Myra Parker, JD, PhD, is acting instructor at the Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington and a Robert Wood Johnson Foundation (RWJF) New Connections grantee. This post is part of a series in which RWJF scholars, fellows and alumni who are attending the American Public Health Association annual meeting reflect on the experience.

I took my seven-year-old daughter to help me pick up my registration materials at the Moscone Center. I was thrilled to map the American Indian, Alaska Native and Native Hawaiian (AI/AN/NH) sessions and discover they are located in one of the central buildings this year! It’s terrific to be able to attend the general sessions AND those specific to my community, which has not always been the case with AI/AN/NH sessions held in off-site hotels last year in Washington, D.C.

My daughter was amazed and excited to see the performances outside the convention center. The artistic displays added to the air of festivity as American Public Health Association (APHA) attendees took over the Moscone area. I was excited to see the diversity of attendees across many different professional backgrounds and ethnic/cultural communities.

We attended the American Indian, Alaska Native and Native Hawaiian Caucus General Membership Business Meeting. This was the first time I had the opportunity to attend the business meeting, which included officer elections for the upcoming two years, introductions of members and visitors, and updates on the caucus budget and events. The caucus was able to fund six undergraduate, masters, and doctoral students from AI/AN/NH communities to attend APHA this year at $2,000 each. This is a wonderful new opportunity for these students, each of whom also applied to present a poster at the conference. I plan to attend the caucus social on Monday evening, which includes a silent auction of native art! This fundraiser contributes to the cost of providing caucus-specific sessions as well as to the student scholarship fund. I also learned that if we pack a room at the conference, there is a higher chance the caucus will be able to offer these sessions next year.

This is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act.  Margaret P. Moss, PhD, JD, RN, FAAN, is associate professor, Yale School of Nursing and an alumna of the RWJF Health Policy Fellows program (2008 – 2009).

As I reflect upon the monumental decision by the Supreme Court to uphold the Affordable Care Act, I can’t help but be awed by how the branches of government are alive and well and operating just as they were designed to work.  But as I filter what this decision will mean for the groups I am most closely tied with professionally and personally, I am struck at how the ‘system’—public and private—has largely let them down.

My professional focus has been in aging, and in particular American Indian aging.  My profession is nursing, with a background in law.  I am optimistic that these groups, both patient and provider, will be lifted and solidified by the spirit of this law.  But I am cautious that the letter of the law must be handled with an eye toward impact, unintended consequences, short-term pilot and demonstration projects, and authorized but unfunded rules.

There can be no question that there are provisions in the Act that no-one would dispute are positive.  The most cited are: 1) no more pre-existing condition exclusions, 2) the ability to keep adult children under parents’ plans until after college age, and 3) widening the net for coverage to include those now uninsured. The opposing point being moot now with the Supreme Court’s decision, we must look forward and responsibly carry out the law before us.  Unfortunately, the devil, as they say, is in the details.