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

Over the past five years—since the initial passage of the Affordable Care Act (ACA)—implementation of the health plan has been in turmoil. Between planning problems; implementation flaws; conflict between supporters and detractors; constant regulatory and procedural changes; and continuing ambiguity over legal issues and challenges, attorneys have found it difficult to track the program and give advice to clients. This situation promises to continue for the foreseeable future, placing long-term stress on many practices.

Our approach to dealing with these constant changes has been to work toward building a fundamental understanding of how the ACA is affecting the health care system, and then interpreting the changes in this framework. To this end, we have developed a useful resource for attorneys by examining how organizations of all kinds in the health care system have been reacting—and continue to react—to the ACA.

In this way, we have been able to prepare an overview that can be used as a frame of reference. Significant changes of all kinds can then be assessed by drawing on this “knowledge base” for the health care law.

The change is continuing, with a Supreme Court challenge to subsidies provided through the Health Benefit Exchange (to be ruled upon in June), continuing changes over how ACA-related penalties and taxes are going to be handled (as tax time approaches), and constant adaptive scheduling of enrollment periods (most lately extended for “Round 3” next year). The ACA knowledge base can be used to “size up” the likely significance of such ongoing changes.

We have written two books for Thomson Reuters that describe this knowledge base and how to use it. More on these books may be found on the Legal Solutions blog. The first book (Legal Practice Implications of the Affordable Care Act, Medicare and Medicaid) tells how program changes can be understood and evaluated. The second book (Practice Guide for Funding and Access to Health Care) gives more background about the health care system.

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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