A little more than a year ago, the 2,700-page Patient Protection and Affordable Care Act (PPACA) became law, changing many aspects of the health insurance industry and—in a domino effect—the provider market, the agent and broker community, and even state government functions. More changes are headed our way from the legislatures (both federal and state), regulatory agencies, and possibly even the judicial branch.

In the judicial arena, three courts have ruled that the individual mandate in the bill is constitutional, while three other courts have ruled it unconstitutional. In early August, a three-judge panel in the 11th U.S. Circuit Court of Appeals in Atlanta found the individual mandate unconstitutional in a lawsuit brought by Florida and 25 other states. (An interesting side note: The ruling out of Atlanta is the first case where the judges' decisions did not track based on the party affiliation of the president who appointed them.) The U.S. Department of Justice can appeal in the 11th Circuit for a full-panel hearing versus the three-judge panel ruling recently released. The case is widely expected to end up at the Supreme Court. However, with the Court's decision not to allow a fast-tracking of any of the related cases, it will most likely be June 2012 before the first appeals case reaches the highest court in the land.

Fighting Back LegislativelyOn the legislative side, we have seen several items repealed, including the 1099 provision. This would have required all businesses to report all payments to vendors in excess of $600 per year to the IRS. Also repealed was the free-choice voucher, which mandated that starting Jan. 1, 2014, employers were to give vouchers to employees to aid in purchasing coverage through the exchange that fell into specific guidelines; fines were to be imposed for non-compliance as well.