Talk:Affordable Care Act/GA1

GA Review 1
The edit link for this section can be used to add comments to the review.''

Reviewer: LT910001 (talk · contribs) 03:28, 23 August 2013 (UTC)

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Discussion

Update 1

MOS issues

Update 2

Update 3

Update 4

This article is too big to chew off at a single time, so I'll review in chunks. LT90001 (talk)

Lede + Provisions

 * Wiki's manual of style: Law (WP:MOSLAW) suggests that where possible primary and secondary sources are used for legal cases and law. That relates to the GARC for verifiability. Includes:
 * ✅ "However, the Court held that states cannot be forced to participate in the ACA's Medicaid expansion under penalty of losing their current Medicaid funding.[11][12] " Here
 * ❌ Also guaranteed issue, minimum standards, individual mandate and other points in the provisions section.
 * I'm not sure this is reasonably feasible - at least, as far as I can tell, not being experienced with legal citation. For example, the guaranteed issue provision, I can find references to it (e.g. Page 124 STAT. 243) but that seems more an explanation than the section that actually makes it law; or take the minimum standards, which presumably covers several sections of the law itself. Given this, I think it may be appropriate to accept secondary-only references? However, I have asked Wikiproject law to help, in case I'm mistaken. Sb101 (talk|contribs) 10:39, 20 September 2013 (UTC)
 * Obviously, this is only a recommendation. If the statement is especially interpretive, or makes reference (or uses information from) to a large number of sections (preferably at the subsection level) within the subject Act of the article, then it may be a little too difficult to do good. See Foreign Account Tax Compliance Act‎ for some rather good examples IMO. If a sentence happens to touch on a large number of sections of a law, then this is going to be a very slow process, and not something that I think should be worried about right now. (Because for every word someone changes, they may need to add or remove multiple primary source references, which of course they will not do, causing a mess.) But if required, and  are the templates of note. But beware of WP:PRIMARY; a secondary source should be given regardless, if there what is said will not be immediately clear from the primary sources given. Was this what you were asking? Int21h (talk) 05:16, 21 September 2013 (UTC)
 * I understand the law is over 2,000 pages long (or so the media says), so it's a bit unrealistic for you to be expected to make these specific references. If possible I think it would be good to be specific, but it is not necessary for GA status. LT90001 (talk) 09:24, 22 September 2013 (UTC)
 * Well, I can at least confidently claim to have tried to ensure sufficient secondary source referencing in lieu of law quotations. Sb101 (talk|contribs) 13:06, 29 September 2013 (UTC)
 * No doubts there! LT90001 (talk) 23:25, 30 September 2013 (UTC)


 * Redundant sentences mentioned in the 'provision' section that are covered elsewhere and/or do not relate to the content of provisions, but why they were developed, include:
 * Sentence "For more details, see the list of provisions ('Effective January 1, 2014')." is a little redundant and already mentioned at the start of the section,
 * I know there's the 'main' link but I wondered whether it was worth signaling that there's more details (on the size of the penalty, how it's applied, the exceptions, etc.) in the provisions, which was why I added this bit? Sb101 (talk|contribs) 10:39, 20 September 2013 (UTC)
 * I think this sentence is out of place and detracts from the readability of the paragraph. It is also unusual to have an in-text reference to 'see also' another article. If you want to include it, how about an intra-wiki link such as "These provisions will start January 1, 2014"? LT90001 (talk) 08:16, 22 September 2013 (UTC)
 * That doesn't quite capture why I added it - linking the effective date implies to readers a timeline, not there's more details, so they won't think to check it if that's what they're interested in, or even know that those details are there. I've hyperlinked 'or pay a penalty' to try to accomplish both your readability concern and my concern of indicating where they can go for more details. Sb101 (talk|contribs) 13:06, 29 September 2013 (UTC)


 * This paragraph "This was included on the rationale that ... " could be moved to the section on "insurance exchanges", as it does not directly relate to the nature of what was provided.
 * I've hesitantly deleted this bit. I realized it was not about the nature of the provision but about the rationale for it; but I felt this particular provision required it being the least understood part of the law. It would be great to get a second opinion on whether that was a worthwhile justification for including it in that overview section? Sb101 (talk|contribs) 10:39, 20 September 2013 (UTC)
 * Thanks, this is a mammoth and very thorough article, so any sentence that deviates in the slightest from the purpose of each section I have been asking to remove or move. Without this clarity it is very hard to read... I offer the analogy of a runner who is completing a race, but every so-often is pulled over by a spectator for a word or two about their running style. Even a short diversion can take the metaphorical steam out of you. LT90001 (talk) 09:24, 22 September 2013 (UTC)
 * I believe I see your point. Sb101 (talk|contribs) 12:45, 29 September 2013 (UTC)


