Copyright (c) 2012 Duquesne University
Duquesne Law Review
THE HEALTH CARE ISSUE: EMERGING ISSUES IN HEALTH CARE REFORM AT THE FEDERAL, STATE,AND LOCAL LEVELS: ARTICLE: The Affordable Care Act and Health Promotion: The Role of Insurance in Defining Responsibility for Health Risks and Costs
Duquesne Law Review
50 Duq. L. Rev. 271
Wendy K. Mariner*
President Obama signed the Patient Protection and Affordable Care Act ("ACA" or "Act"), 1 saying that it stood for "the core principle that everybody should have some basic security when it comes to their health care." 2 The ACA's most visible goal is to expand access to health benefit coverage to a majority of the unin sured. 3 Nonetheless, underlying this goal is an equally important objective: "bending the cost curve" or reducing the rate of increase in health care costs, which total about $ 2.6 trillion or almost eighteen percent of GDP. 4 The President and many economists saw controlling health care costs as an important step toward economic recovery. 5 Although the Act does not directly regulate the costs of care, many of its provisions are intended to develop new ways to slow both public and private spending for health care, especially for chronic diseases, 6 which are reported to account for the majority of health care costs, 7 as well as almost two-thirds of annual deaths in the United States. 8
Conventional wisdom argues that most chronic diseases are caused by behavioral factors, such as lack of physical activity, poor diet, and alcohol and tobacco use. 9 It is not surprising, therefore, that policy recommendations to control chronic disease costs emphasize policies to change such behaviors. 10 The ACA follows this trend. Its provisions regulating both public and private insurance include required coverage of preventive care without patient cost sharing and authorization ...
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