Health-Care Overhaul Law Has Tumultuous First Year

March 24, 2011

The Wall Street Journal

Katherine Hobson

A year ago today, President Barack Obama signed the health-care overhaul bill.

As we wrote then, “the executive and legislative branches have been the center of attention in Washington during the health-care fight so far, but the stage could soon be shared by the judiciary.” Indeed, there have been 25 cases challenging the law, according to this scorecard from Kaiser Health News.

Earlier this month, a U.S. District Court judge stayed his Jan. 31 ruling that the law violates the Constitution, which means implementation will continue as the issue works its way through the court system. Most everyone expects the Supreme Court will eventually rule on the law.

Meantime, now that the House of Representatives is controlled by Republicans, the law faces a whole new set of challenges from the legislative branch, though the Democrats’ control of the Senate has already prevented wholesale repeal. The administration itself, faced with the new political landscape, has said it will be flexible on issues such as giving the states more leeway in how they carry out the law’s requirements.

As for the U.S. public, while a host of benefits have kicked in — including coverage for dependents up to age 26 and discounted drugs for Medicare beneficiaries who hit the dreaded “doughnut hole” — confusion still reigns, and opinions remain divided.

So what should we expect to happen in the next year? Kaiser Health News asked a bunch of interested parties, including the secretary of health and human resources in Virginia (one of the states challenging the law), the U.S. Chamber of Commerce’s director of regulations and the head of Medicaid Plans of America. Some of their predictions: states will be busy trying to get their insurance exchanges ready for implementation in 2014, accountable care organizations will be forming and we may be waiting for a ruling from the Supreme Court.

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