Talk:Affordable Care Act

Lead (Resolved)

Prototime has raised a concern about a sentence in the lead:

• "The ACA aims to increase the quality, affordability, and rate of health insurance coverage for Americans, and reduce the costs of health care for individuals and the government."

As he is on a wikibreak for a week, I'll quote him: "'Rate of health insurance coverage' can refer to the number of persons insured. However, I do think that saying 'rate of health insurance coverage' implies to lay readers 'insurance rates,' commonly meaning 'premiums,' and that this would be a source of confusion. While the wikilink can help to clarify, I don't think that readers should have to click it to understand what is meant."

However, I'd argue that 'increasing the rate' (rather than, say, 'reducing the number of uninsured') is more accurate in a technical, policy sense - 'rate' is used frequently in relation to insurance coverage on the 'Health insurance coverage in the United States' page, for example; and is common enough to expect laymen understanding, just as we refer to the 'unemployment rate' rather than the 'number of unemployed.' I also think any potential confusion is made negligible given the inclusion of 'rate of coverage' within the hyperlink, and because 'rate' in the singular suggests, I think, that it's not to do with premium rates, plural. Therefore I quite prefer the current language.

Since I have nominated this article for GA status, I've agreed to consult a reviewer for their opinion. But I also wanted to see if others wanted to weigh in? Sb101 (talk|contribs) 06:59, 29 July 2013 (UTC)

I read it as you've explained it and don't see any need to make changes, but if this somehow remains a sticking point with folks, just have the term rate point to its proper definition instead. The resulting lede would then be . . .

• "The ACA aims to increase the quality, affordability, and rate of health insurance coverage for Americans, and reduce the costs of health care for individuals and the government."

If folks are too lazy to make the extra click to Wiktionary whenever they are in doubt, then there is not much more to be said on the matter is there? -- George Orwell III (talk) 22:53, 29 July 2013 (UTC)

I agree with Prototime. Both "number of uninsured" and "rate of coverage" seem technically valid, though "number of uninsured" is clearer. If you look at Health insurance coverage in the United States you'll see that the lead section takes two sentences to describe the rate and then refers to it as "this rate of uninsurance." That's appropriate in an article that's specifically about coverage statistics. But this issue is only one factor of several for PPACA and doesn't merit such real estate in the lead section. I also disagree with GO3's comment that people can just click on the link to find out what's meant by "rate of coverage." Prototime's point was that the current language is ambiguous, which could lead some readers to be misled. That's much worse than using technical jargon. The misled reader won't click on the link as they (incorrectly) think they understand what Wikipedia is saying. --Dr. Fleischman (talk) 18:20, 30 July 2013 (UTC)

Thanks, Sb101, for bringing this up while I was on wikibreak. Dr. Fleischman accurately expressed my sentiments on the matter. I'll only add that where there is a question of ambiguity, it's wiser to err on the side of clarity. Here, "rate of health insurance coverage" is accurate but ambiguous. "Number of uninsured" is equally accurate but is unambiguous. Thus, I don't see a persuasive reason to choose the former. ("Number of uninsured" may require a new sentence to fit grammatically into the lead, so it may slightly increase the lead's length, but brevity is valuable only to the extent that it doesn't impinge clarity.) –Prototime (talk · contribs) 03:25, 5 August 2013 (UTC)

Sorry, took me a bit longer than intended to reply - life happens. Anyway: So, I do agree that clarity should not be sacrificed for brevity. But I disagree that the current language is ambiguous/potentially misleading for two reasons:

• Familiarity: I think that people only use 'rates,' plural, to refer to premiums. 'Rate' is not merely technically more accurate (if only slightly so, since it connotes degree), but commonly understood even by lay people (through familiarity with things like - if not 'health insurance rate' itself - concepts like percentage rate, unemployment rate, tax rates, literacy rate, birth rate, etc). Rate in the singular is not something I would expect a statistically significant number of people to confuse with premiums/rates. Indeed, the way I read Health insurance coverage in the United States is that when it refers to the rate of uninsurance it does not clarify or define it (there is no colon, en dash, or parentheses to define or clarify that what is meant is the proportion of the population that is uninsured); rather, they use 'rate of uninsured' interchangeably with the specific percentage rate, taking for granted that people understand that’s what rate means, as I think we should do.
• Context: I can concede I could be wrong about the likelihood of ignorance (but I would prefer evidence that I am given my - I would say reasonable - expectation above). But if I am, surely it is sufficient to hyperlink rate of coverage for Americans (i.e. how it is now) and use that to make it clear, as we do with other relevant and necessary terms (like reconciliation - which we aren't using to signify the act of settling or resolving an issue)? When I say make it clear, I don't mean by having to click, but that the mere construction of the sentence and hyperlink itself (by its highlight) serves to disambiguate what is meant: the sentence does not just wikilink to more in-depth information about health insurance coverage, but emphasizes that we are talking about the proportion of the total population that is insured - after all, I've never heard 'rate of coverage' used to mean premiums/rates/'insurance rates';

And yet, given that the sentence is 'increase the affordability... rate of coverage,' assuming someone did read the latter as premiums, that would prima facie contradict the idea of increasing affordability (so, at worst people won't be mislead but actually confused and then would click the hyperlink). In other words, the sentence disambiguates through context already.

Having said all that, please speak up if you still think I have come to the wrong conclusion (WP:BeBold). =) Sb101 (talk|contribs) 17:40, 13 August 2013 (UTC)

When you're having a discussion about the ambiguity of any particular language I think you should give the benefit of the doubt to those who say it's ambiguous. There are certainly arguments to be made either way, but it's not implausible for readers to misconstrue the meaning of the term "rate of health insurance coverage for Americans," particularly in light of the fact that it's sandwiched between the phrases "affordability" and "reduce the costs of health care." On top of that the title of the article has the word "Affordable" in it but nothing overt (for the truly uninformed) about coverage. ("Protection" is such a vague term.) In law, language is generally considered ambiguous if there are two or different but reasonable interpretations of it. In short I don't think it would be unreasonable for an uninformed reader to misunderstand the "rate" language, even with the mitigating factors you point to.

On top of that I continue to be confused by your assertion that "rate of coverage" is technically (slightly) more accurate than "number of uninsured." Both seem equally accurate to me.

I just thought of an idea that might be mutually acceptable: "uninsured rate." The term already shows up a few times in Health insurance coverage in the United States. Moreover it appears to be used much more frequently by reliable sources. A Google News search for "rate of coverage" (w/ quotes) currently brings up 6 hits while "uninsured rate" (w/ quotes) brings up 1,760 hits. FWIW "number of ininsured" (w/ quotes) brings up 990 hits. --Dr. Fleischman (talk) 18:36, 13 August 2013 (UTC)

There are times like this when I think it'd be nice to be able to experimentally test the issue at hand on a random sample of people. *Sigh* Oh well. In lieu of that, whilst I am inclined to think that it is an unreasonable interpretation, I hesitate if only because if politics teaches anything it is not to underestimate the limits of human reason. (Although, that is truly an ambiguous statement since it can go both ways, which is nice and true enough =P ) And also I am happy with the language you suggest; does this work:

• "The ACA aims to increase the quality and affordability of health insurance and reduce both the uninsured rate (through expanded public and private insurance coverage) and the costs of health care for individuals and the government."? I will also probably add Health Coverage & Uninsured and Health Insurance Coverage of the Total Population where appropriate (probably 'Change in Number of Uninsured' section).

(Oh and the predominant reason I think 'rate' is at least slightly more accurate is that it refers to the explicit goal of the drafters: Universal Health Insurance, which is an inherently proportional concept aka rate rather than an absolute number). Sb101 (talk|contribs) 21:09, 13 August 2013 (UTC)

I like it and I'll ping Prototime for his/her feedback as well. --Dr. Fleischman (talk) 21:41, 13 August 2013 (UTC)

I like it as well and believe it adequately addresses the ambiguity. My only other comment would be to restructure the "(through expanded public and private insurance coverage)" bit to avoid deemphasizing this important point, perhaps like this: The ACA aims to increase the quality and affordability of health insurance, reduce the uninsured rate by expanding public and private insurance coverage, and lower the costs of health care for individuals and the government." –Prototime (talk · contribs) 00:27, 14 August 2013 (UTC)

• Resolved Sb101 (talk|contribs) 05:43, 15 August 2013 (UTC)

Opposition and resistance to ACA?

