Today the American Action Forum (AAF) released a eye-opening report demonstrating that the Department of Health and Human Services has serially failed to implement the Patient Protection and Affordable Care Act's (PPACA) numerous regulatory provisions on schedule.
PPACA's manifold regulations did not become effective law with President Obama's signature in in March of 2010; rather, the law establishes a time-table for the gradual implementation of its core provisions. However, the AAF's research shows that of the 42 regulations whose statutory deadlines have already passed, only 20 of them have actually become law.
The Obama administration's failure to implement almost half of the regulatory provisions mandated by its own law to date raises two challenges for trying to predict PPACA's effect on the health care market and the economy writ large.
First, and most obviously, it tells us that the regulatory scheme that PPACA imposes on the nation is complex and difficult to implement. Second, PPACA has increased and will continue to increase regulatory uncertainty in the economy. It will be very difficult for large and small businesses, insurance companies, and health care providers to adequately plan to adjust to the myriad demands that PPACA makes on them when critical details continue to be unknown.
Regulatory "uncertainty" may seem an abstract issue, but it can have a very real and harmful impact on the health care market and the economy as a whole.
Uncertainty in the state of health care regulation makes it difficult for health care providers and insurers to carry out their work in an efficient and cost-effective manner, simply because they don't know what rules they're operating under, and they don't know if or when those rules may change. Businesses likewise suffer, as regulatory uncertainty makes it difficult for them to predict their future costs, which provides a disincentive against making additional investments and hiring.
This, in fact, may be why a recent poll taken by the International Foundation of Employee Benefit Plans found that many businesses (and a majority of small businesses) believed that a Supreme Court decision overturning the entire Affordable Care Act would be the best outcome for them.