 * ✅ "This is designed to extend the solvency of the Medicare trust fund, and therefore reduce the deficit." is covered in the section "reducing the deficit" and relates to the reason for, rather than the nature of the provisions


 * Paragraphs which are not cited include:
 * ✅ Lede of provisions section re. "grandfather clause" is uncited.
 * ✅ This paragraph: "Medicaid eligibility is expanded to include individuals ..." is uncited


 * Miscellaneous grammar issues include:
 * ✅ "bundled payment" ends with a colon
 * ✅ "A single payment is paid to a hospital and a physician group..." Probably more conventional to start the sentence with "For example,".
 * ✅ "health care delivery system" -> "healthcare" or "health-care" or your selected variant: this article alternates between all three.

Legislative History

 * Overall a tight, verifiable and well-written section.
 * Background
 * ✅ "combination of measures to control health care costs, and an expansion of coverage through public insurance (broader Medicaid eligibility and Medicare coverage) and subsidized, regulated private insurance." A little confusing because of the two 'ands' and parentheses. Suggest reword "... through broader public insurance (specifically Medicaid and Medicare coverage)..."
 * ✅ "The latter of these ideas forms the core of the law's insurance expansion. " is redundant, as this section covers background and you have just talked about the provisions above.
 * ✅ "An individual mandate requirement coupled with subsidies for private insurance was considered a universal health care proposal that could win the support of the Senate, for it had been included in prior bipartisan reform proposals." I think this is implied by the title "background". Perhaps reword to: "This has been proposed before in bipartisan reform efforts."
 * ✅ "complex or unrealistic " -> "complex and unrealistic (comma)"
 * ✅ "And in 1994 " -> "Additionally, in 1994"
 * ✅ "penalty provision [46]; " -> "penalty provision;[46]"
 * ✅ "stating had decided " -> "stating he had decided"
 * ✅ Suggest remove "So I’ve been surprised by that argument."[36]"; this paragraph is about republican initiatives and not current opposition. (also I feel the 'I don't remember that being raised at all') already strongly conveys this.
 * ✅ “An individual health-insurance “ -> "health insurance" (with space); occasionally the hyphenated form pops up, this is a little inconsistent
 * Health care debate, 2008–2010
 * Does "in particular - "mean these were all the senators involved in the finance committee?
 * No, the Finance Committee has more members than that, but those were the ones on it considered to have the greatest chance of brokering a bipartisan deal. Sb101 (talk|contribs) 13:31, 20 September 2013 (UTC)
 * Ah, I see. LT90001 (talk) 09:07, 22 September 2013 (UTC)


 * ✅ Suggest move "and can be seen on the C-SPAN web site[58] or at the Committee's own web site.[" to "further references" - I am not aware of other articles which provide in-text external links like this.
 * ✅ Suggest wikilink the names here: "particular attention was given to Bob Bennett, Chuck Grassley, Mike Enzi, and Olympia Snowe".
 * ✅ for clarity, suggest reword "given not only how Democratic (‘blue’) Massachusetts is, but also the symbolic importance of losing the seat formerly held by Ted Kennedy" to "a psychological one: the symbolic importance of losing the traditionally Democratic ('blue') Massacheusetts seat formerly held by Ted Kennedy"
 * ✅ "the loss made "-> "which made"
 * ✅ suggest remove "that had become controversial" as this is implied by the text above, and also the sentence is confusing enough without this extra clause.
 * ✅ "their supermajority " -> "the Democratic supermajority"
 * House
 * ✅ "December 24; the" -> "December 24 (comma) the"

Change in number of uninsured

 * This is just a suggestion, but I think it may be easier to read if this section flows from benefits of insurance and which groups will gain insurance, and then move the part about people who will remain uninsured to a bit lower in the paragraph. As it is, I feel it's a little spontaneous in direction.
 * I'm having trouble seeing what you mean since I thought it kinda followed that direction already - going from number of newly insured to those who remain uninsured, with any other less notable (but still notable enough) details following? Sb101 (talk|contribs) 12:46, 29 September 2013 (UTC)
 * Alright. Looks good as is... must have been something I ate. LT90001 (talk) 01:29, 1 October 2013 (UTC)
 * Perhaps I should have held back on the brownies? =P Sb101 (talk|contribs) 06:13, 1 October 2013 (UTC)
 * Have had a good chuckle about this one! Suspect it would totally destroy my impartiality, so I've had to put these metaphorical brownies in a box for later ;). (*Munch munch*). LT90001 (talk) 09:56, 7 October 2013 (UTC)


