HEALTH CARE REFORM : GOVERNMENT: Government Sources and Research Studies about Health Care Reform PART ONE

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HEALTH CARE REFORM : GOVERNMENT: Government Sources and Research Studies about Health Care Reform PART ONE

David P. Dillard

Government Sources and Research Studies about Health Care Reform PART ONE


Research Guide Directory :

Discussion Group Directory


Improving Health for All Americans
President Obama promised that he would make quality, affordable health
care not a privilege,
but a right. After nearly 100 years of talk, and decades of trying by
presidents of both parties,
that's exactly what he did. Today, 20 million more adults gained access to
health coverage.
We've driven the uninsured rate below 10 percent  the lowest level since
we started keeping
records  and built stronger, healthier communities through advancements in
public health,
science, and innovation.

President Obama Speaks on Health Care in America
An American Life, With or Without the Affordable Care Act3 Letters That
Explain Why President Obama Is Signing the Cures ActThe Story of Health
Care Reform in AmericaRead Letters to the President on Health CareWatch
Videos on Health Care
Improved Access to Care

Prohibited coverage denials and reduced benefits due to pre-existing

129 Million Americans with Pre-Existing Conditions Can No Longer Be Denied
Health Coverage

Today, as many as 129 million Americans with pre-existing conditions can
no longer be denied health coverage.
"Prohibited coverage denials and reduced benefits due to pre-existing
conditions" ?

Eliminated lifetime and annual limits on insurance coverage and
established annual limits on out-of-pocket spending on essential health
benefits Ending Lifetime & Yearly Limits

"Insurance companies cant set a dollar limit on what they spend on
essential health benefits for your care during the entire time youre
enrolled in that plan."


Required health plans to cover dependent children up to age 26

Adult Uninsured Rates 1997-2014

2.3 million additional young adults (aged 19-25) gained health insurance
coverage between the enactment of the Affordable Care Act in 2010 and the
start of open enrollment in October 2013 due to the ACA provision allowing
young adults to remain on a parents plan until age 26.


Prohibited retroactive cancellation of policies, except in the case of
fraud, eliminating the practice of people developing costly illnesses and
then losing their coverage Rescission

"Rescission is the retroactive cancellation of a health insurance policy.
Insurance companies will sometimes retroactively cancel your entire policy
if you made a mistake on your initial application when you buy an
individual market insurance policy. Under the Affordable Care Act,
rescission is illegal except in cases of fraud or intentional
misrepresentation of material fact as prohibited by the terms of the plan
or coverage."


Expanded Medicaid to all previously ineligible adults with incomes under
133 percent of the federal poverty level with unprecedented federal
support (the Supreme Court directed that this expansion be at the
discretion of states)

Medicaid is Expanding Insurance Coverage

The U.S. has seen the sharpest reduction in the uninsured rate since the
decade following the creation of Medicare and Medicaid in 1965, and the
nations uninsured rate is now at its lowest level ever.


Established a system of state and federal health insurance exchanges or
marketplaces to make it easier for individuals and small-business
employees to purchase health plans at affordable prices

To learn more about the Health Insurance Marketplace, visit


Simplified health choices by requiring individual and small business plans
to offer four standard categories at various costs, plus a catastrophic
option for people under age 30 and people who cannot otherwise afford
coverage How to Choose a Plan in the Health Insurance Marketplace

Watch on YouTube How to Choose a Plan in the Health Insurance Marketplace ?

Established individual responsibility by requiring all Americans who can
afford insurance coverage to purchase it or pay a fee

IRS: Individual Shared Responsibility Provision


Established employer responsibility under which mid-size and large
companies provide health coverage to their workers or contribute to their
coverage through a fee The Employer Shared Responsibility Payment

"Some employers with 50 or more FTE employees who dont offer insurance, or
whose offer of coverage is not affordable or doesnt meet certain minimum
standards, are subject to Employer Shared Responsibility provisions. They
may owe a payment if at least one of their full-time employees enrolls in
a plan through the Health Insurance Marketplace and receives a premium tax


Ensured individual and small business health plans include essential
health benefits, covering emergency services, hospitalization, maternity
and newborn care, preventive care such as annual physicals, and more

What Marketplace Health Insurance Plans Cover

Any plan shown in the Marketplace includes these essential health
benefits. This is true for all plan categories (all metal levels,
including Catastrophic plans) and all plan types (like HMO and PPO).


Simplified eligibility and enrollment requirements in Medicaid and the
Childrens Health Insurance Program (CHIP)

CMS: CHIP has provided meaningful health coverage to over eight million

"This program has helped cut the uninsured rate among children by nearly
60 percent since its start in 1997  with more than one-quarter of that
reduction since the President signed  legislation reauthorizing the
program in 2009."


