Rauner's Budget is Bad Medicine for State's Health Services

The following post originally appeared on Crain's Chicago Business.

The much-anticipated “turnaround budget” from Illinois Gov. Bruce Rauner feels more like a “look back,” parading out failed ideas from past years. Rauner says this budget "preserves services to the state's most vulnerable residents”—but a quick review suggests this is far from true. Instead, we see a budget that:

• Further decimates a fragile community mental health system
• Reduces access to lifesaving drugs for people living with HIV and prevention services for those at risk of HIV
• De-funds critical substance-abuse treatments
• Drastically reduces cost-effective breast and cervical cancer screening services
• Makes it harder, and in some cases impossible, for people with disabilities and seniors to get support to live at home
• Reduces funding for evidence-based tobacco prevention and cessation services
• Eliminates Medicaid benefits for preventive health services, including adult dental care
• Eliminates health insurance for workers with disabilities, coverage unavailable in the private marketplace
• Slashes funding for hospitals serving Medicaid populations
• Eliminates funding for care coordination, originally designed to contain costs
• Secures Illinois' position near the bottom of states for per-enrollee Medicaid funding

It's ironic the governor calls these cuts “tough medicine,” when the proposed budget would deny any medicine and critical health care services to so many. We've been down this road before, and here's what we learned:

• Cuts of $113 million to mental health and addiction treatment services in fiscal years 2009-11 increased state costs by more than $18 million due to increased emergency room visits, hospitalizations and nursing home placements.
• Elimination of Medicaid coverage for adult dental services in 2012 caused spikes in emergency department visits for dental problems. In-patient ER treatment for dental problems averaged $6,498, nearly 10 times the cost of preventive care delivered in a dentist's office.
• Disinvesting in HIV prevention will lead to new infections, for which the Centers for Disease Control estimates lifetime treatment costs of $379,668 per case.
• For every dollar Illinois spends on providing tobacco cessation treatments, it has on average saved $1.29. Cutting funding for smoking cessation services will increase costs by up to $32.3 million annually in health care expenditures and workplace productivity losses.

As proposed, the Rauner budget is not only bad for our health, but it's bad for businesses, too, likely resulting in decreased productivity, loss of jobs and economic activity, and greater health care costs for employers. Some examples:

• The proposed child care “intake freeze” and increase in parent co-pays will lead to increased absenteeism as employees will take time off to care for children. Such absenteeism already is costing American businesses nearly $3 billion annually.
• Planned cuts to Illinois hospitals are expected to result not only in the loss of more than 12,500 jobs but $1.7 billion in economic activity.
• Cuts in funding for health care services, such as cancer screening, most certainly will increase the health care costs of Illinois businesses. One study of major employers found that patients with cancer cost five times as much to insure as patients without cancer ($16,000 versus $3,000 annually).

We urge the governor to listen to the critics of this budget and learn from Illinois' past experiences. We stand prepared to support him on this learning curve.

Barbara A. Otto
CEO
Health & Disability Advocates

From Getting Insurance to Actually Using It

After the 2015 Open Enrollment Period 347,300 Illinoisans purchased plans through the marketplace, and 541,000 people have enrolled in Medicaid since its expansion in 2014. While connecting individuals to coverage is good news, the newly insured are often overwhelmed by having to navigate the overly complex healthcare system and understand the related insurance and medical jargon.  This confusion and lack of experience counteracts one of the healthcare reform law’s major goals: to reduce medical costs by increasing access to primary care. Obtaining coverage will not offset a lifetime of avoiding the doctor’s office and visiting the emergency room for primary care. The newly insured must learn how to find a doctor, fill a prescription and read a prescription label. Without that, they are subject to poor health outcomes and high costs. The newly insured must gain health literacy which can only happen through the combined efforts of consumers, communities, providers and governing bodies.

What is Health Literacy? 

The Centers for Disease Control and Prevention define health literacy as the degree to which an individual can obtain, process, communicate and understand health information and services. People with low health literacy are more likely to be uninsured. Similarly, uninsured individuals show lower health literacy scores compared to those receiving employer-based coverage.

So Why Does Low Health Literacy Matter? 

