How quickly the politics of health care has changed. Just over a month ago, the country was debating whether President Obama's health reform law, aka "Obamacare," should be saved or scrapped. Now, with the president's reelection, that's all settled, and regulators, states, employers, and health care providers are rushing to get ready for a transformed system that is coming in 2014.
This involves several challenging tasks. Industry is readying itself for hundreds of pages of regulations, insurance companies for new products and some 7 million new customers in the first year, states for an IT infrastructure unlike anything they have seen. Employers are facing a raft of new requirements, including an obligation to cover all of their workers or pay fines for not doing so. Congress's role is minuscule. House Speaker John Boehner acknowledged as much days after the election, when he said that Obamacare is "the law of the land" and that repeal efforts were over.
But the lingering uncertainty around the law -- and its expansive ambitions -- means that the work to be done between now and January 2014 is enormous.
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Some 50 million people in the United States are without health insurance, and nearly 40 million of them stand to benefit from the law. In states that choose to expand their Medicaid programs, all residents who earn below 133 percent of the federal poverty limit, about $15,000 annually for a single person, can sign up for the federal-state Medicaid program. And in every state, people of moderate income will be eligible for tax credits to help them buy health plans on regulated public marketplaces, called exchanges.