PPACA's Advance Poses Challenges for Rural Healthcare
The U.S. Supreme Court's ruling last month upholding the Patient Protection and Affordable Care Act resolved constitutional questions about the sweeping law. Now states are left with the challenge of implementing it.
And reports show a huge variance in readiness from state to state, particularly as it relates to health insurance exchanges.
"There are a number of states, about one dozen, that have made significant progress on their decision-making and what they are going to do about exchanges," says Sandi Hunt, a principal at PriceWaterhouseCoopers. "They have passed legislation. They have begun the process of planning for the exchange. But even those that are taking very active approach have a huge amount of work to do to be ready to go by 2014 and there are large numbers of states that have to make the decision to either accept the federal exchange or develop the state exchange."
Hunt says the biggest challenge for most states is deciding "how active they want to be in the health insurance market and if they want to be active how to do that in a way that makes the whole insurance market work," she says. "There are some important decisions to make in terms of how active the states want to be, if they just want to allow the health plans to offer whatever plans they want, or if they want to guide the market to more delivery system reform."