 * ✅ Suggest change "uninsured group will be" -> "Among the people who will remain uninsured", for clarity.
 * ✅ "provisions have all taken effect.[109][110][111][112] " cites three primary sources and one secondary source that most likely quotes from one of the cited primary sources. Suggest trim 1-2 and then bundle.
 * ✅ Suggest "eight million – they will " -> "eight million, who will" without the hyphen, for readability.
 * ✅ Suggest new sentence at "; they will also"
 * ✅ Is there any way to make this sentence a bit less technical? I think it's a bit much for someone who might be glancing through the article. "ACA drafters believed that increasing insurance coverage ... costs among.[120]"
 * ✅ "Due to the new regulations ... until age 26," suggest remove "and" for readability
 * The sentence refers to two different regulations - but I reworded the sentence slightly to clarify that. Sb101 (talk|contribs) 12:46, 29 September 2013 (UTC)
 * Great. LT90001 (talk) 01:29, 1 October 2013 (UTC)


 * ✅ "parents" -> "parents'"
 * ✅ "the Census Bureau found at the same time" (unspecified what time)
 * ✅ "In January 2013, the Internal Revenue Service ... new health insurance exchanges starting in 2014. " suggest break into two or three sentences, this is very hard to process
 * ✅ suggest remove "For those unable to afford insurance ... the mandate may be waived.", this is stated in the above criteria. (or below, if you have moved it down)

Insurance Coverage

 * ✅ Suggest topic sentence = "The ACA has two primary mechanisms for increasing insurance coverage: increasing the coverage of Medicare, and creating state-based 'insurance exchanges'", as it is a little confusing what the two mechanisms are at the moment. You can then alter the paragraph accordingly.
 * Much easier to read. LT90001 (talk) 01:46, 1 October 2013 (UTC)


 * The paragraphs "The insurance exchanges are a method... " and "The aforementioned regulations ..." could do with some citation bundling, it is difficult to read with so many citations.
 * I managed to get a few but not a lot of ones from the same author to bundle; although hopefully some of the editors have made it more readable regardless. Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)
 * It's looking better, but there's still an issue where citations interrupt sentences. To get rid of this, I suggest:
 * and inflation)[138] through regulations:[139][89]. Group these three citations, and start a new sentence after "through regulations."
 * "state exchanges[143] to" move this citation to end of sentence.


 * Some intrawiki links could be trimmed from these two paragraphs. These include the two links to "death spiral", two links to "adverse selection" and "Congressional Budget Office", which is surely linked elsewhere.
 * I realize it's unusual, but I thought they were justified: For the CBO, it hadn't been linked in that subsection and since I was only referring to it by acronym I thought it best to hedge bets for the reader. For the other two, the problem is that since you had the concepts are only being alluded and then referenced, I thought it made sense to reference them both - that way readers could realize and follow a link to an alluded concept and not be mystified by the lack of link to the concept once referred if they didn't check the former? Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)
 * I see your point. As a commentator overtly makes the link to "death spiral" I don't think there's a need for the implicit link. Fair enough for CBO; this is a long article and readers might not get to the other links. Some of the allusions (for example 'free-rider problem') are actually quite illuminating. I think in order to reduce the wikilink load and enhance readability it would be best to remove the second reference to "adverse selection," which is more oblique and already alluded to anyway. LT90001 (talk) 01:46, 1 October 2013 (UTC)

Specific suggestions:
 * I have mentioned below some long sentences which could be split up for readability purposes.
 * ✅ "fill out a form to the government that will determine their eligibility for subsidies"... suggest add "fill out a form that will be used to..." for clarity
 * ✅ For neutrality, suggest change from "( contrary to some rumous" -> "Although there has been some controversy, Members of congress..." and remove parenthesis.
 * ✅ Suggest remove "etc." as it is not very encyclopedic. There might be more reasons but I'm confident you've listed the main ones.
 * "And price regulations " -> "Price regulations"
 * I really think that the 'And' is necessary to signal the end of the list (of ways to make it affordable - subsidies, competition, price regulations)? Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)
 * All right. I don't like starting sentences with conjunctions, but as this is a MOS issue it's not part of the GA review and I'm happy to demur. LT90001 (talk) 01:46, 1 October 2013 (UTC)
 * I appreciate where you're coming from, as I used to feel the same. But as I looked into it, it seemed its use is justified if used sparingly and not to create sentence fragments (see: 1, 2, 3) Sb101 (talk|contribs) 06:34, 1 October 2013 (UTC)


