on Massachusetts health insurance reform Primary objective: expand access to health insurance

3. What Does the Law Do? Expand access to health insurance –Medicaid expansion –subsidies –health insurance exchanges –tax penalties for failing to be covered Expand pool of primary care providers Require minimum coverage for preventive services –first dollar –services recommended by USPSTF Provide funds for public health 3

4. 4 Benefits for TB Control Fewer uninsured patients Opportunities for partnerships with the private sector Requirements for preventive services Funding

5. Challenges for TB Control Possible perception that “problem solved” –reduced policy interest in funding TB programs? –expectation of shift to private sector for care Community health centers have other priorities Some patients still uninsured –non-immigrant, non-citizens –persons who drop coverage LTBI screening not reviewed by USPSTF Competition for new funds 5

6. What Can We Do? Build partnerships –federally qualified health centers (FQHC) –“public health/CHC dyads” Articulate public health role vs. clinical role Advocate for USPSTF consideration of LTBI screening Apply for public health specific funds 6