I just stumbled upon this article, which details an alleged Obamacare-induced horror story of a particular cancer patient. The particular claim of which I am skeptical is:

Within one hour of signing the bill into law, Jes was told that she could no longer receive her treatments “due to recent legislation.”

The implication, in the context of the entire article, is that as an immediate result of Obama signing the ACA, her regular cancer treatments were stopped.

I am skeptical of this for a number of reasons:

  1. As the article itself goes to lengths to point out, very few people, including law makers, understood the entire contents of the ACA when they voted for it. So how would cancer-care providers have known so immediately that the new law would have allowed or required them to stop treatment?

  2. Most, if not all, laws take effect at some future date, in part, precisely to allow time that those affected by the new law can be informed of the changes.

Note I realize there are at least three alternate explanations for the statements made in the article:

  1. There was some other legislation (perhaps even state legislation) which did take effect on or about March 23, 2010, which actually did affect the patient in the article, and the signing of ACA was coincidental.
  2. The patient's health providers were incredibly mis-informed, and denied her treatment without cause.
  3. The patient's health providers did actually understand ACA, and informed her that she would be denied treatment once the law took effect in the future.

I'm not interested in discussing these possibilities, since these, while technically within the bounds of the claim, are clearly not what the article intended to convey to the reader. Further, investigating whether any of these things occurred is quite a separate question, and answering it would require interviewing the patient and/or her health-care providers.

  • 2
    many providers started implementing Obamacare immediately because they were afraid to be sued by the government in case they weren't ready in time, so wouldn't surprise me at all if they began denying treatment because of clauses that had not yet officially taken effect.
    – jwenting
    Aug 28, 2013 at 13:15
  • 2
    The law was an impending obligation. Some providers went the the most conservative reading of their obligations to their policy holders. Meaning they started denying claims that were questionable instead of authorizing treatment and forcing the claimant to fight for their benefits.
    – Chad
    Aug 28, 2013 at 18:45

1 Answer 1


Wikipedia has a list of provision of the Affordable Cart Act and the dates at which they come into effect. While some provisions of the Affordable Care Act did come into effect immediately, I don't see how any of those provisions would have affected Jes' ability to receive treatment on medicaid. The provisions that came into effect on March 23rd, 2010 were as follows (copied from the wikipedia article):

-- The Food and Drug Administration is now authorized to approve generic versions of biologic drugs and grant biologics manufacturers 12 years of exclusive use before generics can be developed.[50]

-- The Medicaid drug rebate for brand name drugs, paid by drug manufacturers to the states, is increased to 23.1% (except for the rebate for clotting factors and drugs approved exclusively for pediatric use, which increases to 17.1%), and the rebate is extended to Medicaid managed care plans; the Medicaid rebate for non-innovator, multiple source drugs is increased to 13% of average manufacturer price.[50]

-- A non-profit Patient-Centered Outcomes Research Institute is established, independent from government, to undertake comparative effectiveness research.[50] This is charged with examining the "relative health outcomes, clinical effectiveness, and appropriateness" of different medical treatments by evaluating existing studies and conducting its own. Its 19-member board is to include patients, doctors, hospitals, drug makers, device manufacturers, insurers, payers, government officials and health experts. It will not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment. Medicare may take the Institute's research into account when deciding what procedures it will cover, so long as the new research is not the sole justification and the agency allows for public input.[51] The bill prohibits the Institute from developing or employing "a dollars per quality adjusted life year" (or any similar measure that discounts the value of a life because of an individual's disability) as a threshold to establish what type of health care is cost effective or recommended. This makes it different from the UK's National Institute for Health and Clinical Excellence, which determines cost-effectiveness directly based on quality-adjusted life year valuations.

-- The Prevention and Public Health Fund was created to fund programs and research designed to increase chronic disease prevention.[52][53][54]

-- A National Prevention, Health Promotion and Public Health Council (National Prevention Council) was created to develop a national strategy on prevention, health promotion and public health; by, for example, disseminating evidenced-based recommendations on the use of clinical and community prevention services.[50]

-- The Indian Health Care Improvement Act was reauthorized and amended.[50]

-- Chain restaurants and food vendors with 20 or more locations are required to display the caloric content of their foods on menus, drive-through menus, and vending machines. Additional information, such as saturated fat, carbohydrate, and sodium content, must also be made available upon request.[55] But first, the Food and Drug Administration has to come up with regulations.[55][56] Two regulations - one applicable to restaurants and another to vending machines - have been proposed, but have not yet been made final.[57]

-- States can apply for a "State Plan Amendment" to expand family planning eligibility to the same eligibility as pregnancy related care through a state option rather than having to apply for a federal waiver.[58][59][60]


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