"If a mandate [to health insurance] was a solution, we could try that to solve homelessness by mandating that everyone buy a house. The reason they don't have a house is they don't have the money." (Sen. Obama, 02/05/08)

Text was recently removed from the subsection on [1] about the union representing IRS employees not wanting to leave their current health care plans to join the pools in the ACA. Is there a talk section on why this was removed? Also, other unions have expressed strong reluctance to join in.[2] Shouldn't this also be added to this section on "opposition"? --Cirrus Editor (talk) 05:43, 2 August 2013 (UTC)

That material was removed for two reasons: (1) WP:BE, and (2) see this discussion (deleted per WP:BE). You're welcome to resume the discussion and/or find a new home for the material about the IRS employees. As for the other unions, this already has a passing reference in the "Employer mandate and part-time working hours" subsection, though I agree it probably merits a paragraph in the "Opposition and resistance" section. --Dr. Fleischman (talk) 06:24, 2 August 2013 (UTC)

Thanks for the reply. If I have time/strength for it I will. :) -- Cirrus Editor (talk) 21:42, 2 August 2013 (UTC)

I added the AFL-CIO concerns. There are several more large unions that have concerns, too. More later.--Cirrus Editor (talk) 23:34, 7 October 2013 (UTC)

So instead of modifying the text you simply delete it. It figures. -- Cirrus Editor (talk) 01:39, 8 October 2013 (UTC)

Modifications vetoed by Obama?

During debates I thought I head one representative saying something like "Congress has passed 12 laws to modify ACA and Obama has vetoed every one." If I misheard, ignore this comment. I only see one mention of a possible veto of repeal. If there were vetoes of any other changes, it would be good to put them in. Thanks. User:Carolmooredc 17:26, 1 October 2013 (UTC)

Thanks but it doesn't seem to be the case: List of United States presidential vetoes#Barack Obama. Sb101 (talk|contribs) 16:21, 3 October 2013 (UTC)

More delays

• Pear, Robert (August 12, 2013). "A Limit on Consumer Costs Is Delayed in Health Care Law". The New York Times. {{cite news}}: Italic or bold markup not allowed in: |publisher= (help)

--Dr. Fleischman (talk) 18:39, 13 August 2013 (UTC)

Kaiser Family Foundation Video in Provisions

Innab recently removed the video I had added to the overview section, saying "the video does not work, does not have copyright or notability." Now, I have restored video so we can test what the issue is (as it works for me when I use the Firefox browser).

• I downloaded, converted, and uploaded the file following Wikipedia instructions, before testing it myself, to ensure it played properly. However, having tested it on a different browser, I have found the problem that Innab likely encountered: it does not seem to work on Internet Explorer. If anyone knows how to fix this issue, please let me know.
• In terms of copyright; as I have tried my best to explain on the File page, the video is from KFF, a reliable and non-partisan source. In addition to seemingly being intended for public educational purposes (if given appropriate attribution) - as the video is freely available on KFF's Youtube channel - I also requested and received permission to download and use the video in the exact manner in which I have employed it.

Because I want to be as clear as possible to show that I'm trying to follow WP policy (and because I probably need help fixing it), I thought I'd explain that here and see if anyone else has problems with its inclusion in the overview (possibly on condition that we can get it working for all browsers)? Sb101 (talk|contribs) 11:20, 15 August 2013 (UTC)

Is it technically feasible to take a still screenshot of the video and link it to the video page on KFF's website? That would solve two birds with one stone, by solving the browser/plugin compatibility issues and by relieving remaining copyright concerns. --Dr. Fleischman (talk) 17:41, 16 August 2013 (UTC)

I agree... coming from Wikisource where we host a fair number of .ogg/.ogv files, I can tell you from past expierence that IE users are pretty much hosed by these formats without adding an additional player (see MS Forums and Wikipedia:Media_help_(Ogg)) - something most, if not all, are not likely to do. I believe Doc's solution seems the most practical in light of the situation. -- George Orwell III (talk) 19:48, 16 August 2013 (UTC)

Well, I wasn't able to link the screenshot itself to the video link (i.e. you click the image to be taken to the page) but I added an image to the overview with a link in the caption as the best that I knew how to format? The problems with .ogv are a bit frustrating but at least we have a partial work-around. Thanks for the idea guys. Sb101 (talk|contribs) 01:46, 12 September 2013 (UTC)

I reworked the File: and its linkage, syntax, etc. so that clicking the still-image will take you to the desired page now. You might want to re-word the caption to eliminate the redundancy if you think its worth it. -- George Orwell III (talk) 19:43, 13 September 2013 (UTC)

Thank you. I did try to think of a way to rephrase the caption, but actually reconsidered as I can't see how else to indicate that it is an external site, which I think probably needs to be clear to anyone interested so they know to expect that? Sb101 (talk|contribs) 02:05, 19 September 2013 (UTC)

I restored the video after Solntsa90 deleted. I'm pre-emptively replying to note that this is a neutral, reliable source, and the inclusion has not been objected on grounds of substance or NPOV until now. The substance is reasonable, and the clear intent of the video is public information, not advocacy. This goal - and there neutral stance - is explicit: "[O]ur role on the ACA is to inform the debate and give the American people information they can use to understand the law and make the best choices for themselves and their families... But at Kaiser we take no position on the ACA, or any other law or proposal for that matter." In this regard, it's goals and ours, as editors of Wikipedia, are aligned, and for that reason should be acceptable content to include. Sb101 (talk|contribs) 14:06, 3 October 2013 (UTC)

Requested move (August 2013)

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: no move. -- tariqabjotu 01:30, 1 September 2013 (UTC)

---

Patient Protection and Affordable Care Act → Obamacare – I don't think anyone can seriously argue that "Obamacare" isn't the WP:COMMONNAME for this legislation, nor that it's much more concise (and probably recognizable too). So the multi-billion-dollar question is whether WP:POVTITLE applies. There's no doubt that "Obamacare" was used primarily as a pejorative in its early days, it's also being reclaimed (see the following sources from the article for good background on the term: [3] [4]). An important landmark in this evolution was Obama's own embrace of the word two years ago; usage by supporters of the law has increased since then. Neutral and left-leaning media use it now, such as PBS and The Washington Post. Finally, the use of common names for legislation is not without precedent; compare to Superfund. --BDD (talk) 20:23, 22 August 2013 (UTC)

• Oppose – Still too recent, and the bill will be fully effective in 2020. Per WP:NC-GAL, "Obamacare" is commonly used name for this Act. But it was proposed in 2009 and passed in 2010, and there is the section Term "Obamacare". It has been three years since. Also, even commonly used "Spanish Flu" redirects to the 1918 flu pandemic, a deadly flu crisis in world history. Also, Obamacare is not even precise or accurate based on the article content, and I don't think historians want to call the Act an Obamacare. When did we have Reagancare or Clintoncare or Bushcare? --George Ho (talk) 00:33, 23 August 2013 (UTC)

There was "Reaganomics" as mostly pejorative for "Give tax money to the rich and the poor will prosper" but inflation was curbed by high interest rates applied by Fed chairman Paul Volker starting with prior President Carter. -Wikid77 18:54, 24 August 2013 (UTC)

I don't follow the recentism argument, George. Are you saying the topic as a whole is too recent to decide on a common name? The "Obamacare" term seems to predate the law itself, so I don't think recentism would apply to it. --BDD (talk) 17:20, 23 August 2013 (UTC)

I'm afraid so, and the fact that the term came "earlier" than the law is irrelevant. We can't change the article title to "Obamacare" just because it is widely used. I already pointed out that it is not precise enough. Well, I should say further: I believe that the term will be less used when and after Obama leaves the seat in 2017. --George Ho (talk) 17:27, 23 August 2013 (UTC)

Hillarycare not "Clintoncare" and remember Romneycare, though those articles are not currently using those names. Bushcare is about wilderness, not healthcare, Dubya's plan is usually called Medicare Part D. Though we are missing Brewercare. -- 76.65.128.222 (talk) 12:23, 26 August 2013 (UTC)

