With the presidential election decided in Barack Obama’s favor, we have cleared the last political hurdles to the continued implementation of the Affordable Care Act (ACA). We now have just over a year until the act’s provisions go into effect in January 2014, and it is time for funders not only in healthcare, but in a variety of fields, to think about and plan for the ways in which the legislation will affect their work.
Although the ACA is aimed at changing many fundamental aspects of the healthcare and insurance markets, it will undoubtedly have ramifications that reach far beyond those arenas. For example, many of the services offered to families living in poverty are determined by the federal definition of poverty. The act’s implementation may impact the very definition of who is poor, and what they may expect as safety net services. Just recently, Eduardo Porter, a writer for the New York Times, addressed this issue, citing the uncertainties that still exist in the eligibility of families for free school lunches or housing vouchers due to the coming changes.
In this context, we at Arabella have been starting to ask ourselves how philanthropy itself will be changed by the ACA. Although its most immediate impact will be on health funders, it is clear that the impact will extend beyond health philanthropy, and this is where I think we all have more work to do in determining how best to plan for the changes it may engender in our fields. If, for instance, the act affects the school lunch program, funders who work to improve school nutrition will need to reassess their support. Or, women who rely on domestic violence services in times of crisis may find that the ACA will now cover them in these types of emergency and life-threatening situations. All of these ramifications could mean that funders who devote resources to filling gaps in direct services to poor families have an opportunity to reallocate their dollars to other areas of need.
Much is still to be learned about the ACA, as it is one of the most important and comprehensive legislative changes of the past few decades. It may take some time to understand how the ACA will transform philanthropy, and then only with the hindsight that history will provide. However, we must begin to think about how we may be called upon to engage in this historical moment, and by doing so, better serve the communities and families most in need of a safety net.
Gwen Walden joined Arabella Advisors in June 2012 as a managing director in California. Gwen’s work centers on the strategic needs of boards of directors and senior and executive leadership in private foundations, family foundations, corporate giving entities, and public agency grant makers.