Talk:Affordable Care Act/Archive 14

Initial discussion
Right before the holidays, once again requested a Good Article Reassessment (see diff) because, presumably, he suspects this article no longer satisfies one or more of the Good Article criteria. Yet once again, no reason for the GAR request was given, major contributors to the article (such as DrFleischman, George Orwell III, Sb101, and myself) were not notified, the most recent GA reviewer (LT910001) was not notified, and the relevant WikiProjects were not notified. All of these steps are required by WP:GAR, as I have pointed out before. A reason for why this article may no longer satisfy the Good Article criteria would be particularly helpful; this article has changed little since it was promoted to GA at the end of October. (The best I could tell, the last time George Ho requested a GAR was because the article was experiencing an edit war at the time, although that reason was never made explicit. Either way, the article has been stable for about a month now, so that cannot rationally be the reason this time.)

I will not remove the GA request at this time, but unless these steps are followed soon, I will do so. The reason I am bringing this up here, instead of George Ho's talk page again, is because this is the third time that he has failed to explain or give notice of a GAR request for this article, and if nothing else the editors monitoring this talk page should have the opportunity to weigh in on how to address the issues that prompted the GAR request. But that is difficult to do without knowing the reasons for the GAR request. If George Ho believes the article has deteriorated over the past several weeks to the point that it cannot be fixed without a GA review, then a GAR request certainly is appropriate. But repeatedly playing the guessing game as to what George Ho believes needs improvement is getting quite tedious and tiresome. There are editors continuously working to improve this article who I have little doubt would be more than interested in addressing any deficiencies the article may have, assuming that they are actually notified of such deficiencies. To not even attempt discussion with active editors on what could be improved before jumping into a GAR request is misguided given that the entire point of a GAR is to fix an article. I hope this thread will serve as an opportunity to have such a discussion. George, can you please notify the relevant editors of your GAR request and discuss below your concerns with the article? –Prototime (talk · contribs) 20:16, 4 January 2014 (UTC)
 * There have been edits since the GA promotion, affecting the article's stability. Fortunately, I can see details and adequate sources, although some challenging material may be uncited. Look, scold me all you want, but I hope the article doesn't overbalance or become unilateral. As for notifying editors, I will do that later. George Ho (talk) 20:36, 4 January 2014 (UTC)
 * My intention isn't to scold you, it's to understand your reasons for requesting the GAR and to try to work with you and other editors to fix whatever problems there may be. I greatly appreciate your response just now. Though you still haven't really given us much to work with. (Also, I'm not sure what reasons you have to notify editors "later"; it's already been two weeks since you made your request, WP:GAR is pretty clear that notice of the request is required.)
 * Can I make a suggestion? If your intention primarily is to ensure that this article isn't "overbalanced or unilateral" (which is a great idea for a topic this controversial), perhaps a peer review would be a better process to the put the article through. That way, multiple outside editors can weigh in and evaluate the article for such problems, as opposed to just one in a GAR. (And who knows? If the article were to get a thorough peer review, maybe it would prime the article to become a Featured Article candidate.) –Prototime (talk · contribs) 23:26, 4 January 2014 (UTC)
 * I've requested peer review. Go ahead and make your comments there. George Ho (talk) 02:04, 5 January 2014 (UTC)
 * Fantastic, this looks like a great opportunity to improve the article. Thanks. –Prototime (talk · contribs) 03:28, 5 January 2014 (UTC)
 * There are plenty of problems with the article. As an editor, I was shocked to see it promoted to GA status. On its political merits, I understand completely, though. -- Cirrus Editor (talk) 02:57, 19 January 2014 (UTC)
 * Respectfully, I will again repeat that it would be entirely more productive to actually specify what those problems are than to just allege that this article has plenty of problems with something-or-other. For instance, why were you "shocked" this article was promoted to GA status? –Prototime (talk · contribs) 03:55, 19 January 2014 (UTC)
 * Not that I share the prior editor's POV or anything but there always seem to be a few unresolved "problems" floating about even after I cleared all the citation related ones last month in the hidden catsgories bar for example. Maybe you don't have display hidden categories enabled in your user preferences? -- George Orwell III (talk) 09:53, 19 January 2014 (UTC)
 * Thanks for pointing that out George, I hadn't looked at the hidden categories and there are indeed a few that indicate this article could use some improvements. Nonetheless, it remains unclear what problems that the other editors in this conversation have identified. –Prototime (talk · contribs) 04:14, 24 January 2014 (UTC)

The problems are noted below. I'll summarize those and add more:

1. Opposition and resistance section. Unions have opposed the ACA. This information was missing from the article, until today when I added a few sentences and cites about those facts. In fact, I had twice before added the information to the article, but it was deleted. No one has provided me a good reason why twice before this information was removed from the article. If I were the suspicious type, I'd say it was some left-leaning partisan who did not want any negative information related to the ACA in the article. But I'm not the suspicious type.

2. Changes to the law after it was signed into law. Some have argued below that these changes are not really changes to the law but "administrative regulations". Regardless, these things alter the law. These things ought to be noted in the article because they're notable because they're impacting wide swaths of the American people. Arguing about terms here on the talk page do not change facts of alterations to the law, impacting millions of people's lives. That's notable. That should be included in the article.

3. Implementation. There should be a new section on Impact of Implementation. And I'm not talking about the website Healthcare.gov. That is its own article. I'm talking about what I noted below, including but not limited to: the millions of Americans who have lost (or will lose) their current health insurance policies, job losses due to companies trying to keep below the mandated cut-off, health care premium increases, employees losing current health insurance plans, workers losing hours, reductions in hiring reported by small businesses, Medicaid enrollees finding their coverage limited, shortages of doctors, etc etc etc.

4. Public Opinion section. This section needs more balance, not op-ed pieces from extreme partisans like Michael Moore. "And: Many Democrats believe that the ACA will grow more popular over time, ..." seems like partisan fluff. This section seems to have stopped being updated seriously after Oct. 1, 2013. Today I added text + cite to a Feb. 2014 RAND study showing 53.5% unfavorable rating among 5,500 respondents. As the RAND study folks note, this is a very high number of people polled. 5,500+ outweigh Michael Moore.

5. Non-cooperation section opens with: "Officials in several states[which?]...." GA has this as a cite? Just google it and find out. The text "Other Republican politicians..." is just more icing on the partisan cake.

6. Job consequences of ACA. This section seems flacid (and more partisanship) now that the reality of the impact of the law is taking place. Workers are losing jobs and having their hours cut. That's the reality. See these reliable sources documenting numerous companies cutting employee hours, this NYT article saying "the premium assistance plan sharply penalizes full-time employment in favor of part-time employment." medical device companies laying off workers,

7. Exemptions to the law. The word "exemption" occurs in the article twice. Once in the article, and once in a citation. But the word in the article does not relate to the exemptions to the law as the public understands them, and as they are in reality. Google "Obamacare exemptions" and you have more than half a million results. See reliable sources such as Forbes writing about union exemptions and The Washington Post about exemptions for those who were negatively affected by implementation of the law. These are just 2. Also, the word "waiver" appears 5 times in the article, but not once in relation to businesses requesting waivers (exemptions) regarding the law. According to an article from The Hill in January 2012, HHS said that "1,231 companies applied for and received waivers from the law’s restrictions on annual benefit caps." That's notable.

8. Rah Rah-positive sections. Sections I've scanned include much partisan positiveness. "Effects on insurance premiums" contains nothing negative about insurance premiums like these reliable source articles: "49-State Analysis: Obamacare To Increase Individual-Market Premiums By Average Of 41%" (Forbes) "Why Obamacare could raise your premiums at work" (CNBC News). Given 15 more minutes and google I'm sure I could find half a dozen RS that say that insurance premiums are going to increase for some group or another because of the ACA. These are notable facts. They should be included in the article. The Healthcare cost inflation section is nothing but positive. Really?

