The rights to health care and necessary social services were recognized under the Universal Declaration of Human Rights, unanimously adopted by the General Assembly of the United Nations in 1948. Few would argue about the inherent value in universal health care. We cannot agree, however, on how to achieve this. On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (the Affordable Care Act) (P.L. 111-148). The goal of the law is to provide quality care at an affordable cost. To realize this goal, the law focuses on innovative ways to deliver care that are both efficient and effective. In fact, a provision in the law directed the United States Department of Health and Human Services (HHS) to create the Center for Medicare and Medicaid Innovation to develop demonstration projects to evaluate new health delivery methods in the Medicare and Medicaid programs. In attempting to make health care delivery safer and more efficient, the law places a great deal of emphasis on electronic health records and the exchange of health information among providers. The law also directs the HHS Secretary to issue regulations to govern accountable care organizations -- formal organizations of providers that work together to provide coordinated services to their patient populations. Because it provides for a Medicaid expansion, the law contains provisions aimed at strengthening the primary care workforce to provide better access to care, and it directs the HHS Secretary to provide funding to create new community health centers or to support existing ones. In keeping with its emphasis on wellness and preventive medicine, the law requires that most preventive services be provided without patient cost-sharing. Finally, the law requires that most private insurance plans a set of ‘essential benefits.’ The act is still mostly intact, but the Trump Administration made some changes on how it administers the law.
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