Obama Administration To Accelerate Work on ACA Implementation

Now that the future of the Affordable Care Act is significantly more certain with the re-election of President Obama, the Obama administration must work quickly to ensure that many of the law's key provisions are ready for implementation before the ACA is scheduled to take full effect on Jan. 1, 2014, the AP/Sacramento Bee reports.

Over the past two years, the administration has been planning for the full implementation, but officials also have spent significant time defending the law. According to the AP/Bee, officials now have to shift to the execution phase (Alonso-Zaldivar, AP/Sacramento Bee, 11/8).

To that end, the administration over the next 11 months will be expected to release a raft of guidance and regulations, which will include:

• Details on how states and the federal government will operate the health insurance exchanges;
• Rules defining how insurers must accept all individuals regardless of pre-existing conditions;
• Instructions for insurers to develop different premium rates based on age (Radnofsky/Wilde Mathews, Wall Street Journal, 11/7); and
• Guidelines for employers on the definitions for "full-time" and "part-time" employees (Zigmond, Modern Healthcare, 11/7).

By Nov. 16, all states are expected to inform the federal government whether they will set up their own insurance exchanges or defer to the government to run one for them. Open enrollment for plans available in the exchanges is scheduled to begin on Oct. 1, 2013, and coverage will be effective on Jan. 1, 2014 (Millman, Politico, 11/8).

However, some observers say they have doubts that states and the federal government will be ready to meet the law's deadlines.

David Cordani, CEO of Cigna, said, "It's going to be an all-out spring in many ways to bring that forward ... there's a lot to transpire" (Wall Street Journal, 11/7).

Ilisa Halpern Paul -- managing government relations director for the law firm Drinker Biddle & Reath in Washington, D.C. -- said she thinks that some of the ACA's most unpopular provisions -- such as an excise tax on medical devices and the creation of an Independent Payment Advisory Board -- will be modified or repealed to accelerate the implementation process (Modern Healthcare, 11/7).