Healthcare Reform: 2010 in Review

A look at the past year and what's in store for the Patient Protection and Affordable Care Act (PPACA)

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The Patient Protection and Affordable Care Act (PPACA), signed into law in 2010, will continue to ruffle Republican feathers and play out like a political soap opera over the course of 2011.

Efforts to implement the most dramatic shift in healthcare law in more than 40 years began relatively smoothly with passage in the Senate on Christmas Eve 2009. But then Republican Scott Brown took over the Senate seat the "liberal lion" Sen. Ted Kennedy had occupied for half a century, denying Democrats their 60th Senate vote needed for a supermajority to pass the bill.

Democrats forged ahead and managed to get the bill passed by the end of March, however. Opposition continued to stir as Republicans around the country filed the first of some 20 lawsuits against the provision that requires almost every American to have health insurance (or pay a fine) beginning in 2014.

A federal district judge ruled that Congress had overreached with the law by mandating coverage, while two other federal district judges ruled in favor of the law, which they contend is covered in the U.S. Constitution's Commerce Clause. The matter will likely make its way to the Supreme Court of the United States.

In the mid-term elections, Republicans took over the House and gained six seats in the Senate, vowing to dismantle the PPACA.

Meanwhile, benefits from the law began to take effect in the summer and fall, and the public remained as divided on the measure as it had been since the law's passage, thanks in large to what Drew Altman, president of the nonpartisan Kaiser Family Foundation, deems a political stalemate. Americans are ideologically conservative but operationally liberal, he said.

Republicans will likely continue to hold hearings in an effort to delay and defund certain sections of the PPACA throughout 2011.

A measure from the bill that has already taken effect includes the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which requires insurance plans that supplement medical/surgical costs as well as fund mental health and addiction costs to provide equal coverage for both groups. The act has prompted some plans to drop mental health coverage altogether, such as that of the Screen Actors Guild, as a way of circumventing the law.

Measures set to take effect in 2011 include tax credits for small businesses to provide insurance coverage, the elimination of co-pays for preventive care and an age-extension for young adults, who can remain eligible for dependent care until age 26.

Reviewed by: 
Review Date: 
December 28, 2010
Last Updated:
January 7, 2011