This post was written by Ferd H. Mitchell and Cheryl C. Mitchell, Thomson Reuters authors and attorney partners at Mitchell Law Office in Spokane, WA

The pace of change in health care continues at a high level. The Affordable Care Act is struggling to reach out to uninsured groups, and still trying to make corrections in the various software versions for the state Exchanges and the federal Exchange. At the same time, another case is pending before the Supreme Court, that may threaten the subsidies paid through the federal Exchange.

Congress continues to debate shifting Medicare toward a voucher program, and converting Medicaid to block grants to the states. And, at the same time, financial pressures in the health care system continue to grow. Individuals and large employers are still trying to adjust to mandates and penalties, while providers and insurers struggle to find new ways to operate.

Over the past several years, we have developed strategies and procedures that may be used to help evaluate all types of potential changes in health care, and to support attorneys as they work with clients. A new method has been applied to forecast the likely impact of health program changes—an area of critical need under the circumstances. This method has been demonstrated as being effective over 2010 to 2015, during implementation of the Affordable Care Act.

The method takes advantage of new insights in the fields of qualitative analysis (working with written descriptions instead of numbers) and typologies (arranging types of activities in various categories). A step-by-step procedure has been developed based on progress in these fields, to help attorneys better assist their clients.

This procedure guides the preparation of very specific types of narratives about program changes. These narratives reveal the key issues that are developing, and allow attorneys to prepare strategies that can help clients adapt.

The pace of change for health programs shows no sign of slowing. Through our recent books on the subject, we are continuing to support attorneys in their efforts to develop new insights and skills.

Background information on our health practice books for attorneys, published by Thomson Reuters, is given on the ACA Blog at .

In addition, twice-monthly postings may be found on the Legal Solutions blog at under the tag “ACA and legal practices.”

Ferd H. Mitchell and his wife, Cheryl, are attorney partners at Mitchell Law Office in Spokane, WA. They are active in elder law and health law practice areas. They have been working together on programs and activities on behalf of the elderly and in health care for over 25 years. During their studies, they have visited and evaluated the health care systems of Japan and several countries in Europe to learn how the needs of the elderly are assessed and met in other countries, and they have been better able to understand the U.S. health care system and related care issues from these visits.


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