The Rule-making Process within the Affordable Care Act

Running head: Legal Research and Writing 1
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Running head: Legal Research and Writing 2
The Rule-making Process within the Affordable Care Act
The Affordable Care Act which is also known as the Obamacare brought fundamental
changes to the healthcare coverage, regulation and insurance all over the United States. The
Act was either strongly supported or opposed and this saw its enactment process to be
controversial and unorthodox. A fundamental element of the enactment process is that the
Act is not the only health care bill which became law. Instead, it is composed of two laws
which include the Patient Protection and Affordable Care Act (Pub. L. No. 111-148, 124
STAT. 119) and the Health Care and Education Reconciliation Act of 2010 (HCERA) (Pub.
L. No. 111-152, 124 Stat. 1029. The enactment of the Affordable Care Act occurred on
March 23, 2010 in order to reconcile the differences between the House version and the
Senate bill regarding healthcare legislation. The Act is intended to expand and reform health
coverage. The Health and Human Services Secretary is the one responsible for the
development of the body which regulates the Affordable Care Act. The U.S government has
proposed rules and generated various guidance documents for the clarification and
redefinition of the rules.
The organization of Good Health may seek to modify the rule making process under
the Act so that the Act adopts the narrower definition of the phrase 'standardized nursing care'
that was adopted by the Fifth Circuit Court of Appeals instead of the broader definition
adopted by the Ninth Circuit Court of Appeal. This is because the broader definition poses
increased costs to the organization as well as the clients for the organization which will
ultimately become detrimental to the provision of health care. This means of modification
may be hectic to be relied on by the organization because it would involve taking back the
Act to the legislature for amendments. However, if they successfully convince the
parliamentarians, then their grievances would be successfully addressed.

Running head: Legal Research and Writing 3
Judicial challenges for agency action
Overview of Health Reform Law
The Affordable Care Act has a significant effect on federal revenues and expenditure.
The law includes expenditure of subsidizing the purchase of coverage for health insurance
through the exchanges and increased programs for the expansion of Medicaid. The Act also
provides for appropriate funding of temporary programs to foster for more access and
funding available for targeted groups. The costs required to expand private and public health
insurance coverage as well as other expenditure are catered for by revenues generated from
new fees and taxes as well as savings from from health care delivery and payment system
reforms that are designed for reduction of expenditure on Medicaid and more programs of
federal health care.
The Act is supposed to make provisions for affordable health care. It is for this reason
that as the administrator of Good Health, I would seek for judicial review in the rule under
the Act's standardized nursing care because it injures the organization's finances as well as an
extra cost to the clients. The organization is more likely to be successful if it moves to the
court to convince the court to be able to adopt the narrower definition of 'standardized
nursing care' as was adopted by the Fifth Circuit Court of Appeal even though this is not the
definition which was adopted by the Act. This move would see the organization offset the
threat on its finances and those of its clients.
Market Reforms and Coverage Expansion: Pre-2014
The law provides for various temporary programs in order to improve the funding and
access for the targeted group. They include temporary pools of high risk for uninsured
individuals who have pre-existing conditions, a reinsurance program of reimbursing