I have not even addressed President Obama's broken promise to put healthcare negotiations live on C-SPAN (which is not mentioned in the article), nor the Obama administration arguing that the ACA is not a tax, except when they say it is, as reported by the New York Times, nor ... "You get to keep your doctor if you like your doctor", .... nor Kathleen Seibillius (some say illegally) soliciting health insurance companies to fund the ACA. The list goes on and on and on. With little included in this encyclopedic article. This is exhausting noting all these missing pieces from this article. Why aren't more Wikiepedia editors finding RS to add information on these missing pieces, and more? I mean. Seriously. For the Public Opinion section. It hasn't dawned on anyone that public opinion is shifting to the negative on the ACA and that that needs to be cited in the article on the ACA? Or that waivers/exemptions have been so much in the news over the past year but that these words appear a couple of times in the article? Or that major unions in the country representing millions of workers oppose the ACA? (But that was removed twice before when I put it in the article?) Wikipedia is getting the reputation it deserves.... -- Cirrus Editor (talk) 02:56, 14 February 2014 (UTC)


 * Thanks, Cirrus Editor, for putting some serious thought into how to improve the article. You are correct that this article has not been kept current after the exchanges went live on October 1, 2013; largely that is because the user who devoted six months into taking the article to GA status, Sb101, went on a much-deserved wikibreak (and appears to have returned as of today), and no one else has shown nearly as much initiative in keeping this article current. So I, personally,, welcome your help in updating the article and attempting to resolve potential POV issues. I would like to respond to a few of the things you mentioned, and I may respond to more later:
 * 2. I have no problem with adding more information on how the law itself has been changed since its passage, nor do I have a problem with adding information on how its enforcement has been changed. I simply ask that the content you add recognizes that distinction where appropriate. I also ask that you not include only info on the changes that critics of the law deride.
 * 3. I don't have so much of a problem with the content of your proposed "Impact of Implementation" section as I do creating a whole separate section for this information. The "Impact - Public Policy" section already discusses in length many of the pre-October 2013 predictions on what the law's impact would be; I think it would be more efficient to simply update that information with more current data on the law's impact, both positive and negative - and if there have been more negative impacts than positive impacts, or vice verse, then Wikipedia's coverage should reflect that. That said, I've noticed that virtually every single impact you have mentioned is a negative impact of the law; whatever the pro-ACA bias this article may have, the solution isn't to create a new section that describes only of the negative impacts of the law.
 * 4. Agree that the public opinion section should be updated (and should be continuously updated). Keep in mind that biased sources are allowed on Wikipedia, so long as proper in-text attribution is given. This goes for opinions on both "sides" of the issue. Nonetheless, I agree that it's better to avoid op-eds where we can portray notable information with neutral sources.
 * Some of your other "I didn't even mention..." points appear valid to me, others not so much. For instance, the whole "not a tax" thing may deserve a brief mention to describe inconsistency with what the administration argued in court, but the article already contains enough information about Obama's broken "if you like it, you can keep it" promise. Also, concerning something you brought up in point 3, I am curious to know how Obamacare has limited Medicaid, if you have any information on that.
 * That's all for now... I may provide more feedback later. Thanks again for taking the initiative. –Prototime (talk · contribs) 04:32, 14 February 2014 (UTC)
 * Thank you for saying "thank you," Prototime. I do appreciate it. For the Medicaid information, see "Latest ACA problem: New Medicaid enrollees may find their coverage is limited" I welcome any help in these tasks, and continuing feedback on the issues I've noted above. If I do make major changes to the article, I'll make notes here or just in the Edit summary field. -- Cirrus Editor (talk) 21:51, 14 February 2014 (UTC)


 * Cirrus, before I start I want to say I appreciate the effort you are putting in to discuss/improve the article; speaking from experience (and I'm sure Prototime, George Orwell, et al can empathize), it can be exhausting to make improvements. Some comments I think are important:
 * 1) Opposition & Resistance/Unions. I think (from memory) part of the reasons mentioned on the talk page for the removal of the initial union related edits was for balance and weight concerns. I worry some of the quotes overstate the position of particular unions, and I struggle to identify the stance of unions generally overall. But I certainly agree that union criticism is notable and worthy of inclusion. But I would say is to be careful to provided an accurate impression - even from the quotes you have provided, it seem that unions have narrow/conditional (although very strong) objections to (parts of) the law - namely the employer mandate design and Cadillac tax - but at the same time support health care reform AND the AFL-CIO and SEIU supported votes FOR the ACA & HCERA on their Congressional scorecard. So when we include we should be careful with weight (where we put it, length, the prominence we give it in relation to other opposition) and balance (making sure we give an accurate impression of the overall Union stance). Please take this into account.
 * 4) Please see my reply on the Public Opinion section bit re: including RAND and removing Moore. Addendum: I added the bit about popularity over time - I wasn't sure how to convey it well, but I thought it noteworthy to briefly mention what many designers and supporters of the ACA anticipated - especially given (as the links say) there is an inverse relationship between the popularity of a provision and awareness of it (aka least popular = most well known & vice versa). Though I concede that the way it was phrased could be improved.
 * 5) Non-cooperation. I'm not sure what your point here is. The references identify plenty in detail. I think the '[which]' should just be removed. Since, for reasons of length and summary style, the names of all states weren't transcribed. As for "Other Republican politicians..." is not partisan. It would be a false equivalence to categorize it as anything else (I'm still annoyed about the false equivalence on the government shutdown). Just look at the sources to see names of and quotes from Republican politicians and donors who are acting in those ways.
 * 6) Job consequences. Recently I had the thought of moving and improving the bit we have under the Opposition/Repeal section to the Impact section (I've had some edits I keep meaning to make but, again, been busy IRL). That said, there's two issues you're conflating: the part-time work changes (related to the employer mandate, which I did my best to cover already, but which may need some tweaking to keep up-to-date), and the jobs part. In regards to the part-time hours, STILL, despite the reasons claimed by some business, most labor economists, as far as I can tell, hold that the overall impact of ACA on part-time work will be small due to stuff I've already covered in that section of the ACA article.
 * In regards to the job part, I think it would be incredibly inaccurate for us to put that workers are losing their jobs. The overall evidence does not convey that. The content I wrote relating to jobs is still accurate, even if they number of "full-time equivalent jobs" has now increased from 800,000 to 2.3 million. Copying from : the CBO said that labor force participation will be reduced 1% from 2017-2024: "The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses’ demand for labor, so it will appear almost entirely as a reduction in labor force participation and in hours worked relative to what would have occurred otherwise rather than as an increase in unemployment (that is, more workers seeking but not finding jobs) or underemployment (such as part-time workers who would prefer to work more hours per week)." - CBO. In other words, people choosing to leave their job (to retire, or raise their kids, or take a different job with less hours, or start a business) as opposed to losing their job aka ACA is alleviating job lock. AND as a result of less competition (supply and demand of labor), an underreported but also notable aspect of the CBO report as prediction for the ACA to increase wages in that period. (There are other items from the CBO report that I want to include, but they aren't related to this topic).
 * I don't know how you can write (and believe) that it would be "incredibly inaccurate for us to put that workers are losing their jobs" due to the implementation of the ACA when hundreds of entities have reported that they're either cutting back workers' hours or letting workers go. The section is called Job consequences of ACA. Not sure at all why it's under Repeal efforts, and then under Opposition and resistance? Maybe because those who wrote this section really only believe that conservatives think there will be job consequences of the ACA? See these lists compiling hundreds of entities, both public and private, reporting hours cut or job losses (that is, job consequences) directly due to the ACA. -- Cirrus Editor (talk) 19:57, 16 February 2014 (UTC)
 * 3) Implementation. Please see my reply under "Implementation problems." Addendum: I think a lot of the points you made here are either more complex or outright incorrect. In addition to the employer mandate & jobs issues (above), the latest CBO report affirmed that premiums continue to be below expectations - note also, what's relevant to the law is how things are happening with the law relative to what things would be without the law, the way the CBO is analyzing it. And in regards to Medicaid, that is really neither here nor there as the Medicaid program is generally considered less generous that private plans or Medicare - saying how the coverage is limited might be a criticism of the Medicaid program, but the ACA just expanded it, I don't believe it changed what the program provided in its coverage. Similar for the doctor shortage, that's tangential to the ACA - I think concerns of a doctor shortage (due to medical enrollee numbers and population retirement) preceded ACA. The most that could be said is that expanded coverage could exacerbate it, but that's not clear to me since I haven't seen sources on how the coverage would affect utilization rates nor how the cost reforms (to make care more efficient) would work in the other direction aka you need to provide sources. Finally, in terms of plan cancellations, it has a) been partially covered in the Impact section and b) is quite overblown - more detailed analysis shows many reported as 'losing' their plans have actually been cancelled in the process of renewing it. Most others will either be transitioned to plans of equivalent or higher value (care / cost) or are those who had skimpy coverage but are too rich to qualify for subsidies. The promise itself was an oversimplified bit of unwise campaign rhetoric, but in terms of wiki coverage, I'm more concerned with the actual impact in reality.
 * 2 & 7) Enforcement/"Changes to the law"/"Exemptions." This is where GO3, Prototime and I strongly disagree [with your approach to some of the proposed additions]. Where the court has intervened [or Congress has amended the ACA thru the enactment of subsequent legislation], we can say the law has changed but the administrative side of things are not altering the law. That's what we are getting at. First, the law was deliberately designed to give a lot of executive discretion in the implementation side of things - waivers and deadlines are often this type of thing where the law gave such flexibility. As for the delays, as I tried pointing out with the sources on executive orders and the quote from Simon Lazarus, delays in execution are (legally) not typically considered alterations to the law. So, whilst we should include how the law and its execution are impacting the country, the concern is in characterizing it accurately. That is also why I, personally, have been hesitant to use the words 'exemptions' and 'waivers' because of the intersection of legal and political meanings. Often critics use it to imply something more than is the case, given the aforementioned way the law was deliberately designed (including flexible discretion over certain things). Also, when the subject come up previously, due to length, there is some content on waivers and delays that I moved in to the 'Provisions' article. 
 * 8) Tone. I disagree without about the tone of piece. Note the Forbes reference referred to 'individual-market premiums' aka non-group. I was very careful writing the premiums section to cover what the best sources said. I referred to the fact that changes in the plans' standards increased the PRICE (sticker premium) BUT overall, as the CBO cite I used says, the COST falls WHEN you account for the subsidies. First sentence of second paragraph: "For the effect on health insurance premiums, the CBO forecast that by 2016 the individual market would comprise 17% of the market, and that premiums per person would increase by 10% to 13% but that over half of these individuals would receive subsidies that would decrease the premium paid to "well below" premiums charged under current law." I don't think it's fair to categorize that section as mostly partisan positiveness, as it (as accurately as I was able) conveys what the overall impact is accordingly to neutral experts. Same for the inflation section. It includes the uncertainty and overall impact rather than the sensational headlines you point to.
 * Again and again (as outlined above) it's all very well to say there's been a lot of controversy (google hits) on this or that topic. But, I feel it's fair to say, we should be convey what the facts are. And (not always but) quite often with your examples, the things you point to are not quite right (hence non-inclusion) or already covered. - Sb101 (AFK).
 * Hi Sb101. I just replied to the Job consequences of ACA issue, above. It might be better to tackle one of these many issues at a time. I'm busy in real world, too. :) So, I've loaded up some facts on job consequences of the ACA at the discussion above. Let me know your thoughts on the hundreds of organizations, both public and private, cutting workers' hours and laying people off in response to the ACA. If you go to the news articles listed, the organizations note that it is due to the ACA that they're 1. cutting workers hours and/or 2. laying people off. Job consequences of ACA. Maybe add a sentence or two about each "consequence" (cut hours and layoffs) and then appropriate links? -- Cirrus Editor (talk) 14:32, 17 February 2014 (UTC)
 * Oh. Wait. This goes back to another point I'd made that there is little information about ACA post-Oct 1 2013 implementation date. I don't think the current Job consequences section is the right place for post-implementation information, at all. -- Cirrus Editor (talk) 19:50, 17 February 2014 (UTC)

