The Patient Protection and Affordable Care Act of 2010 (ACA; Pub. L. 111–148) holds great challenges and opportunities for occupational therapy. The law seeks to strengthen existing health insurance access, choice, cost, and coverage as well as expand coverage to an estimated 32 million uninsured Americans. At this writing, the U.S. Supreme Court is considering constitutional challenges to the law, with a decision expected in summer 2012.

One significant aspect of the law is the creation of a package of essential health benefits—10 categories of benefits that all private insurance companies participating in state-based health insurance purchasing exchanges must cover beginning in 2014:

Although many stakeholders would like to see strong federal direction for states on essential health benefits and other implementation questions to achieve consistency and fairness for consumers across the states, others criticize the ACA for being too federally directed:

It is becoming increasingly clear that strong federal...

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