Expanded Community Health Centers and incentives for primary care
providers to practice in the communities that need them most
Expanded Community Health Centers & incentives for primary care providers
to practice in communities that need them:

Created a new FDA approval pathway to advance biosimilars, which offer the
potential to lower treatment costs for patients on high-cost biologics
Created a new pathway to advance biosimilars, with the potential to lower
costs for patients on high-cost biologics:

Provided new home- and community-based options for elderly and disabled
Americans who require long-term care services

Improving Access to Home- and Community-Based Services

In recent years, the Administration has expanded efforts to ensure that
older adults and individuals with disabilities have access to
person-centered services in community settings.  For example, the Money
Follows the Person Rebalancing demonstration helps states rebalance their
Medicaid long-term services and supports systems and provides
opportunities for older Americans and people with disabilities to
transition back to the community from institutions. The Affordable Care
Act extended and expanded this program.


Introduced new coverage options and other improvements for Native
Americans through an improved Indian Health Service

Strengthening Health Care in Indian Country

Another critical step forward is implementing the Affordable Care Act,
which contains many important benefits for American Indians and Alaska
Natives. First and foremost, it includes the permanent reauthorization of
the Indian Health Care Improvement Act, ensuring that the IHS is here to
stay. It also improves benefits and protections for American Indians and
Alaska Natives who have insurance, whether they receive care inside or
outside the IHS. And it gives them more choices for health coverage,
including Medicaid and the Federal Employees Health Benefits Program.


Created a temporary reinsurance program to sustain group coverage for
early retirees prior to 2014 reforms

CMS: Early Retiree Reinsurance Program

"The Early Retiree Reinsurance Program (ERRP) was included in the
Affordable Care Act (ACA) to provide financial assistance to
employment-based health plan sponsorsincluding for-profit companies,
schools and educational institutions, unions, State and local governments,
religious organizations and other nonprofit plan sponsorsthat make
coverage available to millions of early retirees and their spouses,
surviving spouses, and dependents."


Created a temporary high-risk pool program to cover uninsured people with
pre-existing conditions prior to 2014 reforms

Kaiser Family Health Foundation: Explaining the temporary high-risk pool

The health reform law created a temporary national high-risk pool to
provide health coverage to people with pre-existing medical conditions who
had been uninsured for six months. It was a temporary measure designed to
bridge the gap until the implementation of other coverage provisions in
the law that took effect in January 2014.


Created health plan disclosure requirements and simple, standardized
summaries so consumers can evaluate coverage information and compare
Created health plan disclosure requirements & summaries so consumers can
evaluate coverage info & compare benefits:

Provided funding for a voluntary home-visiting program to support mothers
and young children in underserved communities

HHS: Maternal, Infant, and Early Childhood Home Visiting

"HRSA, in close partnership with the Administration for Children and
Families (ACF), funds States, territories and tribal entities to develop
and implement voluntary, evidence-based home visiting programs using
models that are proven to improve child health and to be cost effective.
These programs improve maternal and child health, prevent child abuse and
neglect, encourage positive parenting, and promote child development and
school readiness."


Covered HIV screening for millions without additional cost and prohibited
discrimination due to pre-existing conditions like HIV

This Administration updated its comprehensive 2010 National HIV/AIDS
Strategy for the United States through 2020, and implemented it alongside
requirements to cover HIV screening for millions without additional cost
and prohibit discrimination due to pre-existing conditions like HIV.

Read the Updated National HIV/AIDS Strategy:


Created a new funding pool for Community Health Centers to build, expand
and operate health-care facilities in underserved communities

What is a Health Center?

Health centers have played an essential role in the implementation of the
Affordable Care Act and continue to be a critical element of the nations
health system.


Expanded health provider training opportunities, with an emphasis on
primary care, including a significant expansion of the National Health
Service Corps

HHS Awards More Than $240 Million to Expand the Primary Care Workforce

The Affordable Care Act included funding for health provider training
opportunities, with an emphasis on primary care, including a significant
expansion of the National Health Service Corps. As of September 30, 2015,
there were 9,600 Corps clinicians providing primary care services,
compared to 3,600 clinicians in 2008.


Improved policy and extended funding for the Childrens Health Insurance
Program, which provides coverage for millions of low-income children, in
2009 and extended those policies in 2015

Since 2008, more than 3 million additional children have gained health

Children have also seen important gains in insurance coverage in recent
years, thanks in large part to improvements to CHIP signed into law by
President Obama in 2009 and broader coverage expansions as a result of the

Advanced Biomedical Research to Improve Health Outcomes

Launched the Precision Medicine Initiative to revolutionize how we improve
health and treat disease.