Opposition and resistance
1. Opposition and resistance section. National unions were outraged at how the ACA would negatively impact their members. There are numerous articles from many reliable sources documenting this. The word "union" appears once in the article, though. That's hardly an oversight. I added some information about this some time ago but it was removed by another editor. That's information scrubbing.
 * No one's replied to this issue, so I'll go ahead and post this information on union opposition to the ACA:


 * Jan. 29, 2014: "Unions lash out at ObamaCare regs" Article details letter from Terry O’Sullivan, president of the Laborers’ International Union of North America (LIUNA) (represents about half a million construction workers) and D. Taylor, president of Unite Here (represents about 400,000 hotel and restaurant workers). Text of the union leader's letter is on Washington Post site


 * Sept. 12, 2013: "AFL-CIO: Obamacare implementation "highly disruptive"" (CBS News): At a convention in Los Angeles on Wednesday, the labor organization the AFL-CIO passed a resolution declaring that the Affordable Care Act will drive up costs of union-sponsored health plans to the point that workers and employers are forced to abandon them. While the resolution is strongly worded -- it calls implementation of Obamacare "highly disruptive" to union health care plans -- some unions wanted to take the resolution even further. A draft originally offered by Sean McGarvey, head of the AFL-CIO's Building and Construction Trades Department, said the AFL-CIO could no longer support the health care law and called for its repeal unless changes were made to protect union multi-employer plans. See the AFL-CIO resolution From the AFL-CIO website: "The 56 AFL-CIO unions listed here represent 12.5 million working people in every walk of life."


 * Jul. 15, 2013: "Labor Unions: Obamacare Will 'Shatter' Our Health Benefits, Cause 'Nightmare Scenarios'" (Forbes.com): From the article: Last Thursday, representatives of three of the nation’s largest unions fired off a letter to Harry Reid and Nancy Pelosi, warning that Obamacare would “shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.” The letter was penned by James P. Hoffa, general president of the International Brotherhood of Teamsters; Joseph Hansen, international president of the United Food and Commercial Workers International Union; and Donald “D.” Taylor, president of UNITE-HERE, a union representing hotel, airport, food service, gaming, and textile workers.


 * As I noted earlier, my additions of this type of information some time ago to the introduction to the "Opposition and resistance" section was removed nearly as soon as I added it. I don't know why. Some large, national unions are opposing and resisting the ACA; why not add that information to the article? This section goes to great lengths to list in great detail specific groups that oppose and resist the law, such as "conservative advocacy groups, Congressional and many state Republicans, certain small business organizations, and the Tea Party movement." Can another Wikipedian explain to me 1) why my previous addition of this information on union opposition to the law was removed and 2) why it should not be re-instated now? -- Cirrus Editor (talk) 01:25, 11 February 2014 (UTC)
 * I'll draft something up, boldly, then add it to the article, boldly. For a second time. Hoping it won't be scrubbed this time. -- Cirrus Editor (talk) 01:27, 13 February 2014 (UTC)
 * Hey! I was wrong. Twice before (not once) I've added information to the article about unions opposing the ACA. And it's been scrubbed both times. Maybe third time's the charm? I just now added that information back in, with cites to the letters the union leaders wrote to House and Senate Dem leaders. -- Cirrus Editor (talk) 20:35, 13 February 2014 (UTC)

Changes/enforcement
2. There is no section on the many changes that have been made to the ACA after its passage, or their legality. Many legal experts are questioning the legality of these changes, several of which have been made by President Obama unilaterally.
 * I seriously question the "reality" of this point. For weeks now, I've searched high and low for a specific instance where one of these so called "experts" actually cites the paragraph, section, clause, etc. within the statute that is being "violated" during the courseof or as the result of some post-enactment "action" being taken. All I've been able to find are unsupported innuendos and postulations put forth by one faction or another, then repeated to death by one "news" outlet or the other - neither actually pointing to any specifics that would hold up under actual legal scrutiny. Sure, the lack of any such specific nuance and/or legal citation from being reported along with those assertions hasn't stopped folks from filing suits all over the place (as far as I can tell, technicalities for the most part), but most of those haven't made it as far as the district appeal level yet either. That's why, if they belong anywhere, at best, it would be the main page dealing with legal challenges to the [Constitutionality] of the act & not here. If you do happen to find a source on this - one showing the specific infraction by citing the part of the law being usurped - by all means please bring it to [our] my attention here and we'll go from there. -- George Orwell III (talk) 03:16, 9 February 2014 (UTC)


 * Um. It is real. Ignorance of (or ignoring) the law does not equal exemption from the law, nor does it make it go away.
 * There are numerous sources over a broad time span questioning President Obama's legal authority to make changes to the ACA after it was passed into law. Here are a few:
 * Dec. 23, 2013 / Jan. 2, 2014: "Eleven attorneys general slam Obama healthcare fixes as illegal": Eleven GOP attorneys general say the Obama administration is breaking the law by repeatedly making changes to ObamaCare without going through Congress. News article and AG's letter to Kathleen Sebelius AGs go into great detail about the HHS proposed rule which they claim "both compounds illegal executive action and fails to protect the privacy of consumers using the health insurance exchanges." See 78 Fed. Reg. 72,322 (Dec 2, 2013). The AGs write that the proposed rule is premised on illegal executive action and that "the only way to fix this problem-ridden law is to enact changes lawfully: through congressional action."


 * Dec. 3, 2013: "Obama 'crossed the constitutional line,' House panel is told (+audio)" (Christian Science Monitor) Two constitutional law professors told Congress on Tuesday that President Obama exceeded his authority when he unilaterally extended the deadline for enforcement of the employer mandate in the Affordable Care Act. They said he also “crossed the constitutional line” when he issued an executive order suspending enforcement of US immigration laws to prevent the deportation of immigrants who arrived illegally in the US as children.


 * Nov. 22, 2013: "The Obamacare ‘Fix’ Is Illegal" (by Eugene Kontorovich is professor at Northwestern University School of Law, in Politico) Cogent and succinct arguments from a professor of law.