• Oppose for reasons outlined above by George Ho. --Jfruh (talk) 01:23, 23 August 2013 (UTC)
  • Just want to add, re: Sb101's comments below, that I doubt Obamacare will have long-term traction as a name because of the somewhat disparate nature of the law. "Medicare," for instance, is a specific government program -- it's a government-run health insurance program for seniors. "Obamacare" right now refers to the reforms that are right now mostly in the future. Once they're in place what will people refer to as "Obamacare"? The expanded Medicaid? That's Medicaid, still. The insurance you buy through exchanges? You'll still be insured by a private company, so it seems unlikely that people will call that Obamacare either. And so on. --Jfruh (talk) 02:18, 23 August 2013 (UTC)
• Conditional Support - I'm kinda of in agreement with both BDD and George Ho. WP:NC-GAL does say that we ought to "prefer titles that reflect the name commonly used in reliable sources." But reliable sources use both 'Obamacare' and 'the Affordable Care Act.' I should also point out that 'Obamacare' does redirect to this page, and this article is the first thing that shows up when searching Obamacare on google. At the same time, Medicare is not referred to as the 'Supplementary Medical Insurance Program (Under the Social Security Act).' And if PPACA -> Obamacare happened, keeping the subsection on the name would still be notable for historical interest. I think it boils down to the fact that Medicare is now used as the common term because that's how people (including historians) have come to refer to that program. I think it will happen with Obamacare, and if and when it does we should change it, but until then, to avoid controversy, we should leave it as it is. As per WP:POVTITLE, "Article titles and redirects should anticipate what readers will type as a first guess and balance that with what readers expect to be taken to." Until and unless users refer to it as Obamacare, I can easily imagine people claiming that use of the term would be biased in favor (readers expect to be taken to PPACA), but that this would change once fully implemented. The real problem then becomes, how do I create a 2-year reminder notification? =P Sb101 (talk|contribs) 02:09, 23 August 2013 (UTC)
• Strong oppose - Agree with George Ho and especially agree with Jfruh. –Prototime (talk · contribs) 02:51, 23 August 2013 (UTC)
  • Re:Jfruh/Prototime: Well, I can easily see people referring to the reforms as a whole as Obamacare (precisely because the reforms are disparate, but the term refers to it all), and for specific parts of it (e.g. I'm covered thanks to Obamacare/guaranteed issue, subsidies, bans on limits; I got my insurance through Obamacare/an exchange; the state rejected Obamacare funding for Medicaid/Medicaid expansion; Obamacare's Medicare savings/IPAB). I mean, Obamacare is already used for these purposes (because its concise and efficient) suggesting it does have traction. But, as I said, it's mostly a matter of wait and see whether it becomes dominant among users and, as a result, reporters. But it sounds like you are saying 'We shouldn't rename it because it won't be referred to as Obamacare'; and I think we shouldn't rename it unless and until it does; but IF it did become the dominant term to refer to things as I have outlined, would you then support it (like 'Medicare')? (It wouldn't change present opposition, but I'm interested to know for the future)? Sb101 (talk|contribs) 03:00, 23 August 2013 (UTC)
• Oppose - Per Jfruh. Teammm ^talk
  _email 03:02, 23 August 2013 (UTC)
• Strong support. With all due respect, Wikipedia ain't a crystal ball. We can't predict whether or not Iowa will be more commonly referred to as Aiwmeminoonoo in ten years (hey, it might!) but today, it is most commonly known as "Iowa", so that's where it's located. We can't predict what the common term will be for Obamacare in ten years, but we don't have to know. Today, "Obamacare" wins in naturalness, recognizability, and conciseness, and is clearly tied for precision, and is not inconsistent. Hey, that's the WP:NAMINGCRITERIA right there! That's a policy, btw, unlike WP:RECENT which is an essay. This is really not a difficult call to make. Thanks for nominating, BDD. Red Slash 03:38, 23 August 2013 (UTC)
• Strong Oppose - It's clear that the dominant term used depends upon the type of citation. Of course opinion pieces, blog posts and the like overwhelmingly use the term "Obamacare" right now - Obama is still in office - while every other citation, like those generated by CBO, Kaiser & similar, use the proper legislative terminology or it's derivates more so.

  I agree with the other folks; its too soon to deviate from the official terminology. To me, "Obamacare" infers more of a executive policy (of which the PPACA is a but a single part of) right now & that's not what we're covering here (legislation, law).

  and as an aside... the given Superfund precedent for common-name article renaming does not exactly mirror this situtation 100%, if at all, since Superfund (Act) has been a recognized "Popular Name" since the late 1980's for that piece of passed legislation. Naming that (Superfund) article something other than the official short-title or full title makes perfect sense in that narrow single, instance thanks to this long-standing, authoritative recognition.... but we won't find "Obamacare" on any such authoritative Popular Name list (again, not anytime soon). -- George Orwell III (talk) 04:59, 23 August 2013 (UTC)

  • Talk:Superfund#Requested move 2013 is now made. --George Ho (talk) 05:59, 23 August 2013 (UTC)
• Weak support certainly, it seems the most common name, even amongst Democrats and "liberal" (read: progressive) groups in America. And amongst "conservative" (read: anti-Democrat) and Republicans. And Libertarians and libertarians (read: liberals). -- 76.65.128.222 (talk) 04:46, 23 August 2013 (UTC)
  • (Tangential: you might want to read up on Liberals (Modern Liberalism) vs Libertarians (Classical Liberalism)).Sb101 (talk|contribs) 04:54, 23 August 2013 (UTC)
• Oppose: As noted above, the term "Obamacare" does not refer to a specific institution or government program. It also seems inappropriately informal, and carries particular polarizing connotations. My personal impression is that the term primarily originated as a (mostly pejorative) term for any healthcare reform supported by Barack Obama or the U.S. Democratic Party or anyone generally perceived as "liberal" or "progressive". It may have since been embraced to some limited extent by others, but I would still generally not expect to find it outside of quote marks in sources that try to maintain a dignified encyclopedic tone. Such sources seem more likely to refer to the law in question as the Affordable Care Act, or using some phrase that is not a proper name, such as "the 2010 healthcare reform act". —BarrelProof (talk) 11:22, 23 August 2013 (UTC)

• I think it's fair to summarize the above as Consensus: Opposed Because:
  • 1) Currently, 'Obamacare' might be associated with (positive and/or negative) non-neutrality (WP:POVTITLE, WP:TONE). Reporters do commonly but not universally use it; and the most neutral and authoritative sources, such as the CBO + Kaiser, use the more formal PPACA/ACA to refer to it - Wikipedia strives to be among the CBO/Kaiser group, and that's what readers expect (WP:NC-GAL, WP:POVTITLE).
  • 2) There is disagreement over whether the term will either grow dominant (even in authoritative sources) due to its conciseness and efficiency (for which the best historical and Wiki-precedent is Medicare); or whether it will not outlive Obama. We can't assume one way or the other (WP:CRYSTALBALL).
  • 3) As for recognition (WP:COMMONNAME); beyond reason 1, Obamacare redirects to this article and the lead makes it clear this is the right place so it's not like there is harm in leaving it as is for now.

These reasons call for this to be resolved as 'No Change' for now, at least; and it will be possible to revisit this later, if appropriate (post-2014, once mostly implemented, and/or post-2016 once Obama leaves office). Sb101 (talk|contribs) 19:14, 23 August 2013 (UTC)

You're probably right, but the discussion has only gone on for a day. We might as well allow it the usual one-week period for RMs. --BDD (talk) 20:03, 23 August 2013 (UTC)

• Oppose: Another reason not to use the term "Obamacare" as the title of this article is that this article is really about the law itself. The term "Obamacare" is commonly used to refer not only to the law itself, but to the entire program of health care that is going to result from the law. So, using the term "Obamacare" as the title of a Wikipedia article on the law itself would be imprecise, as the term "Obamacare" describes more than just the law itself. Famspear (talk) 22:43, 23 August 2013 (UTC)
• Support Obama owns this thing, and it will be forever his legacy, even after both he and it are gone. DeistCosmos (talk) 06:30, 24 August 2013 (UTC)
• Strong oppose: The word "Obamacare" began as an insulting name slur for President Obama's plans, as a pejorative often associated with doom and failure, but later reclaimed (see: [5]) which defuses the negative meanings by factual, or positive associations. Similarly, some use the term "Repulsemecans" for Republicans (as "repulse me") and that would be too pejorative for a rename or redirect. I advise to treat the term "Obamacare" as a separate notable article, with history and related issues, because it was not the same as the Act, but a separate word with multiple meanings over the years, and unnecessary clutter in the article about PPACA. -Wikid77 18:54, 24 August 2013 (UTC)

Do any Republicans self-identify as "Repulsemecans"? --BDD (talk) 16:00, 26 August 2013 (UTC)

• Oppose, per WP:POVTITLE. That may change, but I don't think it has at this point. ENeville (talk) 18:00, 30 August 2013 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Good Article

03:28, 23 August 2013 (UTC)

GA Review 1

This review is transcluded from Talk:Patient Protection and Affordable Care Act/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: LT910001 (talk · contribs) 03:28, 23 August 2013 (UTC)

