So long, farewell. But first, a few of my favorite things.

As I wrap up eight years at Community Catalyst, I’ve been reflecting on the momentous changes in the health care system I’ve been lucky to be part of through this work. Before I say farewell, I wanted to mention a few of my favorite things – as well as a few hopes for the future as I say goodbye to health advocacy work… for now.

  1. The Affordable Care Act. I joined Community Catalyst after working on Massachusetts health reform, and for a number of years it seemed the only path to expanding coverage was a state-by-state reform model. Then the 2008 election created the momentum for national reform. The work of state advocates in that fight – organizing rallies, writing op-eds, educating policymakers – led us to a place unimaginable a few years ago. Now 9.5 million uninsured people have coverage. Millions of people do not have to worry that a pre-existing condition will keep them from treatment. Even with all the law’s implementation challenges, sometimes I have to pinch myself when I think how far we have come in such a short time.
     
  2. In-person assistance.  Over the past few years, I am fortunate to have witnessed first-hand the enormous growth in training thousands of experts to assist consumers in understanding our extremely complex health system. This issue has long been a priority of Community Catalyst, and to work with a new crop of CAPs, Navigators, CACs has been gratifying. We went from having a few wonks who understood the system to building community-based capacity in every state and city to help people navigate the health system.
     
  3. Growth of consumer health advocacy. When I started at Community Catalyst in 2007, most consumer advocacy organizations operated on a shoestring with a limited policy agenda. Today, Community Catalyst works with a wide range of groups on multiple fronts – to improve dental access, health equity and care for dual eligibles. Our health system and the care available to consumers are better for it.

But there is more work to be done. Here are a few areas where I hope to see further progress:

  1. Discrimination.  The ACA took made huge strides in making sure people have health coverage. The next step is to dig in and use these new tools so groups that have been systematically discriminated against can get the care they need. There are exciting developments in some areas, but there’s more work to be done to ensure all people of color, people with chronic illnesses, transgender people and those who do not speak English as a first language get high quality care.
     
  2. Make assistance permanent. While we have made great progress in creating a workforce of experts to enroll people, we know from Massachusetts health reform that the need for assistance with navigating the health system does not go away after the first few years of reform. The issue is now at a tipping point – there is an opportunity to use the expertise that has been created to build an on-going system of assistance that keeps people covered and troubleshoots problems.
     
  3. Retain the coverage gains made. As with any significant change, health care reform still has fierce critics. The immense gains in health care access will continue to face challenges. But as we continue to build the capacity of health advocates on the ground, we will continue to move closer to fulfilling the promise of health care for all. 

This is my last blog before I move on to the Massachusetts legislature. But I plan to keep an eye on your work, and I look forward to more good things to come. I am so proud to have worked alongside those who are fighting for health care justice and hope our paths cross again soon.