Along the arduous, confusing, and contentious road to the enactment and implementation of the Affordable Care Act (ACA), no single date stands out as more consequential for the health and well-being of the US public as does January 1, 2014. Barring unforeseen circumstances, this date will stand out as transformational in the annals of US health care reform. On that day, 4 fundamental provisions of the ACA will take effect. First, extension of the “guaranteed issue” provision to all individual health insurance policies inclusive of the elimination of “medical underwriting” in the face of a preexisting condition. Second, implementation of the “individual shared responsibility” provision also known as the “individual mandate.” Third, provision of tax credits and cost-sharing subsidies to middle- and lower-income adults for the purchase of individual health insurance. And fourth, expansion of Medicaid coverage in participating states to include previously ineligible low-income adults. Most Americans, including physicians and other health care professionals, may not appreciate the profound nature of these new realities. This oversight could be attributable to the daily dramas and controversies of the government shutdown, the woes of the HealthCare.gov website, the cancelation of individual health insurance policies, and the establishment of limited physician networks. In this Viewpoint, we assess the significance of the reforms in question and the implications thereof for the US health care system.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 2
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.