It is not altogether surprising that the uninsured and those with low health literacy are less likely to seek preventative care; more likely to experience poor health outcomes; and more likely to encounter higher medical costs. According to the Kaiser Family Foundation, only 1 in 3 uninsured adults said they had a preventive visit with their physician in the previous year, and uninsured adults experienced higher mortality rates than the insured. An Institute of Medicine report found a similar pattern of healthcare use for those with low health literacy, stating this group was less likely to seek preventive care. Research also found that lower health literacy in Medicaid managed care settings is connected with higher mortality. This shows that the uninsured and people lacking health literacy interact with the healthcare system in similar ways: poorly. Using the healthcare system is something people must learn. Giving someone a computer does not mean they know how to type. In the same way, connecting a person with healthcare will not alter their level of health literacy.

Old Habits Die Hard. The newly insured will continue receiving care in ways most familiar to them, which can translate to using the emergency room for non-emergencies. According to the Oregon Health Insurance Experiment, individuals who received Medicaid coverage increased their emergency room use by 40%. Asked to comment on the results, the state director of policy and programs for the National Association of Medicaid Directors alluded to the importance of promoting health literacy in the newly insured. She said, “this is not something that is unexpected” and “the key to getting inappropriate costs down for all patients is educating people about where they should go when it’s not an emergency.”

How to Address Health Literacy

Government Efforts
State initiatives, including an Illinois Emergency Room Diversion Grant are acknowledging the importance of patient education and using outreach to reduce ER use. In Illinois, hospital staff led outreach explaining the proper use of the ER and offered a 24-hour nurse triage line as an alternative. Meanwhile, Maine is targeting ER super-utilizers through community care teams that offer intensive case management including home visits and health coaching. Recognizing state efforts like that of Illinois and Maine, CMS listed patient education as a recommended component of programs targeting ER super-utilizers.

Health Professional Efforts
Beyond education on how to use their health insurance, health professionals can improve the usability of health services by reducing medical speak in patient interactions. Healthcare systems can also create plain-language pamphlets for patients to reference after leaving the doctor’s office. By speaking with patients in a relatable manner and sharing usable information, doctors better position healthcare consumers to adhere to medical recommendations.

Northwestern University’s Division of General Medicine and Geriatrics focuses on improving engagement between providers and patients and has developed plain-language materials that communicate complex health topics. For example, researchers created written information and videos available in Spanish and English that teach patients diabetes self-management. The modules use simple language and rely on pictures to communicate aspects of diabetes care, such as how the disease can impact a person’s eyes. By using these materials when interacting with diabetes patients, health professionals communicate vital aspects of care in an accessible manner, increasing the likelihood that patients adopt the healthy behaviors.

Community Health Literacy Efforts
The Be Covered Illinois campaign is promoting health literacy by generating easy-to-read written and online materials, creating short videos explaining critical concepts and utilizing community partnerships to expand the reach of their communications.  By producing written fact sheets on finding the right doctor and developing web content on using your coverage Be Covered empowers the newly insured with the knowledge to navigate health insurance and health care systems more effectively. Be Covered’s Dr. Lopez video series, presented in both English and Spanish, addresses health insurance topics, chronic disease, prevention and more. Be Covered broadens the reach of their education efforts by partnering with 82 organizations in Illinois, including Illinois Health Matters, that share information and materials with their own constituencies.  As part of that effort, Be Covered provides regular content for social media and shares copies of consumer friendly resources free of charge to partners.

Illinois Health Matters recognizes the importance of not only getting insurance but using insurance. The website features resources such as a Medical Cost Look Up, that allows consumers to estimate out-of-pocket costs for medical services and a resource on Immunizations and the ACA, outlining the vaccines children and adults can access for free because of healthcare reform. The website also has a tip sheet titled What to Know About Provider Networks, explaining steps consumers can take to avoid high medical costs associated with out-of-network care. These are just a few examples.

Illinois Health Matters is taking on the challenge of supporting a more health literate population, but we can’t do it alone. Join us. One great way to start: subscribe to our newsletter to stay informed and share the knowledge with your clients and coworkers. The healthcare community can achieve the vision of the Affordable Care Act, but only through the joint efforts of providers, policymakers and organizations supporting health literacy.

Bryce Marable MSW

Health Policy Analyst 

Health & Disability Advocates

What’s in the New Health Care Law for Women? Well-Woman Visits That Can Improve Your Health

As an emergency physician, I tend to work on the other side of preventive care services. I see what happens when women don’t know about safer sex and birth control, and end up with complications from sexually transmitted infections. I see what happens when women do not get routine screening for cervical cancer and struggle with life-threatening cancer. I see what happens with out-of-control hypertension and diabetes, and the heart attacks and strokes that are detected far too late.

