Patient protection and the Affordable Care Act: implementation issues for the individual and employer mandates

Document Type


Publication Date

Fall 2015


Under the Patient Protection and Affordable Care Act (the "ACA"), will individuals in the U.S. have more options for obtaining affordable, comprehensive healthcare coverage? Or will there be an increase in healthcare costs under the ACA that will force individuals to forego insurance and pay the penalty or to enroll in a government regulated marketplace -- the "Exchanges" -- to purchase a healthcare plan? The options for obtaining health insurance will be determined, in part, by how well the ACA's mandates and its provision of benefits for qualifying individuals are administered by the IRS. The additional funding necessary to implement the ACA, and the short turn-around time required, are real concerns. There are also concerns about potential for fraud, and the U.S. Supreme Court is stepping in to determine the availability, under current law, of the premium tax credit for taxpayers purchasing insurance through a federally-facilitated Exchange. To understand the full effect of the ACA on the choices that individuals will make, one must not only understand how to assess the premium tax credit and individual mandate, but also the controversies that must be overcome for successful implementation.


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