Achieving a Deeper Understanding of the Implemented Provisions of the Affordable Care Act

time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform. The ACA was signed into law on March 23, 2010. Sincethat time thousands of pages of regulations have been written to implement the law; legal cases have been fought and continue to be fought regarding the constitutionality of the various provisions; states have chosen to varying degrees the way in which they will implement the law; and, fınally, patients and providers have begun to experience the effects of the insurance provisions as the law “went live ” on Jan. 1. We have previously published on the major provisions con-tained in the law as passed.1 The purpose of this article is to clarify how those provisions have been implemented and t