NASW Practice Alert: Health Care in 2017

Dec 16, 2016

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



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