 * ✅ "The aforementioned regulations " -> "These regulations" (aforementioned is a little too technical)
 * ✅ New sentence "enrollment,[129][130] without which" -> "Without this, "
 * Created a new sentence from "got sick; in such a situation." Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)
 * Much better. More time for the brain to breathe. LT90001 (talk) 01:46, 1 October 2013 (UTC)


 * "and the limits on open enrollment" not quite sure what this means
 * One can't enroll at any time in the year, only within certain (limited) windows. Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)
 * Ah, ok. LT90001 (talk) 01:46, 1 October 2013 (UTC)


 * ✅ For readability, suggest flip sentence to be: "Without this, a vicious cycle could occur, in which ..." and new sentence "This could result in insurance death spirals."
 * Do you mean the failure to enroll penalty: "six million will pay the penalty in 2016.[154][155] "?
 * Yep! =) Sb101 (talk|contribs) 13:41, 29 September 2013 (UTC)


 * ✅ For readability, suggest split "Under the law, setting-up an exchange..." into 2-3 sentences.
 * ✅ "discretion; and " -> "discretion (comma) and"
 * ✅ Consider integrating parenthesis into text and starting a new sentence here: "functions), whereas "

Change in insurance standards

 * ✅ "their 26th birthday.[168][169][170]" has the primary source, the press release documenting the primary source, and a secondary source. Suggest remove one of them and bundle for readability.
 * Deleted the press release. Sb101 (talk|contribs) 15:23, 29 September 2013 (UTC)


 * ✅ Suggest new sentence "essential benefits,[166][171] which cover"
 * ✅ Suggest reword "Among the essential health benefits; preventive care, childhood immunizations and adult vaccinations, and medical screenings[175][176] will have co-payments, co-insurance, and deductibles eliminated - these services will be covered by an insurance plan's premiums.[21][177][178] " -> "Among the essential health benefits (comma) ... will be covered by an insurance plan's premiums, and have co-paments, co-insurance and deductables elimiated." This one sentence has five citations. I suggest remove one or two, and bundle the rest at the end of the sentence.
 * ✅ Suggest "Specific examples of benefits covered include:" so as to remove the confusion that you gave some examples (preventative care...) previously.
 * ✅ This sentence "Insurers are required to implement an appeals process for coverage determination and claims on all new plans.... policyholders if this is violated.[182][183][184]" suggest remove "and" as start of the new sentence, remove a citation and bundle the other two.
 * ✅ Suggest move citation here "These regulations[187]" in contraceptives section to the end of the sentence.

Effects on insurance premiums
I will more-fully review this section in several days' time. Would it be possible for you to run your eyes over the paragraphs, particularly paragraphs 2 and 3, and decrease the intensity of the technical language? For example, "The analysis forecasts that by 2016, for the non-group market comprising 17% of the market, premiums per person would increase by 10 to 13% but that over half of these insureds would receive subsidies that would decrease the premium paid to "well below" premiums charged under current law. " For the purposes of readability, I would also request that would add a topic sentence to paragraphs 2, 4 and 6, as I find it a little confusing to work out how they fit into the overall section given the technical language. Sorry, I am just a meek medical reviewer! Kindly, LT90001 (talk) 09:18, 22 September 2013 (UTC)
 * Happy to do this - apologies for not having done so sooner; as you may have noticed, it got busy here recently, but things seem to have settled done so I've been able to get back to resolving the issues you've been highlighting. But I won't do that tonight after having worked on the rest ( Sorry, I need sleep - I'm only human! =P ) =) Sb101 (talk|contribs) 15:23, 29 September 2013 (UTC)
 * No worries, I'll await your changes before I get to this section. I'm aware of the discussions on the article and admire your perseverance and dedication in improving this article. LT90001 (talk) 01:47, 1 October 2013 (UTC)
 * Thanks! =)
 * I've tried making it a bit less technical, so hopefully it's more readable now. Sb101 (talk|contribs) 09:45, 7 October 2013 (UTC)
 * Much more readable. LT90001 (talk) 07:57, 9 October 2013 (UTC)

Feedback
 * Much easier to read.
 * For readability suggest replace "individual market" as "market for individuals" and then put in brackets for small and large groups the % of the market, eg: "the market for indivduals would comprise 17% of the total health insurance market... the market for small groups (17% of the market)..." and so on.
 * Sentence "The bulk of the savings were in reduced premiums " is uncited

Healthcare cost inflation
Having read the section on the federal deficit below this section, would it make more sense to move most of the content here? As it is the content is quite similar.

