Every US president for the past century has plied the power of the Oval Office to influence or enact healthcare legislation and policy. While most presidential administrations recognized the structure of the healthcare in the United States as a complex adaptive system (CAS) and offered correction to mitigate or redirect problematic situations, the Patient Protection and Affordable Care Act (PPACA) introduces sweeping restructuring changes. The PPACA restructuring is tantamount to a compilation of a century of health legislation into a single overarching change.
One of the main focus points of the PPACA is to reduce the number of the uninsured through a myriad of arrangements, both popular and unpopular. The legislation is based on the idea of eliminating the uninsured population by mandating the purchase of health insurance. The legislation provides for states to establish health exchanges to allow residents to purchase healthcare policies. The federal government will provide subsidies for the states to establish the exchange. The legislation makes it mandatory for each health plan to contain a schedule of predetermined health factor coverage standards. The realization is that many existing health plans not containing the predetermined coverage standards will no longer be in compliance with the PPACA and will be discontinued.
The migration of individuals to the state exchanges can be achieved through a carefully choreographed process. The process will systematically deem many existing health policies invalid due to gaps in health factor standards as mandated in the PPACA. The second step will expand the roles of Medicaid through state exchange enrollment, moving toward the goal of reducing the number of uninsured. The intention is to drive health plan enrollment through state exchanges in an effort to balance cost and reduce financial risk vis-à-vis a wide spectrum of policies and premiums.