The Affordable Care Act – Overwhelming and Confusing?

This past Monday, the Department of Health and Human Services released the operating rules for state-run health insurance exchanges.  This is interesting enough in itself , since the government provides guidance on how states should establish exchanges, qualify health plans for participation and determine the eligibility of small businesses and individuals.  However, I find it extremely interesting for another reason – the volume of the rules.

Think about it.  The Affordable Care Act was about 2,400 pages long.  Very few actually knew what it contained.  Even in March of 2010, Nancy Pelosi, then Speaker of the House, was quoted as saying “We have to pass the bill so you can see what’s in it ….”  Since it was passed, many individuals and professional organizations have been asking the various agencies in the government for more details about specific sections and how they will be applied.  Often the answer is something similar to “Further guidance will be provided.”

Now we have further guidance on the state exchanges.  The final rule released this week contains 642 pages.  And I am sure that further pages will be released to explain some of the rules listed in those 642 pages.  So if just one aspect of the Affordable Care Act has already taken 642 pages to explain, how many pages will it take to explain the more than 2,400 pages of the full act.

If you look at it from this perspective, it should come as no surprise that there are still many who feel overwhelmed and possibly confused by all the implications of the Affordable Care Act.