Americas Quarterly, August 2, 2010

On March 23, President Barack Obama signed into law a sweeping reform of the U.S. healthcare system. The law, as signed, imposes a host of new requirements on private insurance companies. It expands existing government insurance programs, creates new institutions to oversee insurance markets, offers new subsidies to the uninsured, and requires citizens to have coverage - all in order to expand access to healthcare to 32 million uninsured U.S. citizens and legal residents. Of course, it remains to be implemented. Congress can still delay. Republicans who opposed the bill may refuse funding for individual provisions, and if they win a majority in the 2010 Congressional midterm elections, they may be able to repeal the bill entirely. The key date is really 2014, when many of the provisions of the legislation will begin. A new Republican president in 2012 could have a substantial impact on implementation. As it stands right now, three questions remain. What will happen? When will it happen? Who is responsible?



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