As the record low temperatures hit the Midwest and Northeast earlier this month, kids and adults alike rejoiced as schools and commutes were cancelled so that people could stay inside where it was warm and safe.
Others may have had to make stark choices like to "heat or eat," choosing between staying warm and other essentials, like food or medicine.
Chronic conditions, untreated mental illness, injuries and gaping health disparities plague our healthcare system every single day. During a localized "cold emergency" like the polar vortex, or a large-scale disaster like a hurricane or tornado, these problems can get worse. Fortunately, in the past few years, there have been health reforms that ultimately make Americans more secure and disaster-ready.
The Affordable Care Act (ACA) makes it possible for Americans to access quality, affordable care and health insurance. Because of the law, you can no longer be denied coverage or charged more because of a pre-existing condition. The law also gives states the opportunity to expand Medicaid coverage. With the Medicaid expansion alone, millions of the lowest-income Americans will gain access to the care they need to stay healthy. Many will gain the security and peace of mind that comes with insurance for the first time in their lives.
This is important because the best indicator of how an individual or community will fare and recover after an emergency is how it was doing before the emergency. Odds are that if you are healthy before a disaster strikes, you'll be better able to get out of harm's way. You'll likely fare better if your power gets knocked out, need to evacuate or worse, or lose your home. You will probably recover faster too if you do get hurt.
While health insurance doesn't guarantee that you'll be healthy, it certainly makes it more likely. Health insurance plugs you into the system, and makes is easier to get needed preventive care and disease management. If you are healthier day to day, you'll be more self-reliant in a disaster. When individuals can take better care of themselves, it's good for the entire community. Whether in an outbreak, earthquake or storm, those with these resources can better care for themselves, allowing the authorities to focus on the most vulnerable right away.
Insurance also shields you from the staggering costs of an emergency room visit or hospitalization if you end up sick or injured because of the disaster. If your injury or illness requires long-term care, health reform also makes a difference. The ACA ends lifetime and annual dollar limits on essential health benefits, which protects survivors from medical bankruptcy and allows them to focus on healing.
Importantly, the ACA also requires mental health care and substance abuse services to be covered like any other kind of healthcare, extending these benefits to millions of Americans. In other words, survivors will already have these tools available to heal from the loss and trauma of a crisis already built into their existing plans. It also means that millions who suffer from untreated mental illness can get care before disaster strikes.
Reforms stretching even beyond the ACA also aid emergency response. For example, the Recovery Act in 2009 led to a shift from paper health records to electronic ones. When a tornado tore through Joplin, Mo., in 2011 and destroyed a hospital, old paper and film records were destroyed. Yet the medical personnel retained full access to their patients' electronic health records, allowing nearby hospitals and providers in makeshift emergency rooms to pull up survivor records. Today more than 330,000 health care providers use electronic health records, improving care during disasters and reducing the odds of unnecessary and dangerous medical complications.
There is still much work to do to prevent, prepare for, respond and recover from the adverse health effects of public health emergencies. However, health reform puts into motion important steps to make Americans more resilient and protected in the face of disaster.
Nicole Lurie is the Assistant Secretary for Preparedness and Response at Health and Human Services.