{
  "id": "R41664",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R41664",
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      "id": 409929,
      "date": "2012-07-03",
      "retrieved": "2016-04-07T00:01:50.617670",
      "title": "ACA: A Brief Overview of the Law, Implementation, and Legal Challenges",
      "summary": "In March 2010, the 111th Congress passed health reform legislation, the Patient Protection and Affordable Care Act (ACA; P.L. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (HCERA; P.L. 111-152) and other laws. ACA increases access to health insurance coverage, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. It also expands Medicaid coverage. The costs to the federal government of expanding health insurance and Medicaid coverage are projected to be offset by increased taxes and revenues and reduced spending on Medicare and other federal health programs. Implementation of ACA, which began upon the law\u2019s enactment and is scheduled to unfold over the next few years, involves all the major health care stakeholders, including the federal and state governments, as well as employers, insurers, and health care providers. \nFollowing the enactment of ACA, individuals, states, and other entities challenged various provisions of ACA on constitutional grounds. Many of these suits addressed ACA\u2019s requirement for individuals to have health insurance (i.e., the individual mandate), and claimed that it is beyond the scope of Congress\u2019s enumerated powers. The expansion of the Medicaid program was also challenged, as state plaintiffs contended that the expansion impermissibly infringes upon states\u2019 rights, coercing them into accepting onerous conditions in exchange for federal funds. \nOn June 28, 2012, the Supreme Court issued its decision in National Federation of Independent Business v. Sebelius, finding that the individual mandate is a constitutional exercise of Congress\u2019s authority to levy taxes. However, the Court held that it was not a valid exercise of Congress\u2019s power under the Commerce Clause or the Necessary and Proper Clause. With regard to the Medicaid expansion provision, the Court further held that the federal government cannot terminate current Medicaid program federal matching funds if a state refuses to expand its Medicaid program. If a state accepts the new ACA Medicaid expansion funds, it must abide by the new expansion coverage rules, but, based on the Court\u2019s opinion, it appears that a state can refuse to participate in the expansion without losing any of its current federal Medicaid matching funds. All other provisions of ACA, as amended by HCERA, remain intact.\nThis report provides a brief summary of major ACA provisions, implementation and oversight activities, and current legal challenges. For more detailed information on ACA\u2019s provisions, CRS has produced a series of more comprehensive reports, which are available at http://www.crs.gov. The information provided in these reports ranges from broad overviews of ACA provisions, such as the law\u2019s Medicare provisions, to more narrowly focused topics, such as dependent coverage for children under age 26.",
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    {
      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc819668/",
      "id": "R41664_2012Mar23",
      "date": "2012-03-23",
      "retrieved": "2016-03-19T13:57:26",
      "title": "ACA: A Brief Overview of the Law, Implementation, and Legal Challenges",
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      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc816171/",
      "id": "R41664_2011Mar02",
      "date": "2011-03-02",
      "retrieved": "2016-03-19T13:57:26",
      "title": "PPACA: A Brief Overview of the Law, Implementation, and Legal Challenges",
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