Stephen H. Gorin, Julie S. Darnell, and Heidi L. Allen
This entry describes the development and key provisions of the Patient Protection and Affordable Care Act (ACA), which instituted a major overhaul of the U.S. health system, much of which took effect in 2014. The key provisions of the ACA included an individual mandate to purchase insurance, an employer mandate to offer coverage to most workers, an expansion of Medicaid to all persons below 138 percent of the federal poverty level (FPL), minimum benefit standards, elimination of preexisting condition exclusions, and reforms to improve health-care quality and lower costs. This historic legislation has deep roots in U.S. history and represents the culmination of a century-long effort to expand health care and mental health coverage to all citizens.
Stephen H. Gorin and Terry Mizrahi
This entry presents an overview of national health-care reform in the United States, from its introduction into the public policy agenda at the turn of the 20th century through policy debates and legislative proposals more than a century later. Specifically, it concentrates on the programs and strategies to obtain universal coverage for health and mental-health services for all Americans at the national level, with limited success. It ends with a discussion of the Affordable Care Act (ACA). Special emphasis is laid on the roles of social workers and their professional organizations during this period.
In social work, social capital is linked to both the prevention and treatment of mental and physical health. This concept has also been incorporated in the development of empowering interventions with marginalized minorities. The capacity-based and the youth development models of intervention, both call on social service organizations to work interdependently around meeting the needs for the human and social capital growth of youth (Morrison, Alcorn, & Nelums 1997). Social capital is also a feature of empowering interventions in neighborhoods and community development, as is collective efficacy, which is a measure of working trust that exists among residents and has been popularized as a way to stop youth high-risk behavior.