 * Nov. 19, 2013: "Rand Paul: Obama's Attempts to Fix Obamacare Are 'Unconstitutional'"


 * Nov. 19, 2013: "Citing overreach, Republicans ponder new checks on executive powers"


 * Nov. 14, 2013: "Obama’s prosecutorial discretion raises questions about executive authority": President Obama turned to prosecutorial discretion yet again Thursday as he tried an end run around Congress, claiming unilateral authority to let companies continue to offer health care plans under Obamacare even if those plans violate his namesake law. The move drew howls of disapproval from Republicans and ignited a legal debate over whether Mr. Obama has the executive authority he is claiming.


 * Nov. 14, 2013: "At least 27 significant changes already have been made to ObamaCare" (Galen Institute) This last one is more for interest in changes to the law and could be documented elsewhere in the article.


 * I recommend a new subsection in the article that contains information challenging President Obama's legal authority to change the law after it has been passed into law. -- Cirrus Editor (talk) 00:57, 11 February 2014 (UTC)

Partisan claims that the law has been changed are interesting, but they do not equal "the law has changed." That would require a determination from a court of law. NorthBySouthBaranof (talk) 05:14, 11 February 2014 (UTC)
 * I'm not sure how you can claim that it's partisan to state that an executive order delaying a mandate in the law changes the law. To me it's as simple as A changes B: (A) An executive order (B) delays some mandate in the law. The law has changed. Nothing partisan about it. -- Cirrus Editor (talk) 22:27, 11 February 2014 (UTC)
 * You're assuming too much based mostly on the claims being made and not the facts - as I just outlined below a bit earlier. First, I know for sure there has been no Executive Order issued by Obama changing the ACA (He's only re-affirmed the Hyde amendment and created some Council per directive in the law by Congress). Second, you're assuming that Congress "wrote" the regulations within the law itself and those things were then set in stone - a rare thing if at all. Rather, Congress delegated much of implementation & regulation of the ACA to the appropriate Secretaries or Boards as they determine best. That's why I'd like to see one of these specific violations cited so we can go look at the entire section of the law to make sure there are no such caveats allowed by Congress in the ACA, If there are, then the claim can't be unconstituional because Congress intentionally left whatever it is in question up to some other agency's or department's discretion instead of theri own. -- George Orwell III (talk) 23:05, 11 February 2014 (UTC)

To George Orwell III: The problem with Obama's changes to ACA after enactment come down to this &mdash; his issuing of waivers to whole classes of people (e.g. the employer mandate was delayed a whole year which is a waiver for all employers) contravenes two provisions of the U.S. Constitution: article 1, section 1 "All legislative powers herein granted shall be vested in a Congress of the United States, ..." and article 2 section 3 "... he shall take care that the laws be faithfully executed, ...". JRSpriggs (talk) 07:56, 10 February 2014 (UTC)
 * Then surely a court of law has found his actions to be illegal and/or unconstitutional, and ordered them reversed. NorthBySouthBaranof (talk) 05:15, 11 February 2014 (UTC)
 * By your logic, a President can do anything he wants and it is deemed to be legal until some court says otherwise, correct? Could a President on his own order the IRS to raise income taxes as long as nobody challenged the action and subsequently prevailed in court? Just trying to understand your concept of "co-equal branches of government", since it obviously differs from that of the Founders and the Constitution. I see you mentioning the President and the courts... is there any role for the representatives of the people? If so, what is it? InterpreDemon (talk) 22:55, 12 February 2014 (UTC)
 * Well, if something isn't prima facie illegal (and writing regulations for the execution of laws, as delegated by Congress, is not prima facie illegal), then we cannot assume it is illegal. There are claims that what he is doing is illegal, but surely Obama does not believe what he is doing is illegal, and unless a court of law has ruled that they are, in fact, illegal, we cannot so state. We can, of course, mention that there are claims if those claims are sufficiently developed - as they appear to be. But you are asserting that members of Congress can unilaterally determine what is and is not illegal... and that, the Constitution explicitly says they may not do. It's why we have that third, co-equal branch... the judiciary. NorthBySouthBaranof (talk) 23:42, 12 February 2014 (UTC)
 * No, I'm just trying to understand what you think the roles of the equal branches are. My understanding is that the President, among other things, is to "faithfully execute" the laws, and in my opinion such faithful execution would not include writing regulations designed to NOT execute the laws, for example with immigration or picking and choosing who gets to escape the provisions of Obamacare and who gets a pass due to political inconvenience. I don't want to waste any more space on this here, but what you seemed to be suggesting is that if you observe somebody passing you at 90 mph their action should be deemed legal until such time they are caught and convicted by a court. I always thought the Constitution was designed to be understood by the people, so when they saw a President who chose to ignore or even openly state that he was not going to enforce provisions of the law, or de-facto change the law by edict, that they would understand that what was going on was not within the terms of the agreement between the governed and those by who they consent to be governed. But apparently I am wrong, it's the court who has the power over everybody, so as long as those unelected folks back up a dictator, anything he does is legal. Like Nixon said, "If the President does it, it has to be legal." InterpreDemon (talk) 02:49, 13 February 2014 (UTC)
 * If Congress delegated the authority to implement and enforce regulations to the executive branch, then those implementations and enforcement decisions are presumably legal until proven otherwise. You need to read up on administrative law.
 * The court does have power over everybody - that's the entire point of the Supreme Court, notice the word Supreme - it has final judgment over whether acts are in compliance with law and the Constitution. If you don't like that, take it up with the Framers. NorthBySouthBaranof (talk) 20:21, 13 February 2014 (UTC)
 * I don't think that is what is being said there. Normally - and I use that term lightly given recent history - when Congress wants something to "go a certain way", they damn sure put it in writing in the law itself. Mr. President, here is the money allocated to "run" the military for next year. You can not use one red cent of this money in any way, shape or form to close Gitmo. Period. End of Story. Congress has voiced its will and the President's hands are tied (& have been ever since; to blazes with his Executive Orders on that as well). What has happened of late is nearly the opposite of applying explicit will. More and more, Congress has opted not to impose its "will" in such a way when it comes to legislation; any legislation. Nor do they adhere to recommendations borne from the various committees in drafting/marking-up legislation anymore, never mind following-up with correcting/amending legislation when warranted/needed. They really do suck at even their most basic of job functions if I do say so myself. The same lack of "imposed will" is found through out the PPACA - some of that is because it is truly a complicated piece of legislation, some of it was due to political calculations (by both sides) and some of it is actually in there because it was the most efficient way of doing x, y or z in the best interest of the people.  Does that help clarify the nuances for you any? -- George Orwell III (talk) 23:41, 12 February 2014 (UTC)