These experiences have shown me that prevention is the best medicine. That’s one big reason why the Affordable Care Act provision requiring new insurance plans to cover women’s preventive care without any extra charges or co-pays is a real victory for women. These requirements, which go into effect Aug. 1, will be phased into existing insurance plans over time.

Because of this change, women will be able to obtain complete contraceptive care, screening for sexually transmitted infections, and screening and counseling for intimate partner violence. This builds upon earlier requirements that insurance companies cover – at no additional cost to women -- mammograms and screenings for cervical cancer. It’s clear to me that these mandates will significantly improve women’s health and lives and ultimately lead to a reduction in health care costs.

The Well-Woman Visit

One of the easiest ways to obtain preventive services is through a well-woman visit. These visits, which will soon be covered with no co-pay, give you the opportunity to ask key questions about birth control, sexually transmitted infections, and other reproductive issues, along with questions about diet and exercise and any health concerns you have. You can also discuss changes in your family’s medical history that are important for your health care provider to consider. For example, when my mother was diagnosed with breast cancer, my doctor recommended that I get earlier screenings.

Along these same lines, your health care provider may have questions or issues to discuss with you. Smoking, drinking and recreational drug use can create and contribute to health problems, and often need to be discussed and addressed multiple times before change happens. Well-women visits also give your health care provider a chance to screen for potential high blood pressure, diabetes, depression, domestic violence, and more.

The well-woman visit is important for another reason: it gives you and your health care provider a chance to get to know each other. Most people go to their provider or to a clinic only when there’s a problem, but the best time to get to know your provider isn’t when you’re in distress from a painful or troublesome condition. Studies have shown that health care providers make more accurate diagnoses when they know their patients and can put the symptoms in the context of your life. A well-woman visit is a precious opportunity to build this trusted relationship.

As an emergency physician, I am excited about the new provisions taking effect Aug. 1, which include annual well-women visits for those who want them. I would much rather women regularly visit their health care providers than come to the E.R. later suffering from preventable problems. So please take this opportunity and make an appointment with your provider. The importance of investing in your health is too crucial to ignore.

Leana S. Wen, MD
Dr. Wen is an emergency physician at Brigham & Women’s Hospital and Massachusetts General Hospital and a clinical fellow at Harvard Medical School. She is the author of a forthcoming book on patient advocacy, “When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests.” For more information, visit her blog When Doctors Don’t Listen or her website. You can also follow her on Twitter @DrLeanaWen.

(This post was originally posted here on Our Bodies, Ourselves as part of the Countdown to Coverage Campaign)

Affordable Care Act will greatly benefit women

The Supreme Court’s ruling upholding the Affordable Care Act marks a critical victory for women’s health, and the health of all Americans. Because of this landmark decision, millions of women and families will continue to have access to affordable, quality health care — many of whom previously had inadequate coverage or no coverage at all.

At Planned Parenthood of Illinois, we understand how this law will have an unprecedented effect on women’s health. The law guarantees women direct access to OB/GYN providers without referrals, and ends discriminatory practices against women, such as charging women higher premiums and denying coverage for “pre-existing conditions.” And in just six weeks, women will gain access to birth control without a co-pay — which will have a tremendous economic impact on already stretched family budgets.

Since August 2010, more than 45 million women have already received full coverage for preventive health screenings, including mammograms and Pap tests. Now with this ruling, 17 million more women will have access to health insurance for the first time. And millions more young adults will be able to stay on their parent’s health insurance plans, just like the 3.1 million young adults who have done so since September 2010.

In Illinois alone, 469,469 women of reproductive age will now gain coverage under the Affordable Care Act by 2014.

The increased access to preventive health care and family planning under the Affordable Care Act provides immeasurable economic value to women, families and society. Not only does every dollar invested in federal family planning save taxpayers and families nearly $4, but unintended pregnancies are already costing U.S. taxpayers $11 billion a year.

Women realize that health and wellness are key to prosperity and independence. In times of economic uncertainty, it is more important than ever to stay healthy. For women, birth control isn’t a political or social issue — it’s basic health care and an economic concern. The money — up to $600 on average — that women will save on birth control each year is equal to five weeks of groceries for a family of four, nine tanks of gas in a minivan, or one semester of college textbooks.

