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Implementing the Affordable Care Act: Views from Parallel Universes

Implementing the Affordable Care Act: Views from Parallel Universes. Hanns Kuttner Visiting Fellow Hudson Institute. Only the past is certain. Public Law 111-148, signed March 23, 2010 Some provisions already in place Most take effect in the future.

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Implementing the Affordable Care Act: Views from Parallel Universes

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  1. Implementing the Affordable Care Act:Views from Parallel Universes Hanns Kuttner Visiting Fellow Hudson Institute

  2. Only the past is certain • Public Law 111-148, signed March 23, 2010 • Some provisions already in place • Most take effect in the future

  3. Different beliefs about how the future will unfold • Not all share the belief that the Affordable Care Act will be implemented as described in the law signed March 23, 2010 • These different sets of beliefs reflect different expectations about the future. • Thus the phenomenon of parallel universes.

  4. Base case • Affordable Care Act implemented as described in law signed March 23, 2010 • Implemented on the timeline laid out in the March 23, 2010, law.

  5. Another Universe:Part/All Not Constitutional • Argument: ACA exceeds Congress’ authority. • Currently at district court level • Potential to reach appeals court later in 2011 • If Supreme Court review, 2011/12 or 2012/13 term

  6. Another Universe:Repeal and Replace • Its all about the 2012 election. • Repeal: clear • Replace: not

  7. Another Universe:Direct Federal Administration in Some States • HHS to administer Exchanges in states where states do not act • Go/no go decision in 2012? 13?

  8. Another Universe:Fiscal Crisis Interaction • Easier to take away things the people don’t have yet than things they do • Possibilities: • Rethink subsidy scheme • Delay implementation of subsidies/Medicaid expansion

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