posted on: Thursday, June 28, 2012

By Niki Jagpal

In a historic ruling today, the Supreme Court of the United States (SCOTUS) upheld an important provision of the Patient Protection and Affordable Care Act (ACA). In a 5-4 decision, with Chief Justice John G. Roberts, Jr. tipping the scales, the individual mandate section of the ACA is now safe. In his statement, Roberts said that ACA does not actually impose a true mandate on Americans because it simply requires those who do not have health insurance to pay a tax penalty by 2014. Roberts said that the federal government does not have the authority to order citizens to purchase health insurance but that it does have the power to levy a tax on the uninsured.

While conservatives are already voicing their opposition to today’s outcome, this is welcome news for all who have fought the long and hard battle to secure the most significant health insurance reforms that will be operationalized over the next few years.

Communities are already benefiting from ACA. For example, a study done by the Virginia Commonwealth University on a group of lower-income and uninsured people enrolled in a community-based primary care program for three years found that inpatient costs decreased each year, there were fewer emergency department visits and per-patients costs declined from $8,899 to $4,569.

So with today’s decision, the question I’d like to pose for health-focused foundations is this: How will today’s SCOTUS decision inform your grantmaking?

In Towards Transformative Change in Health Care, health philanthropy veteran Terri Langston looks at the ACA and the benefits of prioritizing underserved communities and social justice in health care. She offers recommendations for ways that foundations can help improve our country’s health care. She encourages funders to ask some themselves some key questions such as:

• What percentage of your grant dollars is used to intentionally benefit underserved communities in your catchment area? How does that compare with exemplary grantmakers in your field?
• Does your foundation support community organizing? Are you familiar with the organizing groups in your area and have you sought them out to learn about their work? What are the barriers that may prevent you from supporting organizing?
• Have you turned to local or state experts for information on the health reform law? What is your state’s position on the implementation of ACA and how can you find out? Does your foundation have a position and is it public?
• Does your foundation support advocacy and civic engagement work? If not, have you sought out the advice of other funders and national organizations that do support advocacy? What type of health care advocacy organizations exist in your state and community?

And in a follow up piece, Langston and Jennifer Ng’andu from the National Council of La Raza offers some principles to guide philanthropy’s role in health reform.

Kudos to the SCOTUS for making the right decision – now is the time for philanthropy to step up and help our communities achieve better health outcomes.

Niki Jagpal is research and policy director at the National Committee for Responsive Philanthropy (NCRP).