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Hello, I haven't done many GA reviews so I'll just leave some thoughts about this article and get this process started. Firstly, I'd like to acknowledge that this article clearly took a lot of work and is about a topic that I'm sure many people would like to know more about. Length. This article is very long. Other articles are split at about 105kb; this is 300kb. (Wikipedia:Article_size). I'd consider splitting 'Provisions by effective date' into a separate article. Prose. Some sections read a little like an essay and could be written a bit tighter. I'll give two examples. "The plan that ultimately became (not needed) the Patient Protection and Affordable Care Act consists of (arose from) a combination of measures to control health care costs, and an insurance expansion through public insurance (expanded Medicaid eligibility and Medicare coverage) and subsidized, regulated private insurance. The latter of these ideas forms the core of the law's insurance expansion, and it (remove) has been included in (previous) bipartisan reform proposals in the past (remove). In particular, (As an alternative to public insurance) the idea of an individual mandate coupled with subsidies for private insurance, as an alternative to public insurance, (remove) was considered a way to get universal health care that could win the support of the Senate. Many healthcare policy experts have pointed out that the individual mandate requirement to buy health insurance was contained in many previous proposals by Republicans for healthcare legislation (this is mentioned above), going back as far as 1989, when it was initially proposed by the politically conservative Heritage Foundation as an alternative to single-payer health care.[176] " Another example where tightening could occur: One point of difference between the plans was that (this is redundant) Clinton's plan was to require (required) all Americans to obtain coverage (in effect, an individual health insurance mandate), while Obama's was to provide (provided) a subsidy but not create a direct requirement. During the (2008 US) general election campaign between Obama and the Republican nominee, Arizona Senator John McCain, (remove) Obama said that fixing health care would be one of his top four priorities if he won the presidency.[191] If you'd like some help I'd be happy to give this a go - it seems a bit unfair to leave the burden of work on the author alone, contact on my talk if you'd like me to have a go. Parenthetised comments. I don't feel it's very encyclopedic to have parenthesised comments, eg. (After failing to obtain a comprehensive reform of the health care system, Clinton did however negotiate a compromise with the 105th Congress to instead enact the State Children's Health Insurance Program (SCHIP) in 1997)." These should be integrated into the main text and cited. Citations. Some sentences are uncited. For example: "Jonathan Gruber, a key architect of the Massachusetts reform, advised the Clinton and Obama Presidential campaigns on their health care proposals, served as a technical consultant to the Obama Administration, and helped Congress draft the ACA." "(After failing to obtain a comprehensive reform of the health care system, Clinton did however negotiate a compromise with the 105th Congress to instead enact the State Children's Health Insurance Program (SCHIP) in 1997)." Many references are just URLs. These need to be cited properly. All right, I'm going to stop there. This article is too long and I find myself glazing over sections because the prose is not tight enough. By this I mean there are numerous example where a sentence is used where a word could do. This article should have sections split: Budgetary analysis of ACA (or some such) Provisions of ACA (or some such) Overall I find this article an extremely thorough analysis, clearly with a lot of work put into it, that needs some slight tweaking to become a GA. In the meantime I'm going to upgrade this article to B class. I hope that this review can get the ball rolling on some other reviews, too. Kind Regards, LT90001 (talk) 03:28, 23 August 2013 (UTC) Technically, "properly" formatted citations are not required. WP:LINKROT is bad, but properly formatted or complete citations are not one of the GA criteria. See WP:GACN for more. WhatamIdoing (talk) 01:31, 31 August 2013 (UTC)

Discussion

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Hi there! Thanks for getting the ball rolling. I need to let you know that I'm about to shoot off and can't reply again for at least 24 hours, but I ought to leave a few quick comments: Sb101 (talk|contribs) 04:40, 23 August 2013 (UTC) Hi, I've added a title to make sifting through this easier. LT90001 (talk) 05:21, 23 August 2013 (UTC) Length. Yep, definitely long. It almost certainly can be made more concise (such as the formatting clean up and prose you've mentioned), but I think most content can't justifiably be deleted; it's simply a complex topic, and whilst we need to ensure WP:Summary, comprehensiveness pushes in the other direction. Re: WP:SIZERULE "These rules of thumb only apply to readable prose (found by counting the words, perhaps with the help of Shubinator's DYK tool or Prosesize) and not to wiki markup size (as found on history lists or other means)." I will try and find out the prose size vs the mark-up size (300kb) asap, but do feel it fair to emphasize that rules of thumb can be violated if required to provide a comprehensive summary, which is my intent? Splitting. The only thing which seems possible (long enough for it's own article that hasn't already been - like Legal Challenges) is the Provisions. That was tried previously and there was opposition (I will link the discussion later). At the very least, I do want to get a template to remove the 'Provisions by effective date' subsections out of the main 'contents' for the article; something like this is what I intend to create. If we could find some precedent for a law's implementation timeline being split, then that might be the best way to restart that old discussion thread. But as for the budgetary analysis, I don't think that (i.e. PPACA impact on Federal Deficit) is long enough to warrant its own section? Sb101 (talk|contribs) 04:40, 23 August 2013 (UTC) I agree with you that the the content needs to stay, although the prose may need some tightening. Regarding splitting, I am happy having put this issue on the table, and await the input of a second reviewer. LT90001 (talk) 05:21, 23 August 2013 (UTC) Prose. Definitely agree (can't promise I'll agree with every proposed change - namely the 'consists of' > 'arose from' - but at a glance I'm happy with most everything else cited) - will have to address when I get back. Although (as much as I appreciate the offer), if I and other editors work on it we'd avoid potential conflict of interest for reviewers - not sure how that works, but thought I'd mention it. Sb101 (talk|contribs) 13:41, 4 September 2013 (UTC) Hah, yes it would rather destroy my impartiality as a reviewer, so I might demur (from editing). When writing about the need for formatting, I am aware of the enormity of revision this simple statement will require, given the size of the article. LT90001 (talk) 05:21, 23 August 2013 (UTC) Parenthesized comments. Perhaps some we can/should go over some, but generally I felt this was correct: e.g. Olympia Snowe's retirement isn't the same subject as the topic of the paragraph in which its included but it is related, interesting to readers, and can't really be included elsewhere (given the appropriate context). But for others, perhaps I could just remove the parentheses from, say, the Clinton/SCHIP example? Sb101 (talk|contribs) 04:40, 23 August 2013 (UTC) I don't see any problems with this article's grammar, but parenthesis detract from the encyclopedia-ness of the article. I don't feel many professional-level publications use parenthesis as much. LT90001 (talk) 05:21, 23 August 2013 (UTC) I agree; the use of the parentheses generally is grammatically sound, but the overuse of parentheses in this article detracts from its encyclopedic tone (most articles use parenthetical statements sparingly, if at all). In most instances, sentences can be restructured to remove the parenthetical statements without damaging the content, and such sentences will have a more encyclopedic tone to boot. –Prototime (talk · contribs) 21:08, 23 August 2013 (UTC) Citations. For some uncited info, I thought wikilink to the program was adequate instead of a reference? e.g. Clinton/SCHIP link, Gruber/Gruber's page (Otherwise I can just copy a ref from those pages, but as I say, I thought wikilink for those kind of tangential things was/is sufficient). And I have been meaning to edit the page to make the citations complete and consistent. Sb101 (talk|contribs) 04:40, 23 August 2013 (UTC) Well, I'm not too sure myself. But I think if you undergo a formal review this is something the reviewer will pickup quite strongly, so I thought I'll give a mention (see e.g. every review of a featured article candidate).LT90001 (talk) 05:21, 23 August 2013 (UTC) Thanks again, look forward to hearing back from you (and I will get started on those edits asap).Sb101 (talk|contribs) 04:40, 23 August 2013 (UTC)

Update 1

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Hey guys. I just thought I'd leave a note about what I intend to do to improve the quality of the article: Length. I followed the instructions of this how-to page (suggested by WP:SIZERULE), and found that that the "readable prose size" is 77 kB (though it doesn't seem to count material from bullet points, even so). According to WP:SIZERULE guidelines, this is in the group "Probably should be divided (although the scope of a topic can sometimes justify the added reading material)." I would definitely argue that (bullet point caveat or no), the length in this case is justifiable (minus prose tightening/formatting). Sb101 (talk|contribs) 11:16, 27 August 2013 (UTC) Thanks for considering this. Yes, I'll note some policies that refer to this: WP:SUMMARY, which states that "Sections of long articles should be spun off into their own articles leaving summaries in their place.", WP:SIZERULE which states that "> 100 kB... Almost certainly should be divided", WP:TOOLONG which states that there may be readability issues above 50kb text, and WP:GACR, which states that a good article "it stays focused on the topic without going into unnecessary detail (see summary style)." Having said this, I understand the length is a matter of some consensus, and I'd be happy to invite some other editors on WikiProject:Med to give their thoughts on this issue.LT90001 (talk) 03:14, 29 August 2013 (UTC) Splitting. Here is the discussion on the List of Provisions. However, I have added a sub-ToC in the Provisions by Effective Date subsection to preserve content within article AND navigability without cluttering the main ToC (I'm working on getting it out of the main ToC but thought I'd put the outline up there now). I feel like this will be a good compromise for the moment. Prose. I edited the two highlighted paragraphs. This may be dense of me, but are you able to point out further sections that could use tightening? I'm not sure if this makes sense, but I think I have author blind spot =P Sb101 (talk|contribs) 11:16, 27 August 2013 (UTC) Will get back to this tonight. LT90001 (talk) 03:14, 29 August 2013 (UTC) Parenthesized comments. Thanks for getting this started Prototime. I'm happy with the reasoning you two provided for this, and will help when I can; but there is at least one parenthesis (beyond things like "(PPACA)" in the lead and e.g. '(D-VA)') that I think we should keep: the one regarding Snowe's retirement. I really don't think that can easily be integrated + getting rid of most parenthesis doesn't have to mean getting rid of them all, if appropriate. Citations. This is pretty straightforward. I just need to find the time to make them complete and consistent. And as for adding references, I should be able to find a suitable ones from the wikilinked pages. Media Misc. There are two images that I really want to include and am trying to get permission to use (if limited use, proper attribution via cite): One of One of the Romneycare signing for 'Background' from Getty Images, and One of the Obamacare signing from the AP. I will email them. Sb101 (talk|contribs) 11:16, 27 August 2013 (UTC) Great, good luck.LT90001 (talk) 03:14, 29 August 2013 (UTC) And I'm still working on including the Kaiser video in the overview. Given the problems with .ogv identified by GO3, I'm planning on embedding the video using its link on youtube, given WP:Linking to user-submitted video sites: "There is no blanket ban on linking to YouTube or other user-submitted video sites, as long as the links abide by the guidelines on this page..." (aka copyright, which I have covered and will use a reference to remove the template that's on that page atm). Sorry for the delay in getting around to it. I've just got a lot of work on atm. Sb101 (talk|contribs) 11:16, 27 August 2013 (UTC) Been a little busy myself! I look forward to your future edits. I'll more fully elaborate some of my positions later. LT90001 (talk) 03:14, 29 August 2013 (UTC)