The following should be changed as it could be constued as NPOV and/or WP:UNDUE:
 * The two quotes from Jonathan Cohn and Joanathan Gruber. These should be paraphrased in text: for example, "The CBO estimate has been criticised as failing to take into account..."

The following are small grammatical gripes:
 * Here: "requires numerous pilot programs and demonstrations that may affect healthcare costs", "requires" is an intransitive verb and needs an object ("requires... to")

Other comments include:
 * This list: "Several studies have attempted to explain the reduction in the rate of annual increase. Reasons " and the paragraph below is a off-topic, as it appears to be talking about reasons that healthcare cost inflation has not increased in the period 2002-2009, whereas the section and article relate to the PPACA. If you retain, I suggest cut it by at least a paragraph and alter to explain why this is relevant.
 * The two images are too big. I suggest either remove one (the first image most likely, as this graph simply shows healthcare costs rising with respect to GDP, which is expressed in the text), or put them as thumbnails with a caption along the lines of "Rising healthcare costs as a percentage of GDP, 2000-2011 (click to view larger image)", so that readers still know that the full image exists, but so that the images don't stand out like sore thumbs in this article.
 * The phrase about having a track record of underestimating is repeated in the section on "federal deficit"; suggest you delete here and retain there.

Federal deficit
A good mix of opinions.

The following are small grammatical fixes:
 * ✅ "total outlays (expenditure) and "total receipts (revenue), maybe use the intrawikilinking to remove this paraphrasing, it is odd to see an article paraphrase itself.
 * ✅ "on the ACA, which enabled " -> "that enabled" (without comma preceding)
 * ✅ "period (because " suggest integrate into text: "(comma) because..."
 * ✅ Suggest reword "editors Noam Scheiber (an economist) and Jonathan Cohn (a healthcare policy analyst), " to "editors Noam Scheiber and Jonathan Cohn" with no introduction (as they have been introduced already); if retain introduction, suggest integrate into text, eg. "editors economist Noan Scheiber and health-care policy analyst Jonathan Cohn"

Other notes include:
 * ✅ This paragraph "found to be overpaid (relative to government Medicare); and reductions in Medicare reimbursements to hospitals that do not meet standards of efficiency and care." is uncited.
 * ❌ Suggest reword "- omitting its cost from the ACA is no different than omitting the cost of the Bush tax cuts" to a passive voice, such as "However, it has been argued that not including ... is no different to..."
 * I have wondered whether a different example should be used, or whether the sentence is equally understandable with a generic "no different than omitting the cost of any other law" (I thought 'no'). However, the suggested reword "it has been argued" implies a degree of ambiguity whereas the intent of the sentence is to address a common misunderstanding. That's why I included the CBO letter that explicitly notes that it's looking at the cumulative effect of two bills, as requested by Paul Ryan, even though they are different + the more plain language source (Chait) and external analysts (CBPP) to verify. Given that the cost of the doc fix would remain even if the ACA were repealed, I feel any ambiguity is too misleading. Sb101 (talk|contribs) 09:22, 7 October 2013 (UTC)
 * All right. I still feel that this sentence reads quite strongly and I think that comes from this phrase "is no different than ". Perhaps you could replace it with "has precedent in?" or "is similar to" to decrease its intensity. LT90001 (talk) 08:12, 9 October 2013 (UTC)


 * Image's caption " CBO: Deficit reduction under ACA; the "bump“ is a little unclear. Suggest reword and cite the CBO heritage. For example, "Deficit reduction under the PPACA [cit]". Also, this might benefit from a sentence in text explaining healthcare costs will go up before they go down (which I assume is the function of this image)
 * I added the citation but I'd prefer to keep ACA>PPACA, it's consistent with the article and with the CBO i.e. the title in the image + they, as I read it, use 'ACA' to refer to the 'PPACA as amended (by the Health Care and Education Reconciliation Bill, subsequent related judicial decisions, statutory changes, and administrative actions)' - See footnote #1.
 * OK. LT90001 (talk) 08:12, 9 October 2013 (UTC)
 * Actually, the main purpose of including image was to have a visual aide to easily show that the CBO estimates net-deficit reduction (even after the coverage expansion starts); the reason I added the 'bump' text to the citation is to make sure that any readers wondering why the deficit reduction is not uniform in the first ten years is because of the one-off expansion of coverage. I thought "The CBO separately noted that while most of the spending provisions do not begin until 2014, revenue will still exceed spending in those subsequent years." was sufficient? Sb101 (talk|contribs) 09:22, 7 October 2013 (UTC)
 * From what I understand and you have said, this image has been included to show the impact of the ACA on the US budget (and thus the debt). So a clearer title might be "CBO: heathcare budget impact of the ACA 2010-22. The 2015-18 inflection reflects the initial expansion of healthcare coverage." LT90001 (talk) 08:12, 9 October 2013 (UTC)