 * I believe Cirrus Editor has established sufficient coverage in secondary sources for the views of those who believe Obama violated the constitutional to be included in the article. That said, those views shouldn't be presented as fact, since a court has yet to rule on whether the changes actually are unconstitutional, and opposing views should be included as well. And I am quite skeptical about adding an entire subsection to the article to address this issue. Not even NFIB v. Sebelius receives that amount of attention in the article, and this issue doesn't even have a court case. And as George Orwell III pointed out, there is an entire article devoted to constitutional challenges to the PPACA. A couple of sentences about the issue in this article should suffice. –Prototime (talk · contribs) 05:31, 11 February 2014 (UTC)
 * Oh yes, I wasn't saying the issue shouldn't be mentioned - only that it shouldn't be mentioned as a "fact". NorthBySouthBaranof (talk) 05:40, 11 February 2014 (UTC)
 * Its familiarity with the law, not ignorance, that drives my questioning of these so called infractions. The entire thing is peppered with things similair to ... the Secretary of Health is authorized to implement the timeline and needed regulations to blah blah blah as the Secretary deems neccessary. So its actually Congeress who has delegated their authority to the executive many times over which allowed for these "changes" to be made 'Constitutionly'. Without the specific citation of what is being "violated", there is no way to for even the layman to double check these assertions to see if indeed the executive is acting beyond what Congress had "allowed" him or her to do in the language of the law. Lawyers opinions presented in press releases are not worth much if they can't show even the most basic of citations to suport such claims is all I'm saying, The track record of such suits that have been brought to date fail to meet even the needed standing to move on the matter one way or the other; and so, are frequently dismissed. And those cases that are still pending, are just that - Still Pending, a definitive ruling concurring with the assertion is just something I haven't seen take place. That said I don't disagree these instances do not rise to the level of inclusion somewhere just not here and not at this stage of the process is all. -- George Orwell III (talk) 22:03, 11 February 2014 (UTC)
 * As I noted above: "2. There is no section on the many changes that have been made to the ACA after its passage, or their legality." The first part of #2 are the many changes. The second part is the legality of those changes. The first part should be simple: A new section is created in the article with some such heading as Changes to the ACA after Its Enactment. Then list the 27 (or 28, there was another change made to the law yesterday) changes (or just note that there were 27/28 and list out some sublist of the most notable changes) that have been made to the law since it was made law. A subsection under this could have some such heading as Legality of Changes to Law. I'm not sure how an argument could be made to keep the Changes section out. It's simply information; it's what's been happening since the law was enacted. Changes. The information is notable because it impacts millions of people in the U.S. And keeping this information out of the article is, to me, suppressing information. Is that what it's about?
 * Regarding your other point about the legality stuff, I'd say this: I don't think anything has to be settled for it to be included in a Wikipedia article. Wikipedia articles are strewn with legal issues that are not settled cases. That's not the point of including information in an article because, again, it's just information about something. Like, for example, 11 state AG's have sent a letter to the Sec'y of HHS claiming that some changes to the law are unlawful. That's notable. One sentence. With a cite to their letter and then a news article. If it's brought to court, you update that sentence in the article. However it's settled, you add another sentence and citation. I don't see how this information is not appropriate to include in the article. It's relevant to the law. And it's notable. And, I'm not sure what you mean by "this stage of the process". -- Cirrus Editor (talk) 22:49, 11 February 2014 (UTC)
 * Sorry, it still seems like you're confusing the law and regulations derived from the law. The law has not changed - only Congress can do that. What's changed is the regulations dictating the application and / or implementation of the law. If Congress wanted certain things to be "written in stone" - they wrote it stone. The question is if such claims fall under those "written in stone" things or not. If they are indeed in there, it should be no problem for experts to point to them (Nobody points - only propose). The bit about 'only Congress' can write laws is absolutely still true, but did they write in allowances for such changes in this case as well? Stuff like this can & should be included, I'm just not sure it should be under the main article for the law and sold as changes to the law when they clearly are not. -- George Orwell III (talk) 23:05, 11 February 2014 (UTC)
 * I concur with George Orwell III. The entire field of administrative law exists because Congress delegates discretion to executive agencies in the implementation and enforcement of laws; to refer to administrative rulemakings and adjudications as "changes" to a law is a mischaracterization of how our legal system works, and it is not a view that Wikipedia should endorse as fact. That said, I have no problem with including a couple of balanced sentences describing the views of those who believe the executive branch has overreached in its enforcement discretion along with the counterarguments, given the prevalence of secondary sources on the subject. Furthermore, if someone would like to suggest that more detail be included in this article about the administrative regulations and other actions that agencies have undertaken to enforce this law, I'm open to that suggestion, but it shouldn't be restricted to the "27/28" things that certain critics of the law focus on. –Prototime (talk · contribs) 23:47, 11 February 2014 (UTC)
 * This is obfuscation, and the conversation is going down a rabbit hole. There should be a new section in the article, which is on the law, on "the many changes that have been made to the ACA after its passage, or their legality". It's that simple. Rarely has such an exhaustive discussion taken place to edit an article. I'll draft something up, boldly, then add it to the article, boldly. -- Cirrus Editor (talk) 01:26, 13 February 2014 (UTC)
 * If something has been "obfuscated", feel free to point out what you'd like clarified, although I'm not sure how much more clearly one can say "administrative regulations aren't legislative changes". As for your insistence in adding this "changes" section to the article, I recommend you keep in mind that Wikipedia is a collaborative project; you're not going to get your way by simply ignoring other editors' arguments and plowing ahead with disputed edits. –Prototime (talk · contribs) 03:52, 13 February 2014 (UTC)
 * And to be even more clear in addition to agreeing with Prototime's last - if "we" are going go by the 'List of 27 changes' as a foundation for this discussion, the 15 pointing to actual subsequent legislation passed by Congress & signed by the President that seem to have amended the ACA in the process + the 2 changes resulting from the Supreme Court's decision aren't really the ones in doubt here. Most of those amendments are already reflected in the PPACA article or in the provisions main article and are kind of "covered ground" to most regular visitors by now (though I didn't double check for that at the moment). It is the remaining 10 or so on that 'List-of-27' that, as far as I can tell, point to changes in regulations rather than the law itself are the ones that specifically concern me. -- George Orwell III (talk) 05:05, 13 February 2014 (UTC)
 * What's being confused is that I merely want to add information to the article about changes to the law, and then other editors take the conversation into a different direction and start arguing points of law as if this Talk Page were a courtroom. To your second point, I'm well aware that Wikipedia is a collaborative project. Thanks for pointing it out, though. -- Cirrus Editor (talk) 20:21, 13 February 2014 (UTC)
 * The arguments concern the correctness of your usage of the term "changes to the law." To clarify, let me ask you point-blank: in your proposed edits, do you plan to characterize things that the executive branch has done as "changes" to the law, or will you restrict that characterization only to Congressional amendments? Because myself and George Orwell III are fine with the latter, but not the former, for the reasons we have explained. –Prototime (talk · contribs) 21:01, 13 February 2014 (UTC)
 * Right. The "evolution" of regulations (the 10 or so "changes" in question that I pointed to earlier) are not "changes to the law". I'd consider those changes in the implemetation of the law (or some similar verbage). In short, its clear (when framed by the 'List-of-27' example) that the other 17 or so could/should go in a section dealing with "changes to the ACA since enactment" (or some similar verbage) because the Courts or Congress have actually affected a change in the content or wording of the law compared to when it was first passed. The remaining 10 simply do not do this and that's why they should be separate from the other 17" (in my opinion - these are implementation affecting at best so that is where they should be added if at all). Push further and attempt to include/question the legality or constitutionality of the same ~10 or so points listed and, imo, you've moved beyond the scope of just 'changes affecting implementation' and now you're into something that would probably go best under the section dealing with post-SCOTUS litigation and/or legality questions in that main article & not here. -- George Orwell III (talk) 01:52, 15 February 2014 (UTC)

I challenge anybody to find where in the legislation it allows the Administration to craft a new three-year delay for employers of under a hundred as long as they swear to the IRS under penalty of perjury that any hiring or firing decisions that result in a payroll of under a hundred were NOT due to Obamacare... which is the new law created out of thin air by executive decree this week. In other words, the administration just wrote a new law making it a crime to give false information about the motives behind a private sector employer's management decisions. That would be the equivalent of making it a crime to make management decisions based upon tax law, which is done all the time, and in order to fully comply with the IRS you would have to claim that your decisions had nothing to do with tax laws, an intrusion and imposition that has never happened before. But I suppose it's legal until some court says it is not, right? What always happens in societies where an arbitrary and capricious dictator ignores the law, or believes he alone is the law, is that eventually everybody else will lose respect for and disregard the law as well, and that is precisely what is going to happen here. InterpreDemon (talk) 19:28, 13 February 2014 (UTC)
 * There have been countless court cases in administrative law that deal with whether the executive branch has appropriately or inappropriately exercised its discretion in enforcing a law, but none that I know of address the specific issues related to the PPACA you are raising. In the absence of court cases, Wikipedia doesn't get to invent answers to those issues. Maybe you don't like the fact that courts are the final arbiters of what is and is not legal or constitutional, but that is how the American legal system works. It goes back to Marbury v. Madison, when the Supreme Court held that it is the court's roll to say "what the law is." That concept has formed the bedrock of countless court cases at the state and federal levels since then. It is a concept fundamental to constitutional law and administrative law. Like it or not, that's just how it is. And even if the administration's actions "aren't truly legal" under some abstract notion of natural law, Wikipedia is concerned with verifiability, not truth, and such an assertion is inherently unverifiable. Now, if reliable secondary sources include people's arguments that the executive branch violated the law or the constitution, that can be included; but it would be factually false, and a breach of WP:NPOV, for Wikipedia to present those views as correct until a court says they are. –Prototime (talk · contribs) 19:58, 13 February 2014 (UTC)
 * Thus the SCOTUS rules over WP as well. But wait a minute... how can we even say that SCOTUS makes it "fact" when so often SCOTUS has overturned itself, replacing the prior "POV" ruling with a new "factual" one? Should we not wait until a generation or two has passed after a SCOTUS ruling before declaring something "fact" rather than POV? And what about decisions in the lower courts... must they also be treated as POV until the nine Gods affirm their decisions as "fact"? But it is a good way to keep the issues out of the article and as I have so often said, just leave the article as is for all time as an example of fiction triumphing over reality. InterpreDemon (talk) 21:11, 13 February 2014 (UTC)
 * Irrespective of whether the court is a lower court or a Supreme Court, the article should probably report on the opinion by using something similar to the phrasing "The [x court] ruled that [y provision] is [legal/constitutional or illegal/unconstitutional]". That's the most accurate way of handling it. As for your question about what happens when a court overturns its previous rulings, then Wikipedia reports that overturning; Wikipedia doesn't guess what will happen, Wikipedia is not a crystal ball. Wikipedia isn't "governed" by the courts; the American legal system is, and Wikipedia's job is to report on how things are, not how you think things should be. The reason for this, again, is because Wikipedia requires verifiability, and again, because Wikipedia requires a neutral point of view. It is getting tiresome constantly explaining to you the basic principles of Wikipedia editing. Please familiarize yourself with the core Wikipedia policies and guidelines, like WP:NOR, WP:NPOV, WP:V, and WP:What Wikipedia is not. –Prototime (talk · contribs) 21:32, 13 February 2014 (UTC)
 * Good thing WP wasn't around during Dred Scott... you'd be squelching any opposing to The Confederacy, claiming that black citizenship was just POV.InterpreDemon (talk) 00:37, 14 February 2014 (UTC)
 * "Squelching any opposing The Conferederacy"? This is completely irrelevant and an egregious personal attack. I'm a stone's throw away from reporting you to ANI for your continuous personal attacks, inability to assume good faith in other editors, incompetence, and POV-pushing. I will say that denying reality and falsely claiming that African Americans were citizens after Dred v. Scott when they factually weren't treated as citizens would not have, in any way, changed anything for the better, and in fact probably would have made things worse by misleading the public about the issue. And I will say nothing more on this matter. –Prototime (talk · contribs) 00:53, 14 February 2014 (UTC)
 * Don't have time for a long reply, but I suggest people read these sources (I think they add some context)
 * Graph on all executive orders http://nymag.com/daily/intelligencer/2013/01/obama-executive-orders-guns.html
 * Graph on major executive orders http://wonkwire.rollcall.com/2014/02/12/obamas-abuse-executive-powers-debunked/
 * Executive power http://www.newrepublic.com/article/116450/obama-use-executive-power-unexceptional
 * ACA delays in context of federal law and judicial precedent. Constitutional scholar Simon Lazarus: delays et al are a lawful discretion of Executive power: e.g. "In effect, the Administration explains the delay as a sensible adjustment to phase-in enforcement, not a refusal to enforce… To be sure, the federal Administrative Procedure Act authorizes federal courts to compel agencies to initiate statutorily required actions that have been ‘unreasonably delayed.’ But courts have found delays to be unreasonable only in rare cases where, unlike this one, inaction had lasted for several years, and the recalcitrant agency could offer neither a persuasive excuse nor a credible end to its dithering" http://www.theatlantic.com/national/archive/2013/07/delaying-parts-of-obamacare-blatantly-illegal-or-routine-adjustment/277873/
 * - Sb101 (see other P.S. note) (Upated

