We live in interesting times!  First, President Obama spent Seven hundred billion dollars ($700 billion) without Congress authorization to pay for subsidies.  Subsequently, the Supreme Court upheld the individual and state rights by categorizing the Affordable Care Act as a tax.  Then, in the case known as King v. Burwell, the Supreme Court upheld the principle allowing federal tax credits to be issued to people who buy health plans through the federally run Obamacare exchange regardless of the existence of State run exchanges. Yet the challenges with the subsidies are not over and now there is a possibility that 1.8 million Americans could lose subsidized coverage due to tax-filing issues.  The issue at large is that individuals who purchase health insurance plans using tax credits must file the right forms or lose their subsidies. Then, if we look at the actual insurance products available and what we can expect for 2016 we hear about the projected increases.  For example, United in Florida is asking for an 18% rate increase while Humana in Texas is looking for a 30% increase.  Do you know of any patient that can afford that kind of increases?  I’m already seen the see fifty dollars ($50) co-payments and five thousand dollars ($5,000) deductibles so what will be the new options for 2016? For some healthcare professionals the above information is confirmation of the precarious situation we face and the end of healthcare as we know it.  However, for me is more about opportunities than frustrations.  Consider the same information from another point of view:

1. More people with insurance means the potential for a wider base of customers;
2. Higher deductibles and co-payments means a cash based Practice;
3. Rates increase means the ability to capture new patients on a fee for service basis.

The point is that we are venturing into uncharted seas.  Everything that we knew may no longer be true but there are plenty of opportunities for those that are willing to change and learn the new rules.  There is no question in my mind that we will continue to hear about the challenges the Affordable care Act bring to us in the healthcare community but my question and advise is: what are you going to do about it?