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Although it is unlikely that the legislative endeavors of 1996 and 1997 relating to the health care industry will be matched in 1998, implementing regulations of the Balanced Budget Act and the Health Insurance Portability and Accountability Act will predicate the successes or shortcomings of these new laws in 1998. It is important that NPs stay in close contact with their state legislators and Medicaid officers responsible for implementing the SCHIP. NPs should also closely track efforts at the Federal level to ensure inclusion of non-physician providers in legislation that is important to NPs, such as bans on "gag" clauses--a protection that should include all health care providers.

Associated with the AIDS epidemic are some of the most difficult policy dilemmas society faces. The issues surrounding HIV are complex and involve legal, medical, ethical, and practice issues. In addition, many policy issues have received and will continue to receive attention--education, public health measures, health care delivery and financing issues, legal issues, state laws and regulations, labor and employment issues, and international concerns. The debate will most certainly continue to heat up. To contribute positively to the public policy debate, nurse practitioners must become knowledgeable about the disease--including its epidemiology--and examine their own practices, feelings, and attitudes regarding this deadly disease.

The potential effects of the report reach far into the health care community. This report could mark the beginning of an era of increased preventive health care. How the report is followed-up, however, is the key to the Year 2000 equation. Countless hours of study and countless dollars have, in the past, produced valuable reports similar to the Year 2000 report. Yet, the results of these other reports, because of lack of follow-up, are less than impressive. If the contributions of more than 7000 individuals are to translate to better health for the nation in the year 2000, follow-up measures must be enacted. This is an opportunity for action on the part of NAPNAP and all pediatric nurse practitioners.

For many pediatric and family nurse practitioners, the Medicaid victory may be the high point of the first session of the 101st Congress. State activities to implement the new Medicaid statute will require many of the resources of NAPNAP members during the upcoming years, however, and implementation of the Medicaid provisions will require a well-designed strategy and careful follow-up.