Question

A major change in health care law in the U.S. is the passage of the Patient Protection and Affordable Care Act of 2010. How did each of the various sources of our laws – common, statutory, and administrative – play a role in making the PPACA law?

Answer 1

Beyond insurance, the Affordable Care Act begins the job of realigning the health-care system for long-term changes in health-care quality, the organization and design of health-care practice, and health information transparency. It introduces many broad changes into Medicare and Medicaid that empower both the Secretary of the U.S. Department of Health and Human Services (HHS) and state Medicaid programs to test new modes of payment and service delivery, such as medical homes, clinically integrated “accountable care organizations,” payments for episodes of care, and bundled payments. All of these changes are intended to allow public payers to slowly but forcefully nudge the health-care system into behaving in different ways in terms of how health professionals work in a more clinically integrated fashion, measure the quality of their care and report on their performance, and target for quality improvement serious and chronic health conditions that result in frequent hospital admissions and re-admissions. HHS and the states are expected to test payment and delivery system reforms that also attract private payer involvement to maximize the potential for cross-payer reforms that can, in turn, exert additional pressure on health-care providers and institutions.
The Act also invests within the development of a multi-payer National Quality Strategy, whose purpose is to get multi-payer quality and efficiency measures to market value purchasing, greater safety, and far more extensive health information across public and private insurers. In this regard, the Act ultimately will build on the Health Information Technology for Economic and Clinical Health Act, enacted into law in 2009 as part of the American Recovery and Reinvestment Act, and further lays the groundwork for performance reporting on a system-wide basis in order that patients can more readily get information about their own health care and how their health-care providers perform. In addition, the Act establishes the Institute for Comparative Clinical Effectiveness Research to promote the type of research essential to identifying the most appropriate and efficient means of delivering health care for diverse patient populations. Throughout these initiatives to improve quality and information, the Act emphasizes efforts to collect information about health and health-care disparities to allow the nation to better assess progress not only for the population as a whole, but also for patient subpopulations who are at elevated risk for poor health outcomes.
Even as the legislation invests nearly $1 trillion over the 2010–2019 time period aimed at making coverage affordable, the Act more than offsets these expenditures through curbs on Medicare and Medicaid spending, new taxes on high-cost plans, and tax shelters used most heavily by affluent families. The Act significantly alters the obligations and reporting rules for nonprofit hospitals by imposing new conduct and reporting obligations on hospitals as a condition of maintaining their federal nonprofit status (a tax exemption worth more than $100 billion annually; states also provide parallel exemptions). The changes include requiring hospitals to undertake ongoing community health needs assessments; furnish emergency care in a nondiscriminatory fashion (a requirement already applicable under the Emergency Treatment and Active Labor Act; which is unaltered by the Affordable Care Act); alter their billing and collection practices; and maintain widely publicized written financial assistance policies that provide information about eligibility, how the assistance is calculated, and the way to use for assistance.

The comprehensive health care reform law enacted in March 2010 (sometimes referred to as ACA, PPACA, or “Obamacare”). The law has 3 primary goals: Make affordable insurance available to more people. Also support innovative medical aid delivery methods designed to lower the prices of health care generally to all the people in the society.