     The Precision Medicine Initiative: The next great revolution in
medicine will emerge from an ability to use genomic, lifestyle,
behavioral, environmental, imaging, and clinical data to understand health
and disease, and to use those insights to develop tailored prevention
approaches and medical treatments. The Precision Medicine Initiative,
launched by President Obama, will revolutionize how we improve health and
treat disease.
     FACT SHEET: Obama Administration Announces Key Actions to Accelerate
Precision Medicine

Launched the BRAIN Initiative to develop neuro-technologies that could
uncover new ways to treat, prevent, and cure brain disorders

     President Obamas BRAIN InitiativeBrain Research through Advancing
Innovative Neurotechnologieshas catalyzed more than $1.5 billion in public
and private funds for novel neurotechnologies aimed at revolutionizing
understanding of the human brain. BRAIN Initiative researchers and
public-private collaborating organizations are pursuing an ambitious
10-year research agenda.
     Read More: Obama Administration Proposes Over $434 Million in Funding
for the BRAIN Initiative
     REPORT: Priorities for Accelerating Neuroscience Research Through
Enhanced Communication, Coordination, and Collaboration

Embarked on a new national effort to end cancer as we know it

     The Vice Presidents Cancer Moonshot SM encourages public and private
efforts to double the rate of progress in cancer prevention, diagnosis,
treatment, and care in order to make a decades worth of advances in 5
     Learn more about the Vice President's Cancer Moonshot? here.

Developed a strategy to combat the rise of antibiotic-resistant bacteria

Read More: The Obama Administration issued a national strategy and a
national action planfor domestic and international efforts to prevent,
detect, and control illness and death related to infections caused by
antibiotic-resistant bacteria.

Launched the first update of biotechnology regulations in a quarter

     The Obama administration openly reviewed and modernized the regulatory
system for biotechnology products to improve transparency and ensure
continued safety in biotechnology.

Made Health Care and Coverage More Affordable

Established financial assistance to help individuals and families who
otherwise cannot afford health coverage purchase it through state and
federal marketplaces

Millions of Americans who are enrolled in Marketplace plans are receiving
financial assistance to help them afford quality coverage.


Created a tax credit for small businesses that provide health coverage to
their employees

Businesses with fewer than 25 employees may qualify for a tax credit worth
up to 50 percent of their premium costs (up to 35 percent for tax
exempt/non-profit employers).


Prohibited charging more for women to receive coverage

Since September of 2013, the uninsured rate for women has dropped nearly
50 percent, meaning that about 9.5 million adult women have gained


Required health insurers to provide consumers with rebates if the amount
they spend on health benefits and quality of care, as opposed to
advertising and marketing, is too low

Thanks to a provision in the Affordable Care Act, if your insurance
company isnt spending at least 80 percent of your premium dollars on
medical care, they have to send you some money back.


Allowed employer health plans to provide incentives for workers related to
wellness programs

The Affordable Care Act creates new incentives to promote workplace
wellness programs and encourages employers to take more opportunities to
support healthier workplaces. Effective for plan years after January 1,
2014, final rules allow the maximum reward to employers using a
health-contingent wellness program to increase from 20 percent to 30
percent of the cost of health coverage, and the maximum reward for
programs designed to prevent or reduce tobacco use will be as much as 50


Phases out the donut hole coverage gap for Medicare prescription drug
coverage to save Medicare beneficiaries money

Nearly 10.7 million Medicare beneficiaries have received discounts over
$20.8 billion on prescription drugs  an average of $1,945 per beneficiary
since the enactment of the Affordable Care Act.


Expanded competitive bidding in Medicare to lower costs for durable
medical equipment such as wheelchairs and hospital beds

CMS Fact Sheet: Medicare Competitive Bidding Program Finds $42 Billion in

"The overall savings to Medicare and beneficiaries as a result of the
competitive bidding program for Durable Medical Equipment, Prosthetics,
Orthotics, and Supplies is expected to total more than $42 billion over
the first ten years of the program, according to the CMS Office of the
Actuary.  The $42 billion savings comes from a combination of savings of
more than $25 billion in Medicare expenditures, and savings of over $17
billion for beneficiaries as a result of lower coinsurance payments and
the downward effect on monthly premium payments."


Created new Medicare payment and delivery models to pay for the value
rather than the volume of services provided, as well as the new Centers
for Medicare & Medicaid Innovation to promote improvement in health care
quality and costs through the development and testing of innovative health
care payment and service delivery models

The economic case for deploying new health care payment models:


Ensured Medicare Advantage plans are paid accurately and required plans to
spend at least 85 percent of Medicare revenue on patient care, while
enrollment has grown by over 60 percent and average premiums have dropped
by 13 percent since passage of the Affordable Care Act.

Affordable Care Act Update: Implementing Medicare Cost Savings


Reduced drug costs through increased Medicaid rebates, expanded discount
programs, and established a new system for approval of more affordable
versions of biologic drugs

Some cutting edge drugs are simply too expensive for many seniors.
Creating a pathway for the approval of generic biologic drugs will improve
affordability of medications for seniors and all Americans.

