Clearing PPACA vs ACA confusion_Integrity DataWhy is all of what we have to sort through for Affordable Care Act compliance so complicated and fluid?

That’s a question we consistently hear from the business professionals using our software to comply with just one slice of the health law – the IRS reporting obligation under the ACA employer mandate.

To best answer this FAQ during one of our recent ACA User Group calls, we looked at the roots of this massive law’s complicating elements – and the compounding confusion they create.

Starting with its name.

Isn’t it the Patient Protection and Affordable Care Act?

If you want to be official as can be in referring to the entirety of what has come to be known as “health care reform,” don’t you refer to “the Patient Protection and Affordable Care Act”? Just referring to “the Affordable Care Act” is shorthand, right?


Affordable Care Act – ACA – is correct. And not just shorthand.

Here’s why:

Changes to the PPACA_Integrity Data explanatory chartThe original legislation was the Patient Protection and Affordable Care Act. It was signed March 23, 2010. This fuller name and its acronym (PPACA) were accurate references for only a week. On March 30, 2010, the Health Care and Education Reconciliation Act of 2010 was signed. This law amended the PPACA.

An as of that date – March 30, 2010 – the amended version as a whole is officially the Affordable Care Act.

Change does not always come logically

Since then, the ACA has been amended another 14 times – including two amendments last year. Both of those legislative changes to the health law affected the part relevant to our work: the ACA employer mandate. One of the amendments was a highway law. 

Whoa. A highway law?

Yes, that’s what happens with a political hot potato. With one political party wanting a total repeal of the Affordable Care Act and the other party threatening a filibuster or veto at the mention of any change, addressing gaps or clarifications within the law has only been achievable by tacking on hoped-for amendments as provisions to other legislation.

Sometimes the legislative vehicle for ACA change is unrelated to health care.

That was the case in July 2015 with the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. The tiny provision in this law that amends the ACA definition of “Applicable Large Employer” started out two years earlier, in 2013, as a bill called the Hire More Heroes Act. When that bill didn’t move up Capitol Hill on its own, it got tucked into a highway bill that did pass both houses of Congress.

Such maneuvering has created a lot of confusion over ACA requirements.

And it does not include changes in the IRS regulations for enforcement of the ACA employer mandate –  where the phrase “until further guidance is issued appears 11 times, and which can make for one notice with 26 clarifications

Bottom line: Expect more changes. Prepare for them. 

Details about ACA compliance will continue to be complicated and fluid. Find and stick with professionals who stay on top of ACA changes in their areas of expertise:

  • To understand details about the health benefits that the Affordable Care Act requires you to offer and how to offer them to your workforce, check with an insurance broker and with an attorney specializing in employee benefits law.
  • To understand details about the IRS reporting you are required to do under the Affordable Care Act and your penalty risk for not making timely benefits decisions throughout the year, check with a knowledgeable vendor of ACA tracking software.


Related post from October 27, 2015:

Budget deal primes repeal of ACA automatic enrollment requirement