Magazine article Policy & Practice

The National Policy Outlook for 2011

Magazine article Policy & Practice

The National Policy Outlook for 2011

Article excerpt

As this issue of Policy & Practice went to press, the 111th Congress was about to end its short but intensive "lame-duck" session--called after the November 2010 elections and composed of members who will continue holding their seats in 2011 as well as those who were defeated. Health and human service programs were the subject of frequent debate and action in this session, just as they were earlier in 2010 and as they will be again in 2011.

The 112th Congress, just convened in January, will continue being closely involved with the programs administered by APHSA's state and local members. As the following articles show, the human service issues on Congress' plate will range from targeted assistance programs such as Temporary Assistance for Needy Families to the financial underpinnings of child welfare, one of the most essential components of any agency's arsenal of family supports.

Congress may spend time on other programs as well, including hearings and other advance work for the scheduled 2012 reauthorization of the Supplemental Nutrition Assistance Program. While SNAP still enjoys broad general support, it is coming under the same increased scrutiny that other programs, particularly TANF, are experiencing: what exactly are taxpayers getting for their investment, and is the program specifically moving us forward toward national public policy goals? SNAP, whose Food Stamp Program predecessor once stirred passionate accusations of errors and fraud, has become one of the mostly tightly managed large programs on the federal landscape. But now, SNAP triggers debates over whether its benefit structure--which allows recipients to make the same grocery choices as any other shopper--promotes healthy eating and does enough to curb the growing public health problem of childhood obesity.

Hanging over all these discussions is a clear sense that countercyclical federal investment in public assistance programs in times of economic crisis--long a cornerstone of the federal-state partnership--has peaked, certainly for the near term. States are required to balance their budgets and so have traditionally turned to Washington when additional funds were needed to meet public need, but there is now wide agreement that health and human programs will do well just to hold on to their past gains.

The Nov. 2 elections were the most recent marker in the changing landscape that APHSA and its members confront. The election results changed the political equation at the local, state and federal levels, most visibly in the Republican takeover of the House of Representatives. Republican gains also narrowed the Democrats' majority in the Senate and captured the majority of governorships. Most governors, no matter their political party, are also taking office for the first time. With these new governors come new cabinet appointments, starkly different budget proposals and the framing of health care reform implementation. Many of the newcomers have vowed to cut spending, especially in the public sector, but how the campaign pledges actually turn into practical governing will be revealed in the coming months.

Budget deficits are a nearly universal problem facing states and the many governors who ran campaigns pledging fiscal discipline. The deficits may particularly challenge states in their implementation of the Patient Protection and Affordable Care Act (P.L. 111-148), commonly known as health care reform. The breadth of tasks related to implementing health care reform is daunting, particularly to those states transitioning to new leadership. States must set up insurance exchanges, overhaul Medicaid enrollment processes, and determine how to pay for the anticipated 16 million additional Medicaid enrollees, among the hundreds of other details in the reform legislation. The governors' newly appointed health and human service commissioners will have significant impact on the implementation of health care reform, which was designed to be flexible and state-specific. …

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