MOS issues

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Having hide/show buttons contravenes the MOS. Most images should be set to default size so that readers can than set the size they wish to see under preferences. Page is to long at nearly 300kb. Sections need to be summarized and split off into sub articles. While one occasionally allows the pushing of 120kb, 300kb has significant accessibility issues. The lead is the OVERVIEW. Why is there a section called overview? There is a picture of a table that should be made as a table here. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:56, 29 August 2013 (UTC) Hi There! Images. I have gone through and tried to format the images in a consistent manner. Pictures with people are now default size. Others I have restored to larger sizes. I have kept them at or below the maximum allowed (500px - WP:IMGSIZE), but image forcing is accepted where appropriate (WP:IMGSIZE); certainly, the ones that I have kept large are images that are practically unreadable at the default size, like graphs, and various maps of the US (PPACA votes, Exchanges/Medicaid). I checked the "Barack Obama" page (first one I could think of that I know is WP:FA) and it uses images in the exact same manner e.g. 'Employment statistics...' under 'Economic Policy'. (As for the table, I have no objections to someone fixing this). Hide/show buttons. I don't *think* this is the case. For example, it is used on election pages for endorsement lists and hypothetical polling; I believe it was accepted to appropriately include relevant historical information that did not merit it's own article. That is how I've used it in the case of the temporary waivers for coverage standards. However, I'm not attached to its inclusion, but in that case summarizing the section will have to be different. I'm not opposed to deleting several sentences in the collapsed bit (to integrate it easily) whilst leaving references linking to the information covered by those sentences. If that sounds preferable, let me know and I'll add it to my to-do list. Overview. The 'overview' section is an overview of the provisions and funding (the central elements of the law as opposed to say the legislative history, or impact, or opposition). This seemed clear, I thought. Perhaps it should be labeled 'Overview of Provisions and Funding' and then bold the 'Provisions' and 'Funding' rather than make them subheadings. But it is certainly a justified section. Length. As per preceding discussion section, the article is not too long. To quote, again, WP:SIZERULE: "These rules of thumb only apply to readable prose (found by counting the words, perhaps with the help of Shubinator's DYK tool or Prosesize) and not to wiki markup size (as found on history lists or other means)." The wiki-markup is indeed nearly 300kb. The readable prose is 77kb (give or take bullet points; I'm simply quoting the readable prose size given my use of the 'Prosesize' tool). I would also say that (prose tightening not withstanding - a work in progress) the sections are summarized, and those sections that merit their own article have already been split off. Constructive suggestions are welcome; there's not a whole I can work with just from a wiki markup quotes without identifying sections that could be summarized better (or how). Sb101 (talk|contribs) 16:48, 30 August 2013 (UTC) Do not consider it a GA at this point in time as these issues remain undealt with. Per (3) I do not consider it sufficiently focused. Per (6) it is not appropriately illustrated as some of the illustration should be tables. A couple currently stretch beyond a single screen and the maps should be set to default size. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:15, 30 August 2013 (UTC) Most of the issues above are not GA criteria. For example, MOS:COLLAPSE is not on the GACR (last I checked, at least). The bigger problem is the WP:UNDUE weight given to primary sources, especially WP:PRIMARYNEWS sources. It would be better to see a couple of those books under ==Further reading== being cited for the bulk of this information. Having nearly 500 different sources cited is almost always an indication that your sources are weaker than they should be. There simply aren't 500 top-quality secondary sources for most subjects, and even if there were (there might be for a subject like Algebra), if your sources are actually high-quality, you'd never need to cite that many different ones to cover the subject. One good, comprehensive book ought to cover at least half this information. WhatamIdoing (talk) 01:41, 31 August 2013 (UTC) I think DocJames/JMH649's comment is very unconstructive (nor persuasive) so I'll skip that and focus on the fixes I discussed in Update 1. However, regarding sources, I have been through most of them and they seem both reliable and necessary - on the latter point, the problem is that a) this is a complex topic; b) a controversial topic. It seems that the sources are appropriate given otherwise challangable material. I figure(d) content is more likely to be challenged without references than with the cumulative number of reliable references we have? Sb101 (talk|contribs) 19:23, 1 September 2013 (UTC)

Update 2

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Right. I'm going to have to write a bit of a longer response here. Firstly, we're both eager to get this article up to GA class. However in the interests of getting along well with fellow Wikipedians it might be good to show some level of amenability to DocJames/JMH649's comments, even if you're not going to change too much. Secondly, I can't remember if I have notified you or not, but I have earlier placed a comment on WikiMed here requesting some more comments. I did this because of the advice in Reviewing good articles that one should get a second opinion on a point of dispute, namely that the article is too long. I'd rather get some second opinions and build consensus on this point of difference rather than stake my entire review around it. On that note, I have copied and pasted the text of the article into my sandbox and it's 130kb there. The kilobyte count is a little immaterial really; having review other articles, and in light of the comments above about length and number of references (related to length) I think there is consensus that irregardless of the kilobyte count, this article is too long. Moreover, I genuinely think that the effective provisions section is below the overall quality of the article. It means that the article doesn't match the "summary style" criteria of a good article (point 3 on Good article criteria) and it is very hard to more-thoroughly review an article that's so long. You can definitely use {{Seealso|x}} or {{Main|x}} to refer to a second article whilst preserving some content. Without these changes I think there is consensus that this article can't be promoted to GA status. The fact you've added a small table of contents implies you've also given some thought to how long the article is. It's very tempting to want to put everything in one article, especially when all the information is so crucial. Unfortunately that's not always possible, and perhaps if you think of articles as sections rather than standalone chapters in a book it will make the transfer easier. The number of references will also decrease if this content is transferred to another article. Moving the content will also improve the focus, decrease need for illustrations, and relocate the troublesome word/table and overflow image (the comments above). As it is, without this change, despite it's many good attributes, this article can't be promoted to GA status. LT90001 (talk) 22:54, 1 September 2013 (UTC) Thanks for linking the Wikimed discussion. I hadn't seen it before. And I wanted to say sorry: I was mostly frustrated that DocJames seemed to jump in without reading any of the preceding discussion on length nor offering any ideas to resolve it. I could have responded better. Look, I'm not resistant to changes; I have and will keep working on improvements: I've addressed (or tried to) the parenthesis and prose issues (and will do more, if more areas for improvement are highlighted), and intend to go try and format the citations. + I suggested ways to address the collapsible buttons and was/am waiting for feedback to resolve; I will focus on fixing the other stuff unless I hear more on the overview/collapsible. However Length/Splitting is the obvious sticking point. First, I appreciate the Sandbox calculation. For the record, I was in favor of changing the List of Provisions by Effective date initially (way before the GAR), but dropped it when I faced resistance. Since that is also the problem section, and there's evidently more support than previously, it seems the best approach is to move the Provisions by Effective Date into its own article (being the biggest, least summarized section). I have attempted to do this myself. I need that article approved for creation so that I can delete the content from the PPACA article and then add a {{Main|x}} in the Overview + edit the Wikilinks within the article. Please let me know whether this is acceptable; and if anyone can please approve the new article, I can get to editing PPACA, and then re-evaluate re: the GAR =) Sb101 (talk|contribs) 12:42, 2 September 2013 (UTC) Hi, thanks for your considered reply. Yep, let's not get stuck on the overview/collapsing thing. From my understanding, as you are a registered user you don't need to go through the Articles for Creation process, and you can directly create the article by clicking on the link here: Provisions of the Patient Protection and Affordable Care Act by effective date. With that content transposed, we can start on a proper review of the remaining content which I will try and get done within a day or two. LT90001 (talk) 12:50, 2 September 2013 (UTC) Ok, so that's done. Look forward to hearing back. =) P.S. If more needed to go, the only section that could easily be deleted would be '3.1.3.2 Temporary waivers during implementation, 2010-2011' given it is rather narrowly applicable (and therefore low notability) historical matter. Beyond that, it gets much harder. But just as a heads-up. Sb101 (talk|contribs) 15:22, 2 September 2013 (UTC) I haven't read much here, but I am a random med participant who is also in the middle of reviewing Talk:Low back pain/GA1, which is thankfully well under half of the prose count here. (I've still identified a variety of ways to help the prose become more concise.) Generally speaking, given the Wikipedia:Length#Readability_issues of such a lengthy article (it's gotta be over 80 kB due to the skipping), I would be disappointed to see this article get up to GA without some significant trimming. Esp. considering that point 1 of WP:GACR says the prose is concise. I hope I don't burst anyone's bubble here, but we really should be putting readers first. That said, I will concede that I have only read small portions of the article. I don't know if my opinion would weaken or strengthen after a more in-depth analysis. Thanks. Biosthmors (talk) 15:52, 2 September 2013 (UTC) First off, kudos to LT90001 for a thorough GA review process and to Sb101 for being thoroughly responsive. I just wanted to throw my two cents and mention that I, too, support splitting off the "provisions by effective date" into its own article. To further condense the article, I suggest merging into the "Provisions" subsection the list of provisions enumerated in the "Change in insurance standards" subsection, since some of that content is duplicative. Concerning the removal of content like the "Temporary waivers during implementation" section, I'd like to point out that WP:SIZE makes clear that material shouldn't be deleted (though can be moved) simply to reduce article size, but if there are other reasons to do so (such as lack of notability), it can be removed. Personally, I agree with the notability view and think that as long as the temporary waivers are mentioned on the List of Provisions article, the corresponding section can be deleted on this article. –Prototime (talk · contribs) 16:35, 2 September 2013 (UTC) I like the idea of an overview of the main provisions (which I'd prefer to rename, 'Overview of Provisions'). I think there needs to be, and people do want, a short summary of the most important policy chances (+ the provisions don't easily merge into change in insurance standards e.g. the mandate, the exchanges, the subsidies, medicaid); I am going to read over it to see if I can improve/tighten the prose. On the other hand, I am inclined to merge 'Funding' with the CBO estimate of deficit impact; and I'm wonder whether the last paragraph of the CBO estimate is redundant - I think eliminating it (per lack of notability) wouldn't detract from the article's content. First, however, I am going to try and move more content into the new 'Provisions' article - namely content relating to regulation waivers and delays (which I believe - but am not 100% sure - are different i.e. some waivers may be part of the law as opposed to the administration's implementation discretion). This will also make this article more concise. Sb101 (talk|contribs) 08:48, 3 September 2013 (UTC) That sounds great, it is good news to hear the article is moving forward. I fully support integrating the 'funding' section and moving further parts to the 'provisions' article. LT90001 (talk) 10:54, 3 September 2013 (UTC) So I've made some more changes. Currently I'm looking at the 'Change in insurance standards' and figuring I should add in a 'see also' to the Provision list page + remove the bullet points because there is too much redundancy; I can integrate the non-redundant bullet points into the preceding paragraphs (if notable). Once that's done, I'll have a look to see if I can think of anything else atm, pending prose-tightening suggestions or anything else. Sb101 (talk|contribs) 12:25, 3 September 2013 (UTC)