Planned Parenthood of Illinois health centers already provide basic health care to nearly 75,000 patients every year, and to 3,321 patients in Springfield alone. Because this landmark law has been upheld, we know we’ll be able to do even more for the communities we serve in the months and years ahead.

Carole Brite

President and CEO

Planned Parenthood of Illinois

(Originally posted on July 10 in the State Journal-Register)

The Economic Toll of Health Disparities

April is National Minority Health Month, and we are commemorating it with this post on health disparities from the Heartland Alliance blog, Heartbeat. The Affordable Care Act's reforms will make a difference in some of these disparities, such as the focus on expansion of access to primary care, innovations in medical delivery models, increased access to health insurance and the Medicaid expansion. 

Health disparities among minority groups account for 30.6% of direct medical expenditures, reflecting the significant toll being African-American, Asian or Hispanic has on one's health and economic well-being.

A study by the Joint Center for Political and Economic Studies found that between 2003 and 2006 almost a third of health care costs for minorities were due to poorer care compared with whites. Minorities face greater barriers to preventive care, acute treatment and chronic disease management.

Eliminating those disparities would have reduced by $229.4 billion direct medical expenditures by minorities, according to the Joint Center's estimate. Minorities could have saved more than $1 trillion on indirect costs -- such as those associated with illness and premature death -- during the four years studied if disparities didn't exist.

The 2010 National Healthcare Disparities Report found that rates of potentially avoidable hospitalizations for blacks are double those of whites. Blacks and Hispanics have higher rates of potentially avoidable hospitalizations for chronic conditions compared with whites.

Differences in access to care, provider biases, poor provider-patient communication and poor health literacy contribute to health disparities, according to the report. It states:
"Unfortunately, Americans too often do not receive care that they need, or they receive care that causes harms. Care can be delivered too late or without full consideration of a patient's preferences or values. Many times, our system of health care distributes services inefficiently and unevenly across populations."

Quoted in an America's Wire article on health disparities, Jennifer Ng'andu of the National Council of La Raza said minority children are particularly impacted by a lack of access to care. Children "will experience developmental setbacks because they are sick or their parents are sick. It makes it harder for them to achieve in school and can have serious consequences on their future."

Financial strains on families due to health care can hinder children's academic success and, in turn, future earnings. At the same time, minority youth are increasingly affected by chronic diseases such as diabetes.

Hispanics in general have higher rates of high blood pressure and obesity than non-Hispanic whites. They are twice as likely to die from diabetes as non-Hispanic whites, according to the Centers for Disease Control and Prevention.

Caring for chronic disease over a lifetime is expensive. With minorities representing more than half of uninsured Americans, the effect on their health and finances can be great. We support efforts to expand access to care -- particularly for preventive services -- to minority communities to eliminate health disparities and the economic costs that come with those disparities.

This article was originally posted on the Heartland Alliance Heartbeat blog. 

The Affordable Care Act: Fulfilling Promises, Cutting Costs

Did you know that the Affordable Care Act has alreadyexpanded affordable preventive health coverage to 54 million Americans?

If you’ve been following the Shriver Brief health care blogs, you probably remember reading about the Affordable Care Act mandate that insurance companies provide a specified list ofpreventive health care services to policy holders without charging a co-payment or deductible. Services like screenings for blood pressure and cholesterol; testing for Type 2 diabetes, obesity, and colorectal cancer; and alcohol and tobacco cessation counseling, among others are included in the mandate. Additional preventive health services like childhood immunizations; screenings for hearing, vision, and oral health; as well as testing for autism, HIV, and obesity, among others must be provided free of co-payment for children’s care. And starting in August of this year, insured women will be able to receive a set of women’s preventive health benefits like well-woman visits, FDA-approved contraception, mammograms, breastfeeding support and supplies, and domestic violence screening and counseling, also without cost-sharing. The health reform law requires that all of these free preventive health services are provided by insurance companies for anybody with a new or a so-called “non-grandfathered” insurance plan. And the mostrecent research shows that people—tens of millions of people—are already receiving these preventive services, for free!