There clearly have been changes to the law with the most recent being a substantial change in the way certain employers do not have to follow the law as originally written. Specifically that employers are only required to have 70% of employees initially covered opposed to 95% and that employers under 100 employees do not have to comply until 2015. You can argue whether this is legal (it most certainly is boarderline if not illegal) however it is unlikely to have any ruling because the only way to test the legality is to sue and the only way to sue is have standing to sue. Regardless, these changes should be noted in the article, it is not like they are a secret. Arzel (talk) 01:13, 14 February 2014 (UTC)

Implementation problems
3. There is no section on the numerous problems that have occurred during implementation of the ACA. I'm not talking about the disastrous rollout of the Healthcare.gov website but the law itself. There should be a section to include these impacts, such as the millions of Americans who have lost (or will lose) their current health insurance policies, job losses due to companies trying to keep below the mandated cut-off, health care premium increases, employees losing current health insurance plans, workers losing hours, reductions in hiring reported by small businesses, Medicaid enrollees finding their coverage limited, shortages of doctors, the list goes on and on. This is all merely information. Neutral information on the impacts of the law. There should be a section documenting this information.

Those are for starters. -- Cirrus Editor (talk) 02:11, 9 February 2014 (UTC)
 * No response on the Implementation Problems subsection? -- Cirrus Editor (talk) 01:29, 13 February 2014 (UTC)
 * Maybe Impact of Implementation section? -- Cirrus Editor (talk) 20:49, 13 February 2014 (UTC)
 * I vote to simply call it "Implementation". It should neutrally describe both the pitfalls and the successes of the Act's implementation, and more weight can be given to those pitfalls or success that have received more coverage in secondary sources. –Prototime (talk · contribs) 20:54, 13 February 2014 (UTC)
 * Moreover, the current "Implementation problems" section is in the wrong section of the article; and it is buried four levels down under the third-level "Insurance exchanges and the individual mandate" section. The history of, and issues associated with, the "Implementation" of the ACA is not a fourth level problem, and it is not merely associated with the implementation of the Insurance exchanges and the individual mandate.  So, no, the article is not ready for a GA level quality rating.
 * I agree that it should not be titled "Implementation problems", and just "Implementation" would be better.
 * One would think that "Implementation" of a complex law like the ACA would be a nearly top-level section, after the "Background" of the ACA, and the Congressional Law-making and legislation-passing part of the the ACA. Then, the full implementation of the law by the executive branch would be discussed in that section in an neutral POV way, discussing what happened to implement it when.  I would assume that certain notable and verifiable controversy would also be covered there, but only as part of a much larger and balanced section.  Cheers.  N2e (talk) 21:09, 13 February 2014 (UTC)
 * Look, this is and has always been a silly argument that I've been meaning to fix for ages (I'm away from my computer, been busy this year sorry). Just change it to 'Healthcare.gov implementation' or 'Federal Exchange Rollout.' Because you can't separate impact from implementation. We shouldn't be trying to set up a whole section just for implementation. It makes no sense. Just edit the Impact subsections as appropriate and retitle the Implementation subection (as suggested) to a title that accurately refers to the context actually covered in said subsection (where, in context of the Exchanges & Mandate section, it belongs). In the future, it would may make sense to have 'Background' -> (historic) 'Implementation' -> 'Impact.' But as far as I can see now, this whole diversion is simply because people misunderstand (due to the title) that the 'Implementation' subsection refers to one notable part, not the implementation as a whole which has (partially), can and should (fully), be covered in the Impact section generally, at least for the moment, imo. - Sb101 (P.S. I do mean to get back on here when I'm less busy in life =) Cheers - keep up the good work guys!).
 * As for your Cirrus' other points, I think you're not quite right. You've got some of your facts wrong (about how the law is working), other points have been covered (at least partially), and I hope to improve other neglected points. I want to go through this in more detail later, but can't right now due to time. Will get back to you when I can - Sb101
 * I concur; I've been saying for quite a while that it makes no sense to divorce "Impact" from "Implementation", but most everyone else has insisted for quite a while on having a separate "Implementation" section. Glad I'm not alone in thinking that having two sections is duplicative and unnecessary. –Prototime (talk · contribs) 21:52, 13 February 2014 (UTC)


 * On the implementation of Healthcare.gov, you are both no doubt correct. Just mix impact and implementation together.  No worries.
 * But on the implementation of the overall law, the ACA, that is clearly a major part of what must happen after any major legislation is passed. And that is definitely within scope of an article on the ACA.  And that ought to be covered clearly, in a higher level section, for the good of all readers of Wikipedia who come to this article to find an encyclopedic article on the subject.  Clearly, it  needs to be done in an NPOV way consistent with Wikipedia policy; but that policy provides guidance on how to cover controversial topics, topics on which there are two sides, or three sides, ...; significant verifiable controversy ought to be covered, and covered (at least at a summary level) in the main article, even if there is then some sort of additional article that covers it in more detail.  N2e (talk) 23:21, 13 February 2014 (UTC)


 * Well, I'm glad we've got the distinction because previously it had been conflated. If someone can make rename the 'Implementation' bit to 'Healthcare.gov implementation' that would prevent THAT subsection from being a source of confusion. (I prefer that name for it as the section it's a part of + the 'main article' + the content makes clear that it's referring to the Federal Exchange).
 * Now, like 's previous comments to Cirrus (04:32, 14 February 2014), I'm hesitant to support a new section on 'Implementation:' "I think it would be more efficient to simply update that information with more current data on the law's impact, both positive and negative." I agree with him. Mostly because I think adding an Implementation section would be Recentism, when viewed in hindsight (given the ability to update the Impact section), and because I think an implementation section is not a standard item of a law article of this nature, and would inconsistent with other (even major) law articles e.g. Medicare/Medicare Part D, etc. I invite you to make the case to the contrary, including examples of other articles to show that it would consistent with WP format, and an idea of what content/structure such a new article could contain (as I believe it would only come about with a summary + fork).
 * Addendum: To put it another way, if an implementation section is atypical (and potential unnecessary, per above comments) in WP law articles, then I can't see how the ACA's implementation warrants such a novel section. After all, it seems other complex and controversial laws would have analogous implementation complexities and controversies, e.e.g Social Security, Medicare, Child Labor Laws, etc.? - Sb101 (still AFK)
 * I have always said that, due to the constant re-writing and re-interpretation of the law as originally passed, implementation and impact should be one section, running blow by blow like a tennis match. This provision enabled, resultant impact, that provision changed or redefined, resultant impact, etc. It is too confusing to try to divorce the two and is inefficient because each section needs to constantly refer to issues already mentioned in the other. Just put them together in a chronological narrative. InterpreDemon (talk) 20:41, 15 February 2014 (UTC)

The current Impact section has two major subsections: "Public policy" and "Political". For the millions of Americans who have lost (or will lose) their current health insurance policies, where would you put that information?

