ABSTRACT
This special issue tries to capture the essence of a monumental piece of public health history and its implications for health and behavioral health care in the United States. The Patient Protection and Affordable Care Act (ACA) of 2010 is in the process of being implemented as this introduction is being written. Although the legislation is not considered perfect by many advocates, the enrollment process for ACA has begun across America. An estimated 32 million people will become eligible for health insurance. With the help of ACA, health will become a right for all Americans and the United States will finally have health reform, comprehensive health insurance, holistic integrated health and behavioral health care, along with a measure of cost control. When our team of authors started writing, we felt the enthusiasm of President Barack Obama’s promise to make ACA his top domestic initiative and a hallmark of his administration and legacy. We remained undaunted, even when several states filed suit, and the U.S. Supreme Court reaffirmed the legality of most of the major provisions of ACA. Already, 3 million young adults have benefited from the provision that allows individuals to remain covered by their parents’ health insurance until age 26. However, at this writing, there is opposition in Congress to the ACA legislation and some states indicate they will not fully participate in the ACA implementation. Perhaps we will have to wait to see how many eligible Americans will enroll in the Medicaid expansion provisions, the next major step in the ACA implementation. For those who enroll in the Medicaid expansion, most of whom are expected to be people of color, how satisfied will they be with the services they receive and how well will the service providers respond to the increase in demand for culturally competent, integrated, health and behavioral health services? Meanwhile, health and behavioral health care professionals, service institutions, consumers, and other stakeholders should prepare for the full implementation of ACA. Being alert to changing federal policies and being flexible and adaptive will be helpful in the coming months. We hope this special issue will assist anyone interested in seeing that ACA fulfills its promise.