According to a study conducted by the Kaiser Family Foundation, “31% of all workers were covered by plans that expanded their list of covered preventive services due to the Affordable Care Act.” Using this data, the Department of Health and Human Services (HHS) was able to calculate just how many people are benefiting from expanded preventive health coverage across the country.HHS estimates that 54 million Americans—and counting—have received one or more of the Affordable Care Act’s mandated preventive health services free of co-payment or cost-sharing. This number breaks down to over 20 million women, 14 million children, and 19.5 million men making use of their increased access to affordable and essential preventive health care. Illinois was among the top five states to benefit the most, with almost 2.4 million Illinois residents receiving free preventive health care services! And this number will only continue to grow as more and more people choose to enroll in new or “non-grandfathered” health plans, and as the health reform lawrolls out its final stages in 2014, adding 16 million individuals to the private health insurance market.

These kinds of meaningful, money-saving provisions in the Health Reform law are making a real impact at a time of need, when many individuals and families affected by the recession have been resorting to cutting back on basic medical care to make ends meet. A Kaiser Family Foundation study conducted in 2009 found that 53 percent of American families were cutting back on medical care because of the cost. In 2010, the Commonwealth Fund reported that 25 percent of Americans were cutting back on recommended tests like blood pressure tests, colonoscopies, mammograms, and other potentially life-saving cancer screenings. And just recently, a study from the University of North Carolina’s medical school found that, during the height of the recession, adults between the ages of 50 and 64 received 500,000 fewer colonoscopies compared to the couple of years before the economy turned, even though the colonoscopies can cut the risk of dying from colon cancer in half. The good news is the Affordable Care Act is increasing access to many of these preventive health tests and screenings at a price Americans can afford.

Households all over the country are pinching pennies trying to stay afloat during hard economic times. Thank you, Affordable Care Act, for working diligently to make sure that nobody’s health is sacrificed because of the cost of care.

Coauthored by Caitlin Padula and Rachel Gielau.
This post was originally published as part of The Shriver Brief's weekly “Did You Know” blog series, which highlights important, but not well known features of the health reform law about prevention, wellness, and personal responsibility for our health.

The ACA Expands Preventative Care for 2,390,000 Illinoisans

To many, the cornerstone of the Affordable Care Act (ACA) is its  emphasis on providing Americans with access to important preventative care. The benefits of preventative care have been discussed in this blog before, in the context of chronic disease ,  breast cancer and  cervical cancer.

How exactly, then, is the ACA expanding access to preventative health care?

 One instance is a provision under the ACA that requires insurance plans[i] to provide important preventative health procedures to beneficiaries, without any cost-sharing measures (such as co-pays). The U.S. Department of Health and Human Services recently released information on how this provision will benefit Americans.

The list of important preventative health procedures was determined based on guidelines from the U.S. Preventive Services Task Force. Due to the ACA, children have gained access to regular pediatrician visits, immunizations, important vision and hearing screenings and developments assessments, as well as screening for obesity and counseling on how to maintain a healthy weight. Both men and women have gained  access to recommended immunizations and flu shots; cancer screenings (including colonoscopies and, for women, pap smears and mammograms); obesity screening and  healthy diet counseling; screening for high blood pressure and high cholesterol, depression and HIV; and tobacco use counseling. In addition, starting in 2014, women will be covered sexually-transmitted infection screening, and other services specific to women, such as gestational diabetes screening and contraception.

While many people with health insurance were already covered for these preventative health procedures, many were not: 31% of those who had health insurance through their employer have seen an expansion in their benefits—that’s 54 million Americans! In Illinois, the impact is among the biggest: 605,000 children, 898,000 women and 887,000 men have gained new access to expanded preventative health care. That is 2,390,000 Illinoisans, total, who have directly benefitted from the prevention expansions in the ACA!

I am proud to serve on the Administration’s Advisory Group on Prevention, Health Promotion, and Integrative and Public Health, established by the Affordable Care Act, where we will continue to develop policy and program recommendations, and advise the National Prevention Council on lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion

Barbara Otto

Health & Disability Advocates, Chief Executive Officer

---

[i] Excluding plans that have Grandfather status

The Affordable Care Act: Preventing Chronic Diseases

Did you know that switching the focus from treating chronic illnesses to preventing the diseases will not only improve the health of individuals and families all over the country, but will also rein in health care costs and strengthen the economy?

The Affordable Care Act (ACA) is applying this logic in its fight to lower the rate of preventable chronic illnesses, produce real savings in the health care sector, and recover lost economic activity at the local, state, and national levels. And it’s doing it in the name of prevention through effective public health initiatives.

