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The Inauguration: Looking Back but Thinking Ahead

I was glued to the TV during Monday’s presidential inauguration, mostly because it’s one of the few times in American civic life so steeped in tradition and references to history.

Picture this. The giant American flags that draped the Capitol represented three eras of the nation’s history - the Betsy Ross flag, the flag used after President Obama’s home state of Illinois became a state in 1818, and today’s flag. They set the backdrop as the president swore the oath of office on the bibles of Abraham Lincoln and Dr. Martin Luther King, Jr. The historical facts roll on and on.

Of course, the pundits focused on recent history, namely President Obama’s first four years. Although the president did not specifically mention the Affordable Care Act (ACA) in his address, he touched on maintaining a safety net – specifically Medicaid, Medicare and Social Security.  The ACA, of course, will likely go down in the history books as his signature piece of legislation. A criticism that may also go down in history books is that his administration didn’t do a very good job of communicating the case for the ACA in the first place. The latest Kaiser News poll shows that the country remains deeply divided about Obamacare: 43 percent in favor, 39 percent against and 19 percent who don’t know or refused to answer.

Because many of the ACA’s provisions go into effect in 2014, this year is crucial for ACA preparation. States are dealing with implementing (and, in some cases, not implementing) health insurance exchanges, deciding whether to expand Medicaid and myriad health insurance reforms.

As Obamacare ramps up, the messages around the legislation will be increasingly directed at consumers, which is crucial. Right now, as many as one in five Americans do not know about the law. For example, how will the public react to the inevitable attention that the individual mandate will receive?

Interestingly, one of the first messages I noticed came from a sector not directly related to health care. A well-known accounting firm is airing a TV commercial featuring an accountant touting that she read “all 900 pages of the Affordable Care Act” to help customers navigate the tax implications of the ACA.

I will be monitoring these messages to see what clues they provide about not only how the health care industry is preparing for 2014, but the public as well.