NASW Practice Alert Brief: Health Care in 2017

by Carrie Dorn, LMSW, MPA

National Association of Social Workers Senior Practice Associate

acaThe National Association of Social Workers (NASW) has supported the Patient Protection and Affordable Care Act (ACA), which has extended health insurance to 20 million Americans.

As the incoming Trump Administration has promised constituents, changes to health care are likely in the upcoming year.  Anti-discrimination provisions in the ACA that have been enacted to protect those with chronic conditions, women and individuals with mental health and substance use disorders are at risk. It’s important for social workers to be aware of the factors that may shift the health care landscape sooner than we may expect.

Budget Reconciliation

As early as January 2017 the budget reconciliation process can take place in Congress. Through budget reconciliation, programs that are subject to financing can be changed.  This process can be used to repeal elements of the ACA by removing funding for them and may be the strategy used to repeal the ACA swiftly.

“Repeal and replace”

President-elect Donald Trump has promised he will repeal the ACA.  Many are encouraging that repeal efforts be paired with a replacement proposal so as not to put people at risk of losing health coverage. Immediate repeal of the ACA could cause insurers to end participation in the health care marketplace. A discontinuation of the individual mandate and tax penalty, would likely result in healthier individuals opting out of purchasing health coverage. Reforming Medicaid and Medicare is also on the Republican agenda.


Analyses from the Urban Institute suggest that repeal of the ACA will lead to an increase in the uninsured population by 30 million people.  Hospitals and providers are also concerned about the likely surge in uncompensated care for the uninsured. Changing Medicaid to a block grant or per capita cap is not sustainable over time. In order to minimize the impact of Medicaid costs on states budgets, states will likely have to institute more restrictive eligibility.

What can be done?

This is a time of uncertainty. While January 2017 may bring changes, we encourage individuals to talk with their elected officials now to express their thoughts and concerns about health care.  Social workers in all practice settings can be impactful by communicating stories and experiences with the health care system to stakeholders.

NASW is aligned with advocacy groups and participating in coalitions that focus on the needs of children, older adults and women.  These groups are working to better understand the new administration’s strategy in 2017 and how they will impact the clients we serve and the social work workforce.  NASW will continue to advocate for policies and regulations that are consistent with our values and ethical standards.  NASW supports health coverage and access to health services for all people.

For more information on the health care outlook for 2017, these organizations are great resources:

Visit NASW’s Practice: Health for more tools




  1. Also see the Institute for HealthCare Improvement’s website They are the leader in healthcare innovations to make health care accessible, safe and efficient for everyone.

    We need to seek ways to improve HOW we deliver healthcare, not just pay for it.

  2. As a profession Social Work is at a Crossroads but doesn’t realize it.

    The incoming admistration’s strategy is made clear by whom is being appointed to the cabinet.

    It is not time to wait to “gain a better understanding” but rather to make clear where the line of our resistance is drawn.

    The Technology profession has taken a stronger and more detailed stance for at-risk populations than we have.

    How is that possible?

    Where are we going make our stand?

  3. As a profession Social Work is at a Crossroad but doesn’t realize it.

    The incoming admistration’s strategy is made clear by whom is being appointed to the cabinet.
    Now is not the time to wait to “gain a bteer inderstanding”.

    Now is the time to make clear where our line of resistance lies.

    How is it that the Tech. Profession has taken a stronger and more detailed stance for at-risk populations than we have?

    Where shall we make our stand?

    • Glenn,

      Social Work is a dying profession, being killed off by its own hands. NASW and the profession have failed to engage in qualitative and quantitative research for our service outcomes. Social Work salaries have remained stagnant for decades. There is little-to-no quantitative analysis of the efficacy of professional Social Work interventions versus those provided by other disciplines. Nursing has us totally beat regarding this type of research, which is why we’re losing jobs in health care.

      The link to the Huffington Post article shows the socialist view of Social Work educators and most of the profession. The over-generalization of the President Elect’s platform (i.e. all of the “isms” and “phobics”) is unfounded in identified policies of the new Administration. Yes, the President-Elect has made some unsavory comments about women (whom he clearly likes their beauty and sexual appeal). Yes, the President-Elect has called for a stop on immigration, UNTIL there is a better system that can safely vet all immigrants, especially those from countries from which terrorists originate. Yes, the ACA needs to be replaced with a better means of healthcare delivery that is cost-effective and generates better quality.

      Frankly, I am less worried about the nominated Cabinet posts. The current government systems need reform and who better to lead this than top world-class business executives with proven track records of making their companies (and the military) perform better?

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