Barack Obama Stays in the Oval Office, Affordable Care Act Stays the Course

Barack Obama was re-elected president of the United States last night, meaning his 2010 Patient Protection and Affordable Care Act will continue its course toward nearly full implementation by 2014.

President Obama defeated Republican Mitt Romney, who vowed to repeal the healthcare reform law immediately, although it remained cloudy whether Mr. Romney would have enough congressional votes to do so or how long "immediately" might take. 

Mr. Romney's loss diminishes the remaining odds the GOP could repeal the entire law, according to a report from The Hill, although Republican governors and lawmakers are still likely to resist the implementation or funding of certain measures. President Obama also still faces a Republican-controlled House of Representatives, which is expected to urge for concessions to the law when negotiations to avert the fiscal cliff begin later this month. 

The next couple years are slated to be provision-heavy years until the law is completely implemented by 2018: Fifteen provisions will take effect in 2013 and 16 measures in 2014, including the extension of health coverage to more than 30 million uninsured Americans.  

Republican governors that recently adopted a "wait-and-see" approach to PPACA implementation, opting to see who won the presidential election, now face some immediate decisions. This includes a Nov. 16 deadline to decide whether they will create their own health insurance exchanges or leave it up to the federal government.

Mr. Romney and his running mate, vice presidential nominee and Rep. Paul Ryan (R-Wis.), also had firm ideas to restructure the federal health programs, including transitioning Medicare to a premium support payment program and curtailing Medicaid spending by roughly $810 billion over the next 10 years. As the election neared, polls showed swing state voters leaned toward President Obama's Medicare policies more than those from the Republican ticket.

Depending on the perspective, the relationship between healthcare and the election was viewed as either binding or lax, at best. Many experts deemphasized the PPACA's direct implications as the election neared, insisting that — due to market forces — most of today's major, industry-wide trends will persist regardless of what happened to the law. These trends include hospitals taking on more risk, a shift toward performance-based reimbursement and population health management.

Other policy and political experts disagreed with that notion. David Blumenthal, MD, the former national coordinator for health information technology, touted this election as the most important presidential race for healthcare since 1964, when Lyndon B. Johnson's victory led to the enactment of Medicare and Medicaid.

More Articles on Hospitals and Health Systems:

What 5 Hospital CEOs Expect After Today's Election
Yay or Nay? 5 Healthcare Initiatives Appearing on State Ballots
Could Romney Really Repeal Healthcare Reform on Day One?

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