Sorry, one more:
 * "commonly heard " -> "commonly-heard" or just "common"

Employer mandate and part-time working hours
Citations
 * ✅ This assertion "stay in place." is uncited.
 * "As of yet, however, only a small percent of companies have shifted their workforce towards more part-time hours (4% in a survey from the Federal Reserve Bank of Minneapolis).[254]" This is a primary source and I am not sure that the FRB of Minneapolis is representative of the entire country.
 * The FRBM study was conducted within the 9th district (out of the 12 Federal Reserve Bank system districts); which covers MT, ND, SD, MN, and parts of WI and MI. That said, it may be the study is not representative. Although I've been meaning to read several articles, when I have some free time, which might give me something to add; the problem is that there seem to have been few studies providing hard data on the issue, so this is one of the few pieces of evidence we actually have, so I thought it better to include it along with context and evidence provided by the other sources? Sb101 (talk|contribs) 11:17, 7 October 2013 (UTC)
 * There is a guideline for medical articles (WP:MEDRS). This study would be called a "primary study" and we actively try and avoid using these, because the results can be easily misinterpreted or distorted, can be specific to the area or group that was studied, and may simply be the result of statistical variation. So I think it might be best to remove this study whilst we await the release of results from a larger secondary study. LT90001 (talk) 08:18, 9 October 2013 (UTC)


 * "Workers who do not receive insurance from an employer plan will still be able to purchase insurance on the exchanges." is uncited.
 * I included this mainly to clarify for any unsure readers, but the substance itself seems well established from both the 'change in number of uninsured' and 'insurance exchanges...' sections - I figured with those (well-referenced) preceding sections, this sentence didn't need a citation as it would be unlikely to be challenged? (I have none-the-less copied one over). Sb101 (talk|contribs) 11:17, 7 October 2013 (UTC)
 * Glad to see the citation. Particularly important to be meticulous in this review. LT90001 (talk) 08:18, 9 October 2013 (UTC)


 * ✅ "law.[262][263][264][265][247] " has six citations (two are bundled); suggest you remove 2-3.
 * Since the sources are referencing different things, I've moved them to their corresponding statements. Sb101 (talk|contribs) 11:17, 7 October 2013 (UTC)
 * Great, much more readable. LT90001 (talk) 08:18, 9 October 2013 (UTC)

Grammar & readability:
 * ✅ Suggest remove "and the employer mandate was a part of this attempt" as meaning is clear from position in paragraph.
 * ✅ Suggest move "(44% of the total population) " to after the 54% statistic for consistency and readability
 * ✅ "situation; however " new sentence -> "situation. However, "
 * ✅ "medically related " -> "medically-related"
 * ✅ "employer’s " -> "employers(apostrophe)"
 * ✅ "political rationale of " -> "rationale for"

Other:
 * ✅ This sentence seems a little off-topic: "(At the same time, though, some analysts ... rather than using the 50-employee and 30-hour cut-offs).[253][262]" ; if retain, suggest reword to "Some analysts have suggested an alternate 'pay or play' system..." Either way, this entire sentence shouldn't be in parentheses.
 * Update: yep, you mention alternate systems in the sentence below, so this follows nicely. LT90001 (talk) 00:37, 1 October 2013 (UTC)


 * (Update note: I will go over the 'Healthcare cost inflation,' 'MOS issues,' and remaining 'Insurance Coverage' bits asap (but no more tonight) whilst I await your replies/reviews of other sections.) Sb101 (talk|contribs) 11:44, 7 October 2013 (UTC)

I will stop here, review "political" in one chunk, and "opposition and resistance" in another chunk.