The prevalence of chronic health conditions in the United States is taking a huge toll on our citizens, our nation’s health care spending, and our workforce. More than half of the people living in the United States have at least one chronic health condition, such as heart disease, stroke, diabetes, obesity, and cancer. Chronic health conditions account for 7 out of 10 deaths in Americaand rack up 75% of our nation’s health care spending. The cost for treating people with type 2 diabetes, heart disease, hypertension, and stroke, alone, amounts to $238 billion each year. In 2010, the United States spent almost $2.6 trillion on health care, meaning we spent around $1.9 trillion just last year on treating and managing chronic illnesses, most of which are largely preventable. Here in Illinois, more than 6.7 million people have reported being diagnosed with a chronic health condition, costing the state $12.5 billion in annual health care expenses.

What’s more is that the cost of chronic health conditions goes beyond the money spent on health care services. The toll these illnesses take on our workforce productivity is telling. According to the Gallup Poll, 7 out of 8, or 83 percent of American workers either have a chronic health condition or are obese. The poll estimates that this prevalence of chronic illness and obesity in our workers could be costing our economy $153 billion a year in lost productivity due to increased sick days. Other reports that take into account other chronic conditions and factors like lost productivity from workers who show up on the job while sick estimate that chronic health conditions are costing the United States more than $1 trillion each year in lost economic activity. To bring these statistics home, chronic disease plaguing Illinois’s workforce cost the state $14.3 billion in lost productivity. And the commonality of chronic disease is rapidly increasing. It is estimated that the number of Americans living with a chronic health condition will increase by 36%, or 46 million people by the year 2030, and that we could be spending $685 billion a year on medical treatment for chronic disease by 2020. Other sources estimate the total economic toll of chronic health conditions to reach $6 trillion a year by the middle of the century.

But it doesn’t have to be this way. As the CDC states, “Access to high-quality and affordable prevention measures (including screening and appropriate follow-up) are essential steps in saving lives, reducing disability and lowering costs for medical care.” And research has proven that for every dollar invested in effective prevention and public health initiatives, $5.60 is saved. The same study reveals that, if we invest $10 per person every year in effective community-based public health programs, we could save the United States more than $16 billion in just five years. 

Fortunately, the Affordable Care Act recognizes the benefits to be had from investing in smart and effective preventive and public health efforts. The ACA established the National Prevention, Health Promotion and Public Health Council within the Department of Health and Human Services (HHS), made up of secretaries from various federal departments and chaired by the Surgeon General. The Council is responsible for developing our first ever National Prevention and Health Promotion Strategy, which was released in June of 2011 and identifies four strategic directions for preventing disease and improving health nationwide. The four strategic directions are: creating healthy and safe community environments; expanding access to quality clinical and community preventive health service; empowering people to make healthy choices; and eliminating health disparities. The Council is charged with providing leadership moving forward with the National Prevention and Health Promotion Strategy.

The ACA also established a Prevention and Public Health Fund, which is administered by the Secretary of HHS, Kathleen Sebelius, and provides financial support for state and community-wide efforts to prevent disease and promote healthy lifestyles. The Fund is a 10-year, $15 billion commitment to support prevention and public health programs across the country, like theCommunity Transformation Grants, which fund community-level programs geared towards reducing the prevalence of chronic disease and promoting healthy lifestyles.   Already, $103 million in grant money has been issued to 61 different state and community programs across the country, reaching 120 million people.

So what does all of this mean for chronic disease in Illinois? Already, the State of Illinois has received $17.14 million out of the Prevention and Public Health Fund to support community- and state-level wellness and prevention programs aimed at preventing chronic disease and raising awareness about healthy living. For a breakdown of what programs received funding and for how much, visit HealthCare.gov online.

The Secretary of HHS will continue to issue funds for prevention and public health programs across the country to reverse the trend of chronic disease, so stay tuned as health reform continues to make a positive impact in our communities. To find out what other kinds of initiatives the Affordable Care Act has taken to increase access to preventive health measures and decrease illness in America, visit the Shriver Brief online.

This post was originally posted on The Shriver Brief by Caitlin Padula. It is part of a weekly “Did You Know” blog series that highlights important, but not well known features of the health reform law about prevention, wellness, and personal responsibility for our health.