Health care premium increases could go under the current subsection "Effects on insurance premiums."

Workers losing hours because companies are trying to keep below the mandated cut-off can go under "Employer mandate and part-time working hours". But where would actual job losses go? And reported reductions in hiring reported by small businesses due to the ACA?

And facts on Medicaid enrollees finding their coverage limited....?

Shortages of doctors caused by the ACA expanding those eligible for care. Not sure where that fits. Could need its own subheading. -- Cirrus Editor (talk) 01:50, 19 February 2014 (UTC)
 * On the Medicaid point, I don't see how that fits into this article. The PPACA isn't the reason Medicaid offers more limited coverage than many private plans; that's an issue that predates the PPACA and would continue to exist should it ever be repealed. Info related to that issue appears more appropriate for the Medicaid article. –Prototime (talk · contribs) 03:21, 19 February 2014 (UTC)
 * Now hang on Cirrus. As both Prototime and I have said, the point on Medicaid is not relevant to this article. Likewise, the point on the Doctor shortage, as I explained, is too tangential. I would argue it's not notable enough in relation to the ACA to be included - indeed, it's not even clear what the overall impact will be as even the source you provided says. If notable, it would belong on the page dealing with Doctor shortages in the US, which I *think* does exist (don't have time for a fuller reply sorry - I have to rush through right now).
 * As to the premium increases, as I said, increases in the individual market are covered in the relevant section, but put in context by the CBO and Kaiser Family Foundation sources that say, yes, of course the sticker price increases due to the higher standards for plans, but that only is a partially analysis. You need to take into account 1) the subsidies, 2) the baseline: as the CBO does, you can't say 'premiums went up x compared to last year' and say 'look what the ACA did.' You need an expectation of what would have occurred in lieu of the law and focus on the difference, as I tried my best to do when writing the section.
 * That relates to the point I need to elaborate on and explain (but I'm in the process of double checking my understanding and sources so I'm not misrepresenting the issue); pointing out sensational headlines does not justify inclusion in an encyclopedic context. Especially with the restrictions on space, we should be aiming to convey the most accurate aggregate-impact possible. Given the law (and economics) generally is complex, this is a hard thing. In particular, the data I pointed to from the Bureau for Labor Statistics and the latest CBO report present overall statistics that show a net-impact picture at odds with the stories you cite. The thing is that the aggregate impact (on part time hours and jobs) suggest that the overall impact on employer decisions is small. That's not to deny that there exists employers who have made changes due to the ACA - I have no reason to doubt their explanations. But the aggregate data suggests those effects, whilst real, are small. And I've done my best to try and ensure that, where covered in the article (namely the employer mandate and job consequences section, even if the latter needs to be moved and updated), do convey the overall picture accurately. I am concerned that what your proposing to include would far overstate the case and create a very misleading impression about the impact of the law in these areas. - Sb101 #StillRegretsBeingUnableToLogin. — Preceding unsigned comment added by 2406:E000:926F:1:25AF:B35A:DEB:633A (talk) 10:58, 19 February 2014 (UTC)
 * "restrictions on space"? So a Michael Moore oped piece gets a paragraph in the "Public opinion" section? (As an aside, why not have the opposite view also included, by, say, Charles Krauthammer? He's too "radical", right? But Mr. Moore's view is not? Wouldn't that be a balanced way to present information?) But there is no information at all in the article about hundreds of public and private entities reporting job losses due to the ACA? Here's a survey from the Advanced Medical Technology Association released 3 days ago saying: "According to the report, the [ACA] tax has led to employment reductions of approximately 14,000 industry workers and foregone hiring of 19,000 workers. The total job impact of the tax on industry employment was approximately 33,000." And here's the NYT yesterday: "Cities, counties, public schools and community colleges around the country have limited or reduced the work hours of part-time employees to avoid having to provide them with health insurance under the Affordable Care Act, state and local officials say." You saying these impacts are "small" is becoming tenuous at best and disingenuous at worst. -- Cirrus Editor (talk) 03:09, 22 February 2014 (UTC)
 * Please stop debating a strawman. As I have repeatedly said, I did not add the Moore piece and do not support its inclusion in the article. If you'll remember, I called Moore's op-ed representative of a fringe view not worthy of inclusion. My comment on restrictions (aka article length) on space was explaining why I try to be cautious around notability and summmary-style.
 * Lol. No strawmen here, believe me. There are too too many real problems. I'll delete the highly partisan Moore stuff. -- Cirrus Editor (talk) 00:21, 25 February 2014 (UTC)
 * I'll throw my hat in the ring and support removing the Michael Moore bit. It gives undue weight to the view of one person and to the leftist critique of the PPACA. It would be fine to include a leftist critique in the article, but it should be sourced to something broader than one person's personal opinion, and it should probably only get a sentence or two considering it's a minority view. –Prototime (talk · contribs) 03:44, 25 February 2014 (UTC)
 * As for the information on part-time hours, there is a lot of coverage on changes in the Employer mandate subsection. As with both the hours and jobs section, how is it so hard to understand the difference between relative and absolute impact? A proportionally small effect (in terms of the statistics from the BLS and CBO) will still affect many people in a country of 300 million. That doesn't make the overall impact any less small in the wider context. And I've to convey that fact: the observed changes of some business versus the overall impact.
 * And for the impact on jobs, the example you use is grossly misrepresentative as the (surely disinterested) lobby you cite is focused not on how insurance changes are affecting employment decisions (by workers and employers), but the medical device tax in the medical device industry. They're not even representative of the health care sector, let alone the wider economy. - Sb101 — Preceding unsigned comment added by 2406:E000:926F:1:E977:D151:DF51:BBCB (talk) 07:23, 22 February 2014 (UTC)
 * You picked one reference from one group. How is an association a "lobby group"? They're surveying their members, who run businesses, who hire real people to do work. That's jobs. Also, what about these references I cited earlier, which compile hundreds of entities, both public and private, reporting hours cut or job losses (that is, job consequences) directly due to the ACA. I think there needs to be a new subsection detailing real-world impacts of the ACA. -- Cirrus Editor (talk) 00:28, 25 February 2014 (UTC)
 * Oh, and here's that other cite for several medical device companies laying off workers. I think there's a pattern here of "impact" from implementation of the ACA. There are dozens of cites from several RS. Why don't you want to include this in the article? -- Cirrus Editor (talk) 00:30, 25 February 2014 (UTC)

So, I'm hearing that a new section titled Implementation (after Impact and before Opposition and resistance) is a good thing, covering both the positives and negatives of the implementation of the law. This new section could then be divided by types of impacts the country is experiencing from the law's implementation. -- Cirrus Editor (talk) 02:52, 2 March 2014 (UTC)

Public Opinion section
This section is woefully out of date. Polling since the new year indicate that most Americans have an unfavorable view of the ACA. I just put in new text + cite for one, the RAND tracking poll. I found numerous others with a tight google search. (As an aside, an op-ed piece by Michael Moore. Really? NPOV?) -- Cirrus Editor (talk) 00:08, 14 February 2014 (UTC)


 * I think this section is the one I've been most wanting to update for a while: Mostly I want to restore/improve the bulleted format to look less messy. I also plan to make sure we've got appropriately representative polls, but overall the description of net-negative opinion of the law (whilst against repeal and for 'fixing'), divided along party lines, is accurate. It's simply that Republicans and Republican-leaning Independents are more united in disapproval than Democrats and Democratic-leaning Independents are in support.
 * I need to double check the tone, but I certainly agree the Moore doesn't belong (way too much prominence given to someone representing a fringe view). - Sb101 (Still AFK) — Preceding unsigned comment added by 2406:E000:926F:1:2948:4B5:A478:6440 (talk) 03:49, 15 February 2014 (UTC)
 * In re "fringe view", if you're referring to a move to a single-payer system, polls show either a majority of Americans (or liberals) are in favor Be careful what you wish for. You might just get it. ;) -- Cirrus Editor (talk) 12:09, 16 February 2014 (UTC)

Effects on premiums, jobs, costs and liberal denialism
Moody's downgrades health insurers citing this "new health-care law". http://www.washingtonpost.com/national/health-science/moodys-downgrades-outlook-for-health-insurers/2014/01/23/1a670a32-846f-11e3-bbe5-6a2a3141e3a9_story.html

Although there is a list of 388 employers that have directly cited the ACA as reason for job cuts http://news.investors.com/politics-obamacare/121913-669013-obamacare-employer-mandate-a-list-of-cuts-to-work-hours-jobs.htm Any search of "jobs cut citing obamacare" returns pages of unique citations yet the article here is still is trying so hard to make believe otherwise.