Update 3

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Ok, so I feel like I've taken a good crack at addressing the length - moving content/prose tightening. I'll definitely keep looking over it myself, but I'd appreciate some secondary input at this point: a fresh set of eyes may see room for improvement that I might be missing. (Also, re: Prototime, whilst I am quite in favor of an overview of provisions, if anyone's got thoughts on a better way to do that section - I dunno if a table or anything would make it more readable - I'd love to hear it because I'm having trouble thinking of something there). P.S. Re: Overview - I think it's small enough that it could stay as bullet points, but it's more of a 'if this can be done better' kind of deal (as opposed to 'this needs to be done better'). Sb101 (talk|contribs) 18:08, 4 September 2013 (UTC) Great job tightening the prose, Sb101. I'll need to think about the provisions section a bit more. Generally Wikipedia disfavors bulleted lists in place of paragraphs, but when discussing the provisions of a piece of legislation (especially a giant one), the bullet approach seems sensible. –Prototime (talk · contribs) 04:33, 5 September 2013 (UTC) Thanks! I agree about the use of bullet points. Sb101 (talk|contribs) 05:22, 5 September 2013 (UTC) On a separate style-related note, I wanted to mention that this article appears to have too many wikilinks. For instance, I've counted the number of times that the NFIB v. Sebelius article is linked to in this article as six. Per WP:OVERLINK, generally something should be wikilinked to only in the lead and the first time it appears in the content below the lead (infoboxes/footnotes excepted). I'm not particularly a stickler for that rule where it seems helpful to include an additional wikilink or two beyond that, but when I read this article, I do find the number (and size) of blue links a bit distracting. It also may be helpful to reduce the number of words in piped links, as a few of them contain rather large phrases that are linked. I'm happy to help with this, but I wanted to mention it here first (as a few removals may be judgment calls). –Prototime (talk · contribs) 04:45, 5 September 2013 (UTC) Yea, I am generally looser too (for example, I think it's helpful to link when something is critical to a subsection in which it hasn't already been linked, even if it's been linked in other subsections). I'll help go over them and see about removing/shortening any; however, I'm just about to head off so I may not get around to working on this myself for a day or two. Thanks for the heads-up. Sb101 (talk|contribs) 05:22, 5 September 2013 (UTC) On second blush looking much better! Some thoughts: Dot points - in the provisions section, they make some points easier to read, although with too many it's not very discursive or encyclopedic. The 'legislative history' section is comprehensive. Length. The article is much better with the content removed to the provisions article. Having moved that much content, I think that this is an issue that is important and controversial enough to warrant a longer article. I'll just flag some issues at the moment that could do with some tightening: The two images that stretch across the screen, is there any way to make them smaller, crop the edges, or move one down to another part? Many statements have multiple sources from the same author. This could be a good thing, considering how controversial this topic is, however I note that several times several consecutive citations come from the same author. For one example: "votes for passage.[66][67][68]" are all from the same author. That's the same here "Republican Senate Leadership who opposed reform.[68][87][88] ", here "They drafted the Health Care and Education Reconciliation Act, which could be passed via the reconciliation process.[98][102][103] ", here "leading cause of bankruptcy in America[120]) and job lock;[121][122][123]" and I'm sure in several other places. The section "Summary of taxes and offsets" could do with some tightening. It is also very similar to this publication: [6] The "For example, a Reuters-Ipsos poll during June 2012 indicated the following:"'s dot points could be summarised a bit more. On the wikilink note, there are some sections with huge wikilinks. Several in the section "Insurance exchanges and the individual mandate" stretch for almost an entire line. To leave you with two positive things about the article, the attribution style is very good - always starting with "According to (x), ...". I think that's wise for an article like this! And lastly, I'll point our that that the Good article review criteria (WP:GACR are not as strict as the featured article review criteria and a GA candidate doesn't have to adhere to the manual of style completely. (Wikipedia:GACR#Notes) LT90001 (talk) 07:41, 5 September 2013 (UTC) Thanks for your thoughts. As mentioned, I don't have time to address them until I get back, but I thought I'd quickly note my ideas for improving the article: For statements with multiple sources from the same author: usually, if I've been the one to add references like that, it's because the two sources aren't (completely) redundant - that there's value in including them both. What I thought would be a good solution for such statements is to bundle the sources from the same author, which I'll get to work on asap. [And, at least for the ones I'll be looking over anyway, I'll try and make references are formatted consistent]. In groups of citations from the same author, I think it might be best in this case to select one or two (at most) from each author that best represents your point, so that these are easier to verify. Bundling is certainly an idea for those bunches of multiple citations where it seems like consensus has been reached. LT90001 (talk) 12:39, 6 September 2013 (UTC) I'll see what I can do to reduce or shorten wikilinks. As for the exchanges subsection in particular, I will try and shorten these ones too, but a couple of them may still be relatively long even after shortening due to the nature of the linked concept; perhaps wait and see what you think after I get a chance to do whatever I can, at least. I'll look into the sections you highlighted for tightening. (I'm also happier with the article post-Provisions split). And I'll review the dot points in the Overview to double check if there's any that can be shortened, merged, or deleted (reserving the overview for significant provisions) to make sure there's not too many. As for the two images, can you confirm which ones? The reason I ask is that, after DocJames first brought it up, I did edit the images I thought were being referred to: either moving them into the provisions article, or - in the case of the health inflation images - formatted to try and fix the issue. If you can clarify, I'll take another look at it. [And I'm still waiting to hear back from AP/Getty]. I refer to the image "U.S. Healthcare Costs - Centers for Medicare and Medicaid Services", which stretches across the screen. Perhaps you could use a <gallery> with the other graph (CBO – Deficit reduction under ACA), or split these into two separate images sections, or repost these on wikicommons in smaller size. As it is, the layout is a little nonstandard. LT90001 (talk) 12:39, 6 September 2013 (UTC) Sb101 (talk|contribs) 10:57, 5 September 2013 (UTC) I've gone through and bundled statements with multiple sources from the same author. I've kept it down to one or two per sentence with the exception of reference 151 (... "spread the cost of insurance in a sustainable manner.") - the reason for keeping 3 in that is that one reference links to Urban Institute Study, another to the CBO, and the last is more narrative (illustrating the concept from the statement). And I've tried to catch and fix incomplete references whilst doing that. I've done my best to reasonably shorten the wikilinks. I resized the two images and uploaded them - I haven't (yet) changed the formatting because I wanted to see if that fixed the problem you're having, because I can't tell (I'm not having the same issue myself). If that doesn't work I'll see about splitting them/using a gallery. I'm kinda crossing my fingers that it won't be necessary since, imo, they look as is. And I've tried tightening the Public Opinion you bit you mentioned, as well as the Overview of provisions. I'm having trouble thinking how to tighten those any more. For the Summary bit in the CBO/deficit section I added a Kaiser Family Foundation resource. Having not uploaded the initial material myself, I'll chalk up the similarity to the link you mentioned to coincidence + the fact that it's presumably referencing the same CBO material. However, I have found (by adding up the quoted changes) that it is very likely to either by an early or incomplete summary, as part of the deficit reduction power identified by the CBO is missing. Given this is the case, I rewrote the section to replace it with a written summary of 'major' deficit reduction (tax increases/spending offsets) sans the dollar figure amount; given the links to the CBO report and it's overall assessment, this should be sufficient + I the end result looks tighter. Sb101 (talk|contribs) 13:19, 8 September 2013 (UTC)