 * Virginia is a Commonwealth, not a State per se. As in the Commonwealth of Virginia, the, "State of Virginia" is incorrect.  — Preceding unsigned comment added by Willmcm (talk • contribs) 20:37, 7 October 2013 (UTC)

More MOS issues
Also, there may be too many external links. I'm not sure the NYT and WSJ topic pages are necessary, and the article from the Atlantic seems a bit random (there are hundreds of magazine articles on the subject; why is this the most relevant?) -- Ypnypn (talk) 14:59, 1 October 2013 (UTC)

Political
Right! Getting to the end of the review. I've reviewed the two sections and lede as well.LT90001 (talk) 08:53, 9 October 2013 (UTC)

Public opinion

 * "Polls indicate" -> "US polls indicate"
 * ✅ –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)


 * The Reuters-Ipsos poll results, as mentioned earlier, are out of place in bullet form. I feel that this impacts on readability and gives undue weight to a particular source. However, I understand that this is provided as an example of US public opinion illustrating what has been noted in the first and second paragraphs. However, in-text it is out of place. Some suggestions might be to include it in a quote or table stucture.
 * ✅ –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)


 * The last two items should not be bulleted (other polls... other specific ideas...) as these weren't from the R-I poll. This may fix the readability concerns above, as the list would then be much shorter.
 * ✅ –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)


 * Style-related only: (52%–34%) normally reported small-> big (34-52%)
 * Feel free to correct me if I'm wrong, but I'm fairly certain that when a question is presented for/against, the results are reported "for -> against" and not "big -> small". I'm certain that's how bill vote totals in legislatures are stylized, but I'm not entirely sure that this applies to opinion poll results, so I could be wrong. –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)

Obamacare

 * "for the uninsured (comma) according to "
 * "without having government take over healthcare (question mark)'. " Although have seen both styles used in nested quotes
 * "most common colloquial term to " -> "term used to"
 * "Stuart Seidel, NPR's managing editor, said that the term "seems to be straddling somewhere between being a politically-charged term and an accepted part of the vernacular." is uncited.
 * All of the above - ✅ –Prototime (talk · contribs) 23:39, 19 October 2013 (UTC)

Myths

 * "Independent Payment Advisory Board " suggest wikilink
 * ✅ –Prototime (talk · contribs) 23:49, 19 October 2013 (UTC)


 * "advance(hyphen)care ". Wikilink?
 * ✅ –Prototime (talk · contribs) 23:49, 19 October 2013 (UTC)


 * I have moved the opinion by Ypnypn here:
 * The section titled "Myths" violates WP:WTW: "Avoid myth in its informal sense, and establish the scholarly context for any formal use of the term." -- Ypnypn (talk) 13:23, 1 October 2013 (UTC)
 * Ypnypn points out that "myth" is a "contentious label" (WP:LABEL) and a "word to watch" (WP:WTW). Such words "should be used with care...". However, it is also noted that the WP:WTW policy "should not be applied rigidly" and "There are no forbidden words or expressions on Wikipedia" (quotes taken from WP:WTW). I believe that here the use of the word "myth" falls within the OED definition (" a widely held but false belief or idea") and, specifically, that the scholarly context has been established, so it is reasonable to use it. As I am quoting from the policy, to ensure that I am not selectively paraphrasing or misinterpreting the policy, consult it directly here: WP:WTW. LT90001 (talk) 09:01, 9 October 2013 (UTC)
 * Correct me if I'm wrong, but I think the "formal use of the term" means a myth as in mythology (i.e. a traditional story, usually involving gods or other supernatural things). For example, Genesis creation narrative is described as a creation myth. The OED definition is the "informal sense", probably. -- Ypnypn (talk) 12:54, 9 October 2013 (UTC)
 * I tend to agree with LT910001's view of this; scholarly context has been established for its use, and I believe "formal use" of the term refers to the accuracy of using the term, rather than referring to stories in mythology. –Prototime (talk · contribs) 23:49, 19 October 2013 (UTC)

Opposition and resistance

 * Legal challenges great to see a child article.

State rejections of Medicaid expansion

 * "of the poverty level " suggest remove wikilink from "the"
 * "However, the Supreme Court ruling created the potential... and the subsidy eligibility threshold" contains assertions that should have adjacent citations, rather than grouped at the end.
 * "below 100% of the poverty line" suggest remove "100%", as this is implied when you say "below the poverty line"
 * All of the above ✅ –Prototime (talk · contribs) 00:04, 20 October 2013 (UTC)

Noncooperation

 * suggest rename to "Non-cooperation" (OED spelling)
 * "required by federal law to functioning " -> "to the functioning of..."
 * Both of the above ✅ –Prototime (talk · contribs) 00:06, 20 October 2013 (UTC)

