ABSTRACT
This chapter explains the primary reasons that influenced passage of the Patient Protection and Affordable Care Act (PPACA). It describes how the PPACA impacted insurance coverage and access to care and how the PPACA was modified because of Supreme Court decisions regarding contraceptive coverage and Medicaid expansion. There are various indicators of health care costs in the United States. The National Health Expenditure (NHE) is one, which began in 1960. Health care costs are also influenced by uncompensated care, which is non-reimbursed, charity care for people who have little or no insurance. Beginning in 2014, all US citizens and permanent residents were required by the ACA to have minimum essential coverage or to pay a fine (tax penalty), even though not everyone is required to purchase health insurance. The chapter presents a case study of a Florida-based company that employs 52 full-time employees and currently only offers health care benefits to ten senior managers.
