It's pretty clear that the political will for health care reform initiatives will be weak for years, if not decades. The bitter battles surrounding passage of the Affordable Care Act and the electronic disasters during rollout, will make it nearly impossible for anyone in Washington to even suggest that this country institute more sweeping health care reform.

Keep in mind that the federal health care law did little to change the flow of money (and the seat of decision-making power) in the health insurance system except to provide more customers for private insurance companies. Ten to 15 percent of Americans will remain uninsured.

One of the few significant improvements in affordable coverage will be for people whose deductibles and premiums may decrease to a more affordable level. That means that the number of underinsured might drop a little.

I have been involved with state and national health care reform organizations for a few decades and something quite disturbing has happened as a result of the passage of the Affordable Care Act. Many organizations formerly dedicated to pushing for substantive reform have put most, if not all, of their energy and resources into the implementation of the Affordable Care Act.

Even more troubling is the fact that many of the major funders of health reform activities have either drastically cut their financial support or moved on to other issues declaring "mission accomplished" for health care reform.

I have been on the board of one of the few national organizations, the Universal Health Care Action Network (UHCAN), still trying to make it clear that the mission has not been completed and that there is still a lot of work to be done to provide universally accessible and affordable health care to all Americans.

There are many other notable organizations such as the Physicians' For A National Health Program, Families USA and others making every effort to stay in the reform struggle for the long haul.

Sadly, many of the funders of UHCAN's activities no longer provide grants. The bulk of financial support that organizations such as UHCAN have relied on have come from foundations and national organizations that have, historically, supported health care reform. As they have moved on, they have left UHCAN without the funding it needs to survive.

UHCAN has been around since the early 1990s and most health care activists would agree that the organization has worked successfully to bring together many of the key reform players so that activists could help the public have not only a voice, but also have enough political power to make it possible for this country to move as far as it has along the road to reform.

But the Affordable Care Act is not the end of reform, it is the beginning. I fear that with the lack of funding and the misguided belief that the health care reform mission has been accomplished, that this country will find it nearly impossible to even talk about what more has to be done to provide equality when it comes to health care.

If one compares the health care reform movement to the emancipation movement against slavery in this country then we have only taken a few modest steps to lay the groundwork for the freedom to live a healthy life without the fear of debt and bankruptcy. Too many Americans remain slaves to a health care system that works well for those who can afford it while the majority of Americans too often feel powerless to free themselves from the chains of economic health care slavery.

We need organizations such as UHCAN to thrive and keep working to make sure this country does not foolishly accept the notion that any significant health care reform has been completed. If we do not find the money and the support to move forward we will not only lose the momentum that took over a century to create, but we will start to lose elements of progress.

Tax-deductible donations to UHCAN may be sent to: Universal Health Care Action Network, 2800 Euclid Ave, Suite 520, Cleveland, Ohio 44115-2418.

Richard Davis is a registered nurse and long-time health care advocate. He writes from Guilford and welcomes comments at