Update 4

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Let's have a review where this article's at in terms of the Good Article Criteria (WP:GACR): Well-written: Issues: Lede does not mentioned controversy. Issue with conciseness, especially in the impact section, of which every subsection could probably have a paragraph trimmed. I find the heading structure of Federal deficit section a little confusing, especially with the images all around it. Verifiable with no original research: Issues: over 350 individual and bundled citations, and 450+ references to citations makes this article very hard to verify. Over 85 from "The New Republic." Occasional primary and secondary sources to present sentences. Over 70 from "Jonathon Cohn", often several supporting same statement. significant size given to Reuters-Ipsos June 2012 poll essay-like format in insurance exchanges and myths suggests original research. Broad in its coverage: Issues: conciseness as mentioned above Neutrality: Issues. generally quite neutral, heavily reliant on some sources, possible OR Stable:  relatively. Illustrated, if possible, by images:[6] Issues: Those two images together stretch way beyond the 500 pixels recommended in the image use policy (WP:IUP) At this stage, I'd like to note that the advised normal duration is a week (WP:GAN/I). In this light I'm going to put this review on hold (GAN#hold). I think it might benefit the article, the reviewer (that's me!) and the review if we slow this process down a little. I can see this article making GA, but in the medium-term, and I don't think there are any 'easy fixes' that can get the citation issue worked out in the near-to-short term. If you're a participant at any active Wikiprojects, an extra set of hands helping do-up this article might help tighten the prose and citations. I'll drop in every few days, and other reviewers are welcome to leave comments on this review during this period. LT90001 (talk) 08:51, 9 September 2013 (UTC) First, thank you for your thoroughness and patience. Presuming it's still ok for me to comment on the issues you've mentioned: Well-written: Y Done? Lead mentioning controversy. Other editors tried to address this in the third paragraph of the lead: It does mention the Supreme Court case, and we wikilinked the 'Opposition and resistance' section in the bit about the law facing challenges? I thought this was sufficient weight in the lead, given that it is well covered in it's section, as can be seen from the contents?  Fixed Heading structure of 'Federal deficit' section. I moved the 'see also' bit about the debt to the same place as the 'see also#Provisions' under the CBO estimates heading to fix this (bringing the two section headings closer together, making it more readable). Verifiable with no original research: Y Justified for verifiability? Citations/References. If it makes a difference, it's about 350 all up: the bundles aren't hiding the overall count because many of the bundled citations were created by breaking a 'ref name' citation i.e. before I bundled the citation count included repeated references, now it includes bundled references. This is in line with other large (featured) articles, for example. Jonathan Cohn writes at "The New Republic," so that explains the latter. The reason I've cited Jonathan Cohn is that he writes nearly exclusively and frequently on in-depth health care policy; he jointly publishes many columns with Kaiser Health News; and often quotes and links to new studies (by GAO/CBO, and Kaiser, etc.). So I'd defend such references because they are reliable, and including them makes the content more verifiable. Also, since most of the bundled references are Cohn links (which were formerly multiple referenced citations instead of bundled ones), the ref count overstates his relative contribution to the sources: I counted, and there's 'only' 52 (some repeated in bundles), significantly less than 70+. The Reuters-Ipsos June 2012 poll seems representative, but other polls and polling aggregators are referenced in that section - from Pollster.com, 538.com, RealClearPolitics, CNN, USAToday, Kaiser Family Foundation, and WSJ.  Verifiably not OR Insurance Exchanges and Myths sections. The first 3 and last 2 paragraphs of the insurance exchanges are pretty straightforward - hardly any room for original research; the final and most complex paragraph I realized might look like that which is why I included the studies by the CBO, Jonathan Gruber, Rand Health, and Jonathan Cohn - which all say the same thing i.e. I've referenced the most challengeable material so people can verify that reliable sources say what I've summarized. Similarly for myths, sources from PolitiFact, FactCheck, and Snopes.com have been referenced to show that it is not original research. Broad in its coverage: Y Conciseness, especially 'impact' section.  Question: I have fixed previously highlighted issues; without specific suggestions, I'm having trouble seeing if/where/how it can be improved I have tried my best. At this point trimming will, I think, be cutting into content - so any removals would have to be for lack of notability. I'm not a member of any Wikiprojects, but I have asked the people from WikiProject United States Public Policy and WikiProject Law to take a look. Illustrated:  Fixed U.S. Healthcare Costs images. Images changed to gallery style, which (I didn't realize before) seems to solve the stretching problem. Neutral.  Done Stable.  Done (Updated: noting recent changes and clarifying my thoughts on where the article stands) Sb101 (talk|contribs) 01:09, 12 September 2013 (UTC) Thanks, I think with an article as vast as this it must be quite a lot to do as a one-man show, so I support the inclusion of some extra editors to get some new eyes on the job. LT90001 (talk) 11:12, 9 September 2013 (UTC) Ha! Yea, I can confirm it feels like that. But I've seen it through this far because I think it'd be great if we can get to GA status by the start of October, when the exchanges start, to ensure people will have a good quality article with reliable information on hand by that time. Sb101 (talk|contribs) 11:55, 9 September 2013 (UTC) This article is looking much better and the prose size is significantly down to 85k of readable text and 'only' 31 full page views from top to bottom of article (stopping @ references), including contents and those two huge pictures (I'm only using this as a metric to indicate how much the article as changed). I'll start with a full review later today. LT90001 (talk) 00:54, 12 September 2013 (UTC)

This article is too big to chew off at a single time, so I'll review in chunks. LT90001 (talk)