CBO analysis cited by the administration determined that average premiums for consumers who buy their own coverage would be 14% to 20% lower because of the law. The president likewise claimed lower premiums http://online.wsj.com/news/articles/SB10001424127887324557804578374761054496682?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424127887324557804578374761054496682.html

Any source will show premiums have risen every year since the ACA's passage.

Great job by the obviously not paid shill spinbots. No it is a full time hobby distorting in the name of objectivity. — Preceding unsigned comment added by 98.225.252.201 (talk) 01:08, 24 January 2014 (UTC)
 * Thanks for the sources and content recommendations. You may get further on Wikipedia if you drop the snark. 04:08, 24 January 2014 (UTC)
 * Drop the snark and the anonymity. Open an account and start editing! -- Cirrus Editor (talk) 01:52, 9 February 2014 (UTC)

How many times can one quote Jon Cohn in one piece? He is far, far away from a NPOV, his livelihood is in part selling books based on theoretical socialized healthcare systems. I counted six separate quotes of 100% Cohn opinion based on zero facts. Really good work presenting an encyclopedic article from a NPOV. — Preceding unsigned comment added by 98.225.252.201 (talk) 04:44, 24 January 2014 (UTC)

The new healthcare law will slow economic growth over the next decade, costing the nation about 2.5 million jobs and contributing to a $1 trillion increase in projected deficits, the Congressional Budget Office (CBO) said in a report released Tuesday.

The nonpartisan agency’s report found the healthcare law’s negative effects on the economy will be “substantially larger” than what it had previously anticipated.

The CBO is now estimating the law will reduce labor force compensation by 1 percent from 2017-2024, twice the reduction it previously had projected. This will decrease the number of full-time equivalent jobs in 2021 by 2.3 million, the CBO said. It had previously estimated the decrease would be 800,000. http://www.cbo.gov/sites/default/files/cbofiles/attachments/45010-Outlook2014.pdf

Negative effects? Where?? not in this Wikipedia article. Here everything is still coming up roses. — Preceding unsigned comment added by 98.225.252.201 (talk) 17:49, 4 February 2014 (UTC)


 * The CBO is *not* predicting a decrease in the number of *jobs*. It's predicting a reduction in the number of *workers* (e.g. from people who were only working to get health insurance dropping out of the labor force).  This is a very different thing, and it's not even obvious whether it is negative or positive (latimes.com).  — Steven G. Johnson (talk) 18:46, 4 February 2014 (UTC)


 * Right. How anybody could think that having fewer people working is a negative thing is beyond me... a society where all the jobs are somehow being performed by nobody at all would truly be Utopian. I think it was Pelosi who said we all needed more time for painting or learning the violin. I mean, why have a job just to pay for your health care when you can sit at home and let the other fools pay for it? All the same, I think the article should remain frozen in place so future historians and comedians can opine upon what happened prior to the implosion. InterpreDemon (talk) 22:43, 4 February 2014 (UTC)
 * If someone who doesn't want to work anymore and otherwise doesn't have to quits a job, that opens that job for someone else who does need the work.
 * Social Security and Medicare also reduce the number of workers - because *retirement* takes people out of the workforce. I assume you think that they're also bad things because people should have to work right up until the day they die, right?
 * Given that you're opposed to the masses having leisure time, I assume you also believe the 40-hour week should be repealed, because those lazy bums don't need two days off, right? NorthBySouthBaranof (talk) 22:52, 4 February 2014 (UTC)
 * Even in that case (replacement), you would have the same number of workers. What I don't understand is how you can have more jobs but fewer workers... a job is not a job without a worker, and one who is not working is not a worker even if he is looking for a job, so if somebody is saying there will be more jobs but fewer workers I think it needs some type of cogent explanation. If one were to say there will be fewer jobs and fewer workers, but those workers will be more productive, earn more and be punished sufficiently with enough taxation to pay for all the rest who are not working... that would at least make sense and from a demographic and political policy view is at present the most likely outcome, at least until they too, decide to stop pulling the wagon and jump on for the ride. People working spurs the economy, creates opportunity and fills the coffers, not empty desks and lockers, or people who feel no job is better than working, especially if somebody else can subsidize their existence and health care. As to retirees and other self made folks who have already saved and paid own their way (as well as those of a few others), more power to them, and hopefully they will still have something to sustain themselves if they are unfortunate enough to live beyond the collapse. InterpreDemon (talk) 00:26, 5 February 2014 (UTC)


 * Goods and services cannot be consumed unless and until they are produced. Therefor, workers dropping out of the work force (when they are still able to work) makes us all poorer and harms the nation.
 * There is not a fixed number of jobs. So one person giving up his job will not make a job available to another person. Whether a job is available to a person depends on whether he is capable of performing it effectively. JRSpriggs (talk) 08:16, 5 February 2014 (UTC)
 * Uhhh, yes it will. If I quit a job, that position becomes vacant and the organization is highly likely to hire someone to fill it if it is a necessary position for the organization's operations. Assumedly, the work performed in that position was beneficial to the organization, and the need to do that work doesn't stop just because I stop doing that work. I'm not irreplaceable and there *are* other people else out there with the skills to perform my job effectively. NorthBySouthBaranof (talk) 09:15, 5 February 2014 (UTC)

Another relevant source (Washington Post's Fact Checker):
 * The CBO, in its sober fashion, virtually screams that this is not about jobs. (Note the sections in bold face.)
 * “The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses’ demand for labor, so it will appear almost entirely as a reduction in labor force participation and in hours worked relative to what would have occurred otherwise rather than as an increase in unemployment (that is, more workers seeking but not finding jobs) or underemployment (such as part-time workers who would prefer to work more hours per week).”
 * Once again, we award Three Pinocchios to anyone who deliberately gets this wrong.

AntiqueReader (talk) 12:01, 5 February 2014 (UTC)
 * Exactly, so if you have less labor force participation you cannot have greater overall employment and, since we do not yet tax indolence, less economic production, turnover and tax revenue. What you encourage is situations where more and more people have less need to work because more of their lives are being subsidized by those who continue to work. A person rationally decides not to work harder or earn more because the effort required to do so does not give them a greater return on sweat equity than working less, paying a lower tax rate and qualifying for subsidies, so rather than contributing more to production and the economy they can afford to take up painting or watch reality TV. The subsidy "cliff" in Obamacare is particularly sharp and punitive because it virtually phases out entirely for the middle class who are concomitantly being hit with much higher premiums and lower benefits. There literally are spreads where one can earn twenty thousand more and have not an additional penny to show for it after the increase in income taxes, the loss of their subsidy and the full weight of the now much higher premiums kick in. It's as foolish as having a 90% top marginal tax rate... everybody finds a way to avoid being in it. InterpreDemon (talk) 05:53, 7 February 2014 (UTC)

Thanks to everyone who keeps the conversation on getting multiple perspectives represented in the article. Anyone with ideas should also find reliable sources to share. I take no position whatsoever about any of the politics here, but please keep discussions here on the topic of developing Wikipedia.  Blue Rasberry   (talk)   14:30, 7 February 2014 (UTC)
 * I just removed a user's comment. All comments on Wikipedia have to be about developing Wikipedia articles according to Wikipedia guidelines. Other forums exist for discussing politics. Thanks.  Blue Rasberry    (talk)   16:21, 7 February 2014 (UTC)
 * These impacts from implementation of the ACA surely would go into a new section on Implementation, as discussed elsewhere on this Talk page. To include balance of countless news reports of lost jobs, millions of Americans losing their plans, premiums rising, etc. etc., we could add Sen. Reid's comments last week about how the Obamacare horror stories: "all of them are untrue". Now, interestingly, I searched the AP news site, but there was no coverage from that news organization of the Senator saying this on the chamber floor on Feb. 26; nor could I find the words he said in any Reuters story. Sources that did quote Sen. Reid include Town Hall and Forbes. -- Cirrus Editor (talk) 02:04, 3 March 2014 (UTC)