Improved Accountability, Efficiency, and Quality of Care

Established new transparency requirements and a star rating system for
hospitals, nursing homes, Medicare Advantage plans, physicians, and other
providers to give consumers information related to quality and cost

CMS: CMS expands quality data on Physician Compare and Hospital Compare to
help consumers choose health care providers

Consumers want trustworthy, reliable, and understandable information about
the quality of health care delivered by providers, said CMS Deputy
Administrator and Chief Medical Officer Patrick Conway, M.D., MSc. Both
Physician Compare and Hospital Compare show consumers that they have a
choice. This large release of quality measures for hospitals and
physicians empowers consumers with information to make more informed
health care decisions, encourages health care professionals to strive for
higher levels of quality, and drives overall health system improvement.


Provided incentives to hospitals in Medicare to reduce hospital-acquired
infections and avoidable readmissions

Patients Safer as Hospital-Acquired Conditions Decline?

From 20102015, 21 percent of hospital-acquired conditions (HACs) such as
adverse drug events, healthcare-associated infections, and pressure ulcers
have been prevented in hospital patients. Reducing these HACs has saved an
estimated 125,000 lives and nearly $28 billion in health care costs,
according to HHS' annual report on patient safety.


Linked Medicare payments to physicians, hospitals, and other providers to
quality of care improvements and lower costs

The Administration set goals of tying 30 percent of traditional Medicare
payments to alternative payment models by the end of 2016 and 50 percent
by the end of 2018, and met its 2016 goal 11 months early.


Improved coordination of care between Medicare and Medicaid to better
serve individuals who receive care through both programs. Formed the Elder
Justice Coordinating Council to identify and prevent elder abuse, neglect
and exploitation

Examining Medicare and Medicaid coordination for dual-eligibles.

Elder Justice Policy Brief

Elder abuse is a serious public health problem affecting millions of older
Americans each year, with some studies suggesting that as few as one in 23
cases is reported to authorities.  Elder abuse is defined as intentional
actions that cause harm or create a serious risk of harm to an older
person (whether or not harm is intended).  Elder abuse encompasses
physical abuse, neglect, financial exploitation, sexual abuse, as well as
emotional and psychological abuse.


Included tools to combat fraud, including increased sentencing guidelines
for criminal health care fraud with over $1 million in losses and new
prevention and detection efforts that identify fraudulent activity and
prevent inappropriate payments

CMS Fraud Prevention Initiative ?

By using innovative predictive modeling technology similar to that used by
credit card companies, CMS has stopped, prevented or identified $820
million in fraudulent payments over the past three years.  The system
identified or prevented $454 million in Calendar Year 2014 alone, a 10 to
1 return on investment.


Increased consumer protection and community service requirements for
charitable hospitals

IRS: New Requirements for 501(c)(3) Charitable Hospitals Under the
Affordable Care Act

The Affordable Care Act added new requirements that hospitals must adhere
to in order to qualify as a 501(c)(3) charitable hospital. The new
requirements provide additional benefits to patients and their


Raised the Medicare hospital insurance tax and imposed a new tax on net
investment income for high income taxpayers in order to strengthen the
Medicare Hospital Insurance Trust Fund

Questions and Answers for the Additional Medicare Tax


Required drug and medical-device manufacturers to publicly disclose
payments and other compensation, like gifts and travel, to physicians and
teaching hospitals to limit conflicts of interest (also known as the
"sunshine" provision)

Why Open Payments is Important to You
Section 6002 of the Affordable Care Act requires the establishment of a
transparency program, now known as Open payments. The program increases
public awareness of financial relationships between drug and device
manufacturers and certain health care providers.


Visit the Open Payments homepage.

The @WhiteHouse Record on Health Care: Required drug & medical-device
manufacturers to publicly disclose info:

Required the posting of calorie information on menus of chain restaurants
with 20 or more locations and vending machines
The @WhiteHouse Record on Health Care: Required the posting of calorie
information on menus of chain restaurants:

Promoted the adoption and usage of certified electronic health records by
doctors, hospitals, and other providers

Until the President made investments in health information technology by
signing the American Recovery and Reinvestment Act, our health care system
ran largely on paper. Now, more than 75 percent of doctors now use
electronic health records thanks to Administration policies.

Electronic Health Records

Learn more about electronic health records.


Delivered a fix to the Medicare physician payment problem, eliminating
cliffs for payments to physicians, while protecting patient-doctor
relationships and creating incentives for quality of care improvements,
lower costs, and adopting alternative payment models HHS finalizes streamlined Medicare payment system that rewards
clinicians for quality patient care


Created new policies to improve nursing home quality and safety

HHS finalized regulations to improve care and safety for nursing homes
residents; Revisions mark first major rewrite of long-term care conditions
of participation since 1991

The Centers for Medicare & Medicaid Services (CMS) issued a final rule to
make major changes to improve the care and safety of the nearly 1.5
million residents in the more than 15,000 long-term care facilities that
participate in the Medicare and Medicaid programs. The policies in this
final rule are targeted at reducing unnecessary hospital readmissions and
infections, improving the quality of care, and strengthening safety
measures for residents in these facilities.

