The Patient Protection and Affordable Care Act, commonly
referred to as the Affordable Care Act (ACA), was enacted in March
2010, but its primary provisions go into effect Jan. 1, 2014.
The ACA is the most sweeping and widespread federal program in
decades, equivalent to passage of the Social Security Act in 1933
and Medicare Act in 1964. During the past three years, three
Cabinet-level federal agencies (Departments of Health and Human
Services, Labor and Treasury, which includes the Internal Revenue
Service [IRS]) have been drafting regulations and guidelines
governing implementation. The regulations are a work in progress,
but the basics of what is required of employers now are known.
The ACA's three principal purposes are to expand access to
affordable health care, thereby increasing the number of Americans
with health insurance coverage by about 30 million; reduce the rate
of health insurance premium increases that had more than doubled
during the decade before the ACA's passage; and prohibit certain
insurance practices that adversely affected individuals with health
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