PPACA Regulations Issued During the First Four Months of the Act’s Implementation

Curtis W. Copeland
Specialist in American National Government

More than 40 provisions in the Patient Protection and Affordable Care Act (PPACA, P.L. 111-148, March 23, 2010, as amended) specifically require or permit federal agencies to issue regulations to implement the act's requirements. This report describes the PPACA-related final rules, proposed rules, and other rulemaking-related documents that were published in the Federal Register during the first four months of the act's implementation. An Appendix to this report lists these publications.

As of July 23, 2010, 10 final rules had been issued implementing certain provisions in PPACA. The legislation specifically required that 3 of the 10 rules be published. The other seven final rules cited particular sections of PPACA as the statutory authority, but those sections did not specifically require the agencies to accomplish the underlying policy objectives through the rulemaking process. All 10 of the final rules were issued without a prior notice of proposed rulemaking, with the agencies often invoking the "good cause" exception in the Administrative Procedure Act (APA, 5 U.S.C. §551 et seq.) for not allowing the public to comment before the final rules were issued. In 5 of the 10 rules, the issuing agencies also stated that Congress had specifically authorized the issuance of final rules without first issuing a proposed rule. Nine of the 10 final rules permitted post-promulgation public comments, with the comment periods ending on or after the dates that the rules took effect. Six of the 10 rules were considered "economically significant" (i.e., with an annual impact on the economy of at least $100 million), so the agencies provided estimates of their costs, benefits, and transfers. Although the agencies usually provided monetary estimates of the rules' costs, none of the agencies provided monetized estimates of the benefits.

In addition to these 10 final rules, the Internal Revenue Service (IRS) published five proposed rules cross-referencing five of the PPACA final rules that it issued or co-issued with other agencies. IRS said that the text of the final rules served as the text of the proposed regulations, and allowed the public to comment on each of the proposed rules for 90 days. Also, the Centers for Medicare and Medicaid Services within the Department of Health and Human Services published three proposed rules implementing changes made by PPACA, and permitted the public to comment on each of the rules for at least 30 days. Federal agencies published several other documents in the Federal Register related to the implementation of PPACA, including two requests for information "in advance of future rulemaking."

This report will not be updated; its intent is to describe the initial rules being issued pursuant to PPACA, not to serve as an ongoing compendium of all PPACA-related rules.


Date of Report: July 28, 2010
Number of Pages: 22
Order Number: R41346
Price: $29.95


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