Lede + Provisions

Lede + Provisions  Done

Wiki's manual of style: Law (WP:MOSLAW) suggests that where possible primary and secondary sources are used for legal cases and law. That relates to the GARC for verifiability. Includes:  Fixed "However, the Court held that states cannot be forced to participate in the ACA's Medicaid expansion under penalty of losing their current Medicaid funding.[11][12] " Here ✗ Also guaranteed issue, minimum standards, individual mandate and other points in the provisions section.  Question: I'm not sure this is reasonably feasible - at least, as far as I can tell, not being experienced with legal citation. For example, the guaranteed issue provision, I can find references to it (e.g. Page 124 STAT. 243) but that seems more an explanation than the section that actually makes it law; or take the minimum standards, which presumably covers several sections of the law itself. Given this, I think it may be appropriate to accept secondary-only references? However, I have asked Wikiproject law to help, in case I'm mistaken. Sb101 (talk|contribs) 10:39, 20 September 2013 (UTC) Obviously, this is only a recommendation. If the statement is especially interpretive, or makes reference (or uses information from) to a large number of sections (preferably at the subsection level) within the subject Act of the article, then it may be a little too difficult to do good. See Foreign Account Tax Compliance Act‎ for some rather good examples IMO. If a sentence happens to touch on a large number of sections of a law, then this is going to be a very slow process, and not something that I think should be worried about right now. (Because for every word someone changes, they may need to add or remove multiple primary source references, which of course they will not do, causing a mess.) But if required, {{USC}} and {{USStat}} are the templates of note. But beware of WP:PRIMARY; a secondary source should be given regardless, if there what is said will not be immediately clear from the primary sources given. Was this what you were asking? Int21h (talk) 05:16, 21 September 2013 (UTC) I understand the law is over 2,000 pages long (or so the media says), so it's a bit unrealistic for you to be expected to make these specific references. If possible I think it would be good to be specific, but it is not necessary for GA status. LT90001 (talk) 09:24, 22 September 2013 (UTC) Well, I can at least confidently claim to have tried to ensure sufficient secondary source referencing in lieu of law quotations. Sb101 (talk|contribs) 13:06, 29 September 2013 (UTC) No doubts there! LT90001 (talk) 23:25, 30 September 2013 (UTC) Redundant sentences mentioned in the 'provision' section that are covered elsewhere and/or do not relate to the content of provisions, but why they were developed, include: ? Sentence "For more details, see the list of provisions ('Effective January 1, 2014')." is a little redundant and already mentioned at the start of the section,  Question: I know there's the 'main' link but I wondered whether it was worth signaling that there's more details (on the size of the penalty, how it's applied, the exceptions, etc.) in the provisions, which was why I added this bit? Sb101 (talk|contribs) 10:39, 20 September 2013 (UTC) I think this sentence is out of place and detracts from the readability of the paragraph. It is also unusual to have an in-text reference to 'see also' another article. If you want to include it, how about an intra-wiki link such as "These provisions will start [[list of provisions ('Effective January 1, 2014')|January 1, 2014]]"? LT90001 (talk) 08:16, 22 September 2013 (UTC) That doesn't quite capture why I added it - linking the effective date implies to readers a timeline, not there's more details, so they won't think to check it if that's what they're interested in, or even know that those details are there. I've hyperlinked 'or pay a penalty' to try to accomplish both your readability concern and my concern of indicating where they can go for more details. Sb101 (talk|contribs) 13:06, 29 September 2013 (UTC) Y This paragraph "This was included on the rationale that ... " could be moved to the section on "insurance exchanges", as it does not directly relate to the nature of what was provided.  Question: I've hesitantly deleted this bit. I realized it was not about the nature of the provision but about the rationale for it; but I felt this particular provision required it being the least understood part of the law. It would be great to get a second opinion on whether that was a worthwhile justification for including it in that overview section? Sb101 (talk|contribs) 10:39, 20 September 2013 (UTC) Thanks, this is a mammoth and very thorough article, so any sentence that deviates in the slightest from the purpose of each section I have been asking to remove or move. Without this clarity it is very hard to read... I offer the analogy of a runner who is completing a race, but every so-often is pulled over by a spectator for a word or two about their running style. Even a short diversion can take the metaphorical steam out of you. LT90001 (talk) 09:24, 22 September 2013 (UTC) I believe I see your point. Sb101 (talk|contribs) 12:45, 29 September 2013 (UTC)  Fixed "This is designed to extend the solvency of the Medicare trust fund, and therefore reduce the deficit." is covered in the section "reducing the deficit" and relates to the reason for, rather than the nature of the provisions Paragraphs which are not cited include:  Fixed Lede of provisions section re. "grandfather clause" is uncited.  Fixed This paragraph: "Medicaid eligibility is expanded to include individuals ..." is uncited Miscellaneous grammar issues include:  Fixed "bundled payment" ends with a colon  Fixed "A single payment is paid to a hospital and a physician group..." Probably more conventional to start the sentence with "For example,".  Fixed "health care delivery system" -> "healthcare" or "health-care" or your selected variant: this article alternates between all three.

Legislative History

Legislative History  Done

Overall a tight, verifiable and well-written section. Background  Fixed? "combination of measures to control health care costs, and an expansion of coverage through public insurance (broader Medicaid eligibility and Medicare coverage) and subsidized, regulated private insurance." A little confusing because of the two 'ands' and parentheses. Suggest reword "... through broader public insurance (specifically Medicaid and Medicare coverage)..."  Fixed "The latter of these ideas forms the core of the law's insurance expansion. " is redundant, as this section covers background and you have just talked about the provisions above.  Fixed? "An individual mandate requirement coupled with subsidies for private insurance was considered a universal health care proposal that could win the support of the Senate, for it had been included in prior bipartisan reform proposals." I think this is implied by the title "background". Perhaps reword to: "This has been proposed before in bipartisan reform efforts."  Fixed "complex or unrealistic " -> "complex and unrealistic (comma)"  Fixed "And in 1994 " -> "Additionally, in 1994"  Fixed "penalty provision [46]; " -> "penalty provision;[46]"  Fixed "stating had decided " -> "stating he had decided"  Fixed Suggest remove "So I’ve been surprised by that argument."[36]"; this paragraph is about republican initiatives and not current opposition. (also I feel the 'I don't remember that being raised at all') already strongly conveys this.  Fixed “An individual health-insurance “ -> "health insurance" (with space); occasionally the hyphenated form pops up, this is a little inconsistent Health care debate, 2008–2010 Does "in particular - "mean these were all the senators involved in the finance committee?  Note: No, the Finance Committee has more members than that, but those were the ones on it considered to have the greatest chance of brokering a bipartisan deal. Sb101 (talk|contribs) 13:31, 20 September 2013 (UTC) Ah, I see. LT90001 (talk) 09:07, 22 September 2013 (UTC)  Fixed Suggest move "and can be seen on the C-SPAN web site[58] or at the Committee's own web site.[" to "further references" - I am not aware of other articles which provide in-text external links like this.  Fixed Suggest wikilink the names here: "particular attention was given to Bob Bennett, Chuck Grassley, Mike Enzi, and Olympia Snowe".  Fixed for clarity, suggest reword "given not only how Democratic (‘blue’) Massachusetts is, but also the symbolic importance of losing the seat formerly held by Ted Kennedy" to "a psychological one: the symbolic importance of losing the traditionally Democratic ('blue') Massacheusetts seat formerly held by Ted Kennedy"  Fixed "the loss made "-> "which made"  Fixed suggest remove "that had become controversial" as this is implied by the text above, and also the sentence is confusing enough without this extra clause.  Fixed "their supermajority " -> "the Democratic supermajority" House  Fixed "December 24; the" -> "December 24 (comma) the"

Public policy

Change in number of uninsured

Change in number of uninsured Done

? This is just a suggestion, but I think it may be easier to read if this section flows from benefits of insurance and which groups will gain insurance, and then move the part about people who will remain uninsured to a bit lower in the paragraph. As it is, I feel it's a little spontaneous in direction.  Question: I'm having trouble seeing what you mean since I thought it kinda followed that direction already - going from number of newly insured to those who remain uninsured, with any other less notable (but still notable enough) details following? Sb101 (talk|contribs) 12:46, 29 September 2013 (UTC) Alright. Looks good as is... must have been something I ate. LT90001 (talk) 01:29, 1 October 2013 (UTC) Perhaps I should have held back on the brownies? =P Sb101 (talk|contribs) 06:13, 1 October 2013 (UTC) Have had a good chuckle about this one! Suspect it would totally destroy my impartiality, so I've had to put these metaphorical brownies in a box for later ;). (*Munch munch*). LT90001 (talk) 09:56, 7 October 2013 (UTC)  Fixed Suggest change "uninsured group will be" -> "Among the people who will remain uninsured", for clarity.  Fixed? "provisions have all taken effect.[109][110][111][112] " cites three primary sources and one secondary source that most likely quotes from one of the cited primary sources. Suggest trim 1-2 and then bundle.  Fixed? Suggest "eight million – they will " -> "eight million, who will" without the hyphen, for readability.  Fixed Suggest new sentence at "; they will also"  Fixed? Is there any way to make this sentence a bit less technical? I think it's a bit much for someone who might be glancing through the article. "ACA drafters believed that increasing insurance coverage ... costs among.[120]"  Fixed? "Due to the new regulations ... until age 26," suggest remove "and" for readability  Note: The sentence refers to two different regulations - but I reworded the sentence slightly to clarify that. Sb101 (talk|contribs) 12:46, 29 September 2013 (UTC) Great. LT90001 (talk) 01:29, 1 October 2013 (UTC)  Fixed "parents" -> "parents'"  Fixed "the Census Bureau found at the same time" (unspecified what time)  Fixed "In January 2013, the Internal Revenue Service ... new health insurance exchanges starting in 2014. " suggest break into two or three sentences, this is very hard to process  Done suggest remove "For those unable to afford insurance ... the mandate may be waived.", this is stated in the above criteria. (or below, if you have moved it down)

Insurance Coverage

•  Moved to preceding subsection, Fixed Suggest topic sentence = "The ACA has two primary mechanisms for increasing insurance coverage: increasing the coverage of Medicare, and creating state-based 'insurance exchanges'", as it is a little confusing what the two mechanisms are at the moment. You can then alter the paragraph accordingly.

Much easier to read. LT90001 (talk) 01:46, 1 October 2013 (UTC)

• Y The paragraphs "The insurance exchanges are a method... " and "The aforementioned regulations ..." could do with some citation bundling, it is difficult to read with so many citations.

 Question: I managed to get a few but not a lot of ones from the same author to bundle; although hopefully some of the editors have made it more readable regardless. Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)

It's looking better, but there's still an issue where citations interrupt sentences. To get rid of this, I suggest:

• and inflation)[138] through regulations:[139][89]. Group these three citations, and start a new sentence after "through regulations."
• "state exchanges[143] to" move this citation to end of sentence.

• • ? Some intrawiki links could be trimmed from these two paragraphs. These include the two links to "death spiral", two links to "adverse selection" and "Congressional Budget Office", which is surely linked elsewhere.

 Question: I realize it's unusual, but I thought they were justified: For the CBO, it hadn't been linked in that subsection and since I was only referring to it by acronym I