Congressional opposition and government shutdown

 * contains a "citation needed"
 * suggest de-wikilink "APAB" as you have wikilinked it above.
 * Both of the above ✅ –Prototime (talk · contribs) 00:15, 20 October 2013 (UTC)

Repeal efforts

 * "None of the bills were considered by either body." is uncited
 * I simply removed this sentence. It seems like more trouble than its worth to find a source saying that these two specific bills, out of the many repeal efforts, were not considered by either body. The more important point is that these bills were the first repeal bills to be proposed (and clearly they failed). –Prototime (talk · contribs) 00:15, 20 October 2013 (UTC)

Job consequences of repeal

 * "once they have health insurance outside of their jobs." is uncited (although I would hesitate to guess it is covered by the in-sentence citation).
 * Correct; I placed the cite at the end of the sentence. –Prototime (talk · contribs) 00:15, 20 October 2013 (UTC)

Re-review of Lede
Having now reviewed the entire article I will re-review the lede:
 * The lede covers the law, its provisions and challenges.
 * Using citations in the lead, whilst not always recommended stylistically, is a wise choice considering the contentious nature of the article.

Conclusion
, thanks so much for helping out. I will shortly conclude this review, but there's one outstanding issue, and that's the two very large images. I suggest that you put them in a gallery format with labels, that allows users to click to view more, or put them in captioned images. The current state is not readable and preventing nomination. I would welcome any of your thoughts, this issue has previously been discussed by Sb101 and myself in this review. LT910001 (talk) 00:54, 20 October 2013 (UTC)
 * Glad to help, . I've turned the images into thumbnails with captions; let me know if they still need some work. –Prototime (talk · contribs) 01:35, 20 October 2013 (UTC)

Comments
Will be updated shortly, when the issue with images is resolved. LT910001 (talk) 01:16, 20 October 2013 (UTC)

I am promoting this article to GA status and commend the primary nominator,, on their continued and persistent improvement to the article. This nomination has been a very long process with extensive discussion on numerous points, and has been thoroughly looked-over by myself and several other reviewers. I would strongly encourage any commentator to read the above discussions before offering commentary on this review. I will note some particular points with regard to this article for future reviewers or readers of this review:
 * Firstly, I would like to (again) commend the primary nominee, Sb101, who's been working tirelessly on the article's talk page and on this review. And thanks to for taking over at the last minute.
 * I find this article to be readable and concise. This issue of length has been raised above, and as discussed, considering the contentious and broad nature of the issue covered, I feel that the current length is adequately broad without being excessively specific. This is warranted to give adequate coverage to each portion of the article.
 * This article contains numerous citations. There is a risk of citation overload. However, at the current stage, and considering the contentious nature of the article, I think this is a reasonable and suitable choice.
 * Neutrality. This article receives a large view count (9 million plus per year) and in society at-large, there is a notable debate. I find the article provides a NPOV analysis and portrayal of the bill, its provisions and history, whilst acknowledging the debate and the primary reasons for it.
 * Stability. With the exception of a user who makes continually-reverted edits to the article, this article is in-the-main, stable. By this I mean there are continual edits around the edges of the article, but there are no sizeable reversions, additions or removals. A team of interested Wikipedians is monitoring the page and directly contention to the talk page, where consensus is reached for change.
 * No problems with images.

In consideration of the above, I am promoting this article to GA status and congratulate the contributors for their well-written article. Kindly, LT910001 (talk) 01:39, 20 October 2013 (UTC)
 * All right!!! Congratulations to all of the editors who helped make this article what it is today, especially . And thank you,, for doing a great job with this extended GA review process. This is quite an accomplishment. –Prototime (talk · contribs) 01:49, 20 October 2013 (UTC)

Thank you, and. Sorry for my recent absence - just been swamped with some work of mine, unfortunately. I do intent to return shortly to help maintain the page - I already noticed some changes I want to make to the Public Opinion section, for example - and close down a few of the edits that we were in the middle of, though I suspect Prototime has dealt with most of them. This month has been (and still is) just hectic for me but I'm hoping to enough time by Friday to read over/edit the remaining things so we can close/format them (like 'Lede + Provisions Done').

They shouldn't, however, upset the article new status. =D I really appreciate the kind words from people. But obviously a lot of people (far too many to mention) have put a lot of work into getting this far and maintaining it. In particular, though, thank you and  for your work on the review, and also to  and  who have done a great job maintaining the page! Great work. =) Sb101 (talk|contribs) 12:40, 21 October 2013 (UTC)