The Patient Protection and Affordable Care Act (PPACA) and the related amendments contained in the Health Care and Education Reconciliation (HCERA), referred to herein as the Reform or Affordable Care Act (ACA), represent one of the most sweeping and costly legislative provisions in the history of the country. With an estimated cost of just under $1 trillion—a figure challenged by many as low because of the manner in which the Congressional Budget Office is required to score legislation—that, in turn, is supposed to be financed by dramatic cuts in Medicare spending along with a bevy of new taxes, it comes at a time when the nation faces unparalleled crisis with runaway entitlement spending and a burgeoning national debt in the middle of the Great Recession. Among other goals, the legislation seeks to add 20 million individuals to the Medicaid program atop the existing 50 million, a number that has increased significantly due to the recession. Another 16 million individuals are supposed to obtain coverage through Affordable Insurance Exchanges established by each of the 50 states to bring consumers and insurers together on the Internet. All of this is alleged to occur while the solvency of the Medicare Trust Fund is extended, something certain to challenge the imagination of any professional facile with the numbers.

This Guide is targeted to be useful to finance and operations personnel in the healthcare provider community as well as finance and benefits personnel in the ...

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