Addressed the Prescription Opioid and Heroin Epidemic

Signed into the 21st Century Cures Act, which funds the President's $1
billion proposal to combat the opioid epidemic and enacts mental health
reforms focused on serious mental illness, suicide prevention, and mental
health parity protections

Remarks by the President and the Vice President at the 21st Century Cures
Act Bill Signing

"Today, I could not be prouder that this legislation takes up the charge I
laid out in my budget to provide $1 billion in funding so that Americans
who want treatment can get started on the path to recovery and dont have
to drive six hours to do it. It is the right thing to do, and families are
ready for the support."

Watch on YouTube


SAMHSA to award nearly $1 billion in new grants to address the nations
opioid crisis


Developed a comprehensive, intergovernmental strategy to combat outbreaks
of the flu (H1N1), Ebola, and other infectious diseases, and to address
critical prescription drug shortages

Fact Sheet: Obama Administration Takes Action to Reduce Prescription Drug
Shortages in the U.S.


Expanded access to medication-assisted treatment of opioid use disorders

The Administration finalized a regulation to expand access to opioid
treatment by increasing the number of patient's physicians who can treat
with the opioid use disorder treatment medication buprenorphine.

The change allows qualified physicians to prescribe buprenorphine to more
patients. As of October 2016, 2,400 practitioners have applied for and
been granted waivers to prescribe at the increased limitimproving access
to buprenorphine, which is prescribed along with psychosocial supports as
part of Medication-Assisted Treatment.

Read more about HHS change here.


The HHS also took action to enable nurse practitioners (NPs) and physician
assistants (PAs) to begin taking the required training to prescribe the
opioid use disorder treatment, buprenorphine.

Read more here.


The Administration also awarded $94 million in Affordable Care Act funding
to 271 health centers across the country to increase substance use
disorder treatment services, with a specific focus on expanding
medication-assisted treatment of opioid use disorders in underserved

See the map of communities here.


Released a new guideline for prescribing opioids for chronic pain to help
primary care providers ensure the safest and most effective treatment for
their patients

Read the CDC Guideline here.

Download the CDC checklist here.

The Administration also released an Opioid Overdose Prevention Toolkit for
community members, first responders, prescribers, and patients and family
members. The toolkit, developed by the Substance Abuse and Mental Health
Services Administration, can be found here.

Announced a new $11 million funding opportunity to States to purchase the
opioid overdose reversal drug, naloxone, and train first responders and
others in its use

Fact Sheet: Obama Administration Announces Additional Actions to Address
the Prescription Opioid Abuse and Heroin Epidemic


Additionally, the Administration awarded $1.8 million to rural communities
to expand access to naloxone  a drug that reverses an opioid overdose and
released Medicaid guidance to states identifying Best Practices for
Addressing Prescription Opioid Overdoses, Misuse and Addiction including
steps to increase the use of naloxone to reverse opioid overdose and to
expand coverage of opioid use disorder treatment.

Announced a Presidential Memorandum requiring Federal Departments to
provide training on appropriate opioid prescribing to Federal health care
professionals and requiring Departments to develop plans to address
barriers to opioid use disorder treatment in Federal programs.

Read the Presidential Memorandum here:


Required substance use disorder benefits to be included in all health
plans offered in the individual and small group insurance markets

Learn about the Health Insurance Marketplace:


Finalized mental health and substance use disorder parity rules to ensure
greater equity between these benefits and medical and surgical care
benefits in group, individual and Medicaid health plans. Administration issues final mental health and substance use
disorder parity rule


The Administration also finalized a rule to implement parity protections
in TRICARE, including expanding mental health and substance use disorder
treatment to include coverage of intensive outpatient programs and
treatment of opioid use disorders with medication-assisted treatment.


Collected a record amount of unused prescription drugs through the 2016
National Prescription Drug Take-Back Day

More than 893,000 pounds of unwanted medicines or about 447 tons were
collected -- to help make homes safe from potential prescription drug
abuse. Take-back days have collected and destroyed 5.5 million pounds of
unused prescription drugs over five years.

Learn more about Tack-Back Day here:


The Administration also finalized a rule making it easier for communities
to establish ongoing drug take-back programs to reduce the amount of
unused prescription drugs in homes.

Read more about the US Drug Enforcement Administrations final rule here.

Launched a heroin response strategy through public health-public safety
partnerships in regional High Intensity Drug Trafficking Areas in
Appalachia, New England, Philadelphia/Camden, New York/New Jersey,
Washington/Baltimore, Ohio and Michigan

White House Drug Policy Office Funds New Projects in High Intensity Drug
Trafficking Areas


Amplified the first-ever Surgeon General Report on Alcohol, Drugs, and
Health covering prevention, treatment and recovery

Read the Report here.
Increased Access to Mental Health Services

Eliminated out-of-pocket costs for recommended preventive services,
including depression screenings for adults and adolescents, through the
Affordable Care Act

See the list of preventive services.


Formed the Mental Health and Substance Use Disorder Parity Task Force to
work together to ensure that Americans are benefiting from the mental
health and substance use disorder parity protections under the Affordable
Care Act

The Task Force met with parents, advocates, clinicians, health plans,
regulators and others and developed a series of action steps and
recommendations for future action to help ensure that mental health and
substance use disorder benefits are treated at parity with medical and
surgical benefits.


Signed the Clay Hunt Suicide Prevention for American Veterans (SAV) Act,
to improve mental health care and suicide prevention programs for veterans

Learn more about the Clay Hunt Suicide Prevention for American Veterans
(SAV) Act and the Administration's commitment to help veterans.


Hosted the White House National Conference on Mental Health to reduce
stigma and help the millions of Americans struggling with mental health

The White House hosts a National Conference on Mental Health at the White
House as part of the Administrations effort to launch a national
conversation to increase understanding and awareness about mental health.


Issued an Executive Order to improve mental health services for veterans,
service members, and military families

In response to the Executive Order, VA increased its mental health
staffing, expanded the capacity of the Veterans Crisis Line, and enhanced
its partnerships with community mental health providers; DoD and VA worked
to increase suicide prevention awareness and, DoD, VA and the National
Institutes of Health jointly developed the National Research Action Plan
on military and veterans mental health to better coordinate federal
research efforts.


Announced 19 new executive actions that the Departments of Defense and
Veterans Affairs are taking to improve the mental health of service
members, veterans and their families

The mental health executive actions fell under the following six

     Improving service members' transition from DoD to VA and Civilian
Health Care Providers
     Improving access and quality of mental health care at DoD and VA
     Continuing our commitment to improve treatments for mental health
conditions including PTSD
     Raising awareness about mental health and encouraging individuals to
seek help
     Improving patient safety and suicide prevention
     Strengthening community resources for service members, veterans, and
their families

FACT SHEET: President Obama Announces New Executive Actions to Fulfill our
Promises to Service Members, Veterans, and Their Families


Invested $100 million to improve access to mental health services

Vice President Biden Announces $100 Million to Increase Access to Mental
Health Services

Strengthened Nutrition Standards and Promoted Healthy Living

Promoted public-health initiatives that target heart disease, diabetes,
and other conditions that afflict large segments of the population

New investments in the Recovery Act, expanded through the Prevention and
Public Health Fund in the Affordable Care Act, supported public-health
initiatives that target heart disease, diabetes, and other conditions that
afflict large segments of the population.

HHS: Prevention and Public Health Fund

The Affordable Care Act established the Prevention and Public Health Fund
to provide expanded and sustained national investments in prevention and
public health, to improve health outcomes, and to enhance health care
quality. To date, the Fund has invested in a broad range of evidence-based
activities including community and clinical prevention initiatives;
research, surveillance and tracking; public health infrastructure;
immunizations and screenings; tobacco prevention; and public health
workforce and training.


Created new powers for the Food and Drug Administration to regulate
tobacco products, offering significant new tools to combat preventable

FACT SHEET: The Family Smoking Prevention and Tobacco Control Act of 2009


Created new laws and regulations to improve food safety

FDA: Background on the FDA Food Safety Modernization Act (FSMA)

The FDA Food Safety Modernization Act (FSMA), signed into law by President
Obama on Jan. 4, 2011, enables FDA to better protect public health by
strengthening the food safety system. It enables FDA to focus more on
preventing food safety problems rather than relying primarily on reacting
to problems after they occur.


Established Lets Move!, an initiative led by First Lady Michelle Obama
dedicated to helping kids and families lead healthier lives

In 2009, First Lady Michelle Obama planted the White House Kitchen Garden
on the South Lawn to initiate a national conversation around the health
and wellbeing of the country. In time, that conversation led to Let's
Move!. Through policy, programs, public awareness, and partnerships, Lets
Move! is about putting children on the path to a healthy future during
their earliest months and years; giving parents helpful information and
fostering environments that support healthy choices; providing healthier
foods in our schools; ensuring that every family has access to healthy,
affordable food; and helping children become more physically active.


Established practical, science-based nutrition standards for school meals

The Healthy, Hunger-Free Kids Act updated school meal nutrition standards
for the first time in 15 years and increased school meal funding for the
first time in 30 years. The law boosted the quality and nutrition of meals
for over 50 million children through the National School Lunch and
Breakfast Programs. Its regulations substantially increased offerings of
fruits, vegetables, and whole grains, and reduced the amount of saturated
fat, trans fat and sodium.


Enacted Smart Snacks in School: practical, science-based nutrition
standards for snack foods and beverages sold to children during the school

Ensured that any food or beverage that is marketed on school campuses
during the school day meets the Smart Snacks in School nutrition standards

Smart Snacks in School standards apply to foods sold a la carte, in the
school store, and vending machines. This allows schools to offer healthier
snack foods to children, while limiting junk food. Any food sold in
schools must: Be a whole grain-rich grain product; or have as the first
ingredient a fruit, a vegetable, a dairy product, or a protein food; or be
a combination food that contains at least  cup of fruit and/or vegetable;
or contain 10% of the Daily Value of one of the nutrients of public health
concern in the 2015 Dietary Guidelines for Americans (calcium, potassium,
vitamin D, or dietary fiber).

Many of the foods and beverages that have been heavily marketed to
children contribute to poor diet quality, high calorie intake, and excess
weight gain. Foods offered and marketed to students during the school day
now must be consistent with nutrition standards, so that any food or
beverage that cannot be sold in school cannot be marketed in school


Enabled schools and local educational agencies with high poverty rates to
provide free breakfast and lunch to all students

As part of the Healthy, Hunger-Free Kids Act, the Community Eligibility
Provision impacts more than 18,000 schools in high poverty across the
country that are eligible to serve free lunches and breakfasts to all
students.  It helps give 8.5 million American children access to free
nutritious meals with no stigma and less time spent in cashier lines.


Modernized the Nutrition Facts label to help consumers make healthier

First Lady Michelle Obama announced the modernized Nutrition Facts label
for packaged foods reflecting the latest science, the most relevant
nutrition information and a refreshed design. Found on nearly 800,000
products, the label had not been significantly updated since its initial
release twenty years ago.


Cut artificial trans fat from the food supply

In 2015, the Food and Drug Administration finalized its determination that
partially hydrogenated oils (PHOs), the primary dietary source of
artificial trans fat in processed foods, were no longer "generally
recognized as safe for use in human food. Food manufacturers are required
to remove PHOs from products by 2018. This step is expected to reduce
coronary heart disease and prevent thousands of fatal heart attacks every


Updated the Dietary Guidelines for Americans in 2010 and 2015 to reflect
the latest body of science and encourage healthy eating patterns and
created MyPlate and its Spanish-language version MiPlato

     The Dietary Guidelines for Americans (DGA) is the nations trusted
resource for evidence-based nutrition recommendations. They are required
to be updated every 5 years and serve as the foundation for vital
nutrition policies and programs across the U.S. The DGA is designed for
nutrition and health professionals to help all individuals ages 2 years
and older and their families consume a healthy, nutritionally adequate
diet. The 2015-2020 Dietary Guidelines for Americans focus on the
importance of a healthy eating pattern. Read more.
     In 2010, MyPlate replaced MyPyramid as the governments primary food
group symbol. MyPlate is based on the Dietary Guidelines for Americans and
serves as a visual reminder for consumers to follow a healthy eating
pattern. MiPlato was released in 2011. Read more.

Initiated the Healthy Lunchtime Challenge and Kids State Dinner to
encourage cooking and healthy eating among young people

Through the Healthy Lunchtime Challenge, First Lady Michelle Obama, in
collaboration with the U.S. Departments of Agriculture and Education and a
media partner, invited children ages 8-12, with the help of a parent or
guardian, to create a lunch recipe that was original, healthy, affordable,
and delicious. One winner from each U.S. state, territory, and the
District of Columbia won the opportunity to attend the Kids State Dinner
at the White House, where a selection of the winning recipes were served.
Altogether, over 6,000 recipes were submitted and more than 270 young
chefs and their families were welcomed to the White House for a total of
five annual Kids State Dinners.


Improved food safety to ensure the U.S food supply is safe by shifting the
focus from responding to contamination to preventing it

The Food and Drug Administration (FDA) Food Safety Modernization Act
(FSMA), the most sweeping reform of our food safety laws in more than 70
years, was signed into law by President Obama on January 4, 2011. It
enables FDA to better protect public health by strengthening the food
safety system and to focus more on preventing food safety problems rather
than relying primarily on reacting to problems after they occur.


Required the posting of calorie information on menus of chain restaurants
with 20 or more locations and vending machines
The @WhiteHouse Record on Health Care: Required the posting of calorie
information on menus of chain restaurants:

Improved nutrition standards across the armed services

For the first time in 20 years, the Department of Defense (DoD) updated
their nutritional standards to include more fresh fruits, vegetables,
whole grains, lean meats, and low-fat dairy products at the 1,100 service
member dining facilities. Healthier foods were also made available at DoD
schools and other areas where food is purchased on military bases, such as
snack bars and vending machines.


Reauthorized the Supplemental Nutrition Assistance Program (SNAP) to
include important investments that help participants move to
self-sufficiency, strengthen program integrity, modernize technology, and
emphasize good nutrition

The Agricultural Act of 2014 was enacted February 7, 2014. The law
reauthorizes the Supplemental Nutrition Assistance Program (SNAP), the
largest program in the domestic hunger safety net. It offers nutrition
assistance to millions of eligible, low-income individuals and families
and provides economic benefits to communities. The reauthorization of SNAP
preserved the fundamental structure of the Program, and made a number of
new investments such as providing $200 million for SNAP Employment and
Training pilots to help participants find jobs and increase earnings,
testing on-line grocery purchases, enhancing retailer standards, and
helping participants stretch their dollars to purchase more fruits and


Expanded access to healthy foods in underserved communities while
increasing farmers and ranchers customer base by making Electronic
Benefits Transfer available at farmers markets

Farmers markets and farm stands can now accept government benefits such as
SNAP and coupons from participants in the Women, Infants and Children
program from an electronic system.


Initiated a Summer Electronic Benefits Transfer demonstration project to
reduce food insecurity among children during the summer

During the school year, millions of children receive nutritious free and
reduced price school meals through the USDA. However, less than a fifth of
these children receive meals through USDAs summer meals programs when
school is out of session. As a result, low-income children are at higher
risk of food insecurity and poor nutrition during the summer. The Summer
EBT demonstration project is meant to help bridge that gap. It has showed
a significant reduction in food insecurity among participating families
and led to positive changes in childrens nutrition.


Increased access to healthy food choices for families participating in

     Increased access to healthy food choices for SNAP participants by
setting new standards for SNAP retailers
     Created a two-year, nationwide pilot to enable SNAP participants to
purchase their groceries online
     Created a purchase and delivery pilot to improve access to groceries
for homebound elderly and disabled SNAP participants
     Helped families avoid food insecurity and hunger during the Great
Recession with higher monthly SNAP benefits
     Incentivized participants in SNAP to purchase more healthy fruits and
vegetables through the Food Insecurity Nutrition Incentive Program

Launched a multi-year, multi-agency Healthy Food Financing Initiative to
leverage private funds to increase the availability of affordable, healthy
foods in underserved urban and rural communities across the country

The Healthy Food Financing Initiative (HFFI) has brought grocery stores
and other healthy food retailers to low-income, low-access communities in
urban and rural communities across America. Without alternatives,
residents of these communities often have to travel long distances to shop
or rely on fast food restaurants and convenience stores that offer little
or no fresh food. With technical assistance, improved access to capital,
and financial support for retailers and other businesses in the food
supply chain, HFFI is expanding access to nutritious food in these

The Work Ahead

President Obama asked each member of his Cabinet to write an Exit Memo on
the progress weve made, their vision for the countrys future, and the work
that remains in order to achieve that vision. Here are their key points on
the work ahead to improve health for all Americans.

Building on the Progress of the ACA

Repealing the ACA, as some have suggested, risks rolling back consumer
protections  like making it illegal to discriminate against those with
pre-existing conditions and improving benefits  for Americans who get
health insurance through the Marketplace, Medicare, Medicaid, or on the
job.  A recent study shows nearly 30 million Americans would lose their
coverage under one version of repeal as well.  We can work together to
make the system even better, but we should build on the progress weve
made, not go backwards.
Secretary Burwell

Reforming the Health Care Delivery System

Building on the successful models developed during this Administration,
while seeking out opportunities to extend value-based payment to an even
broader range of providers and health care services, including high-cost
drugs, not only benefits patients but allows clinicians the flexibility to
practice medicine in the way that best meets the needs of their patients.
The passage of MACRA was a monumental step forward in the effort to reward
quality and value in physician payments; however, additional federal
legislation should be considered that would use payment incentives to
drive the delivery of value-based health care throughout the entire health
care system, improve the interoperability of data, and integrate care.
Secretary Burwell

Developing Precision Medicine

The next great revolution in medicine will emerge from an ability to use
genomic, lifestyle, behavioral, environmental, imaging, and clinical data
to understand health and disease, and to use those insights to develop
tailored prevention approaches and medical treatments.
Director Holdren

Continuing the Fight against Opioids

In late 2015, President Obama appointed me to lead an interagency federal
effort focused on the rural heroin and prescription opioid crisis. In 2014
alone, we lost 28,648 lives too soon and according to NIH, the epidemic
incurs $72 billion in health costs each year. The opioid crisis
disproportionately affects rural communities in part due to the lack of
outreach and treatment resources available in remote areas. After hearing
from mothers and fathers who've lost their children to opioid misuse, and
listening to mayors and medical personnel appeal for greater treatment
resources, it's clear that rural communities need our help.
Secretary Vilsack

Combating the Global Threat of Infectious Diseases

Continued high level U.S. leadership will be critical to maintain momentum
and further institutionalize the gains that have been made, including
through support to WHO and partners for external evaluations and country
planning.  U.S. leadership should include working with partners to follow
through on their commitments, emphasizing the importance of country
preparedness as a national priority, and highlighting the need for sectors
beyond health, including the animal health, development, security,
technology, and foreign affairs sectors, to support this work.
Strengthening the multi-sectoral approach will benefit long-term health
systems and the ability to respond effectively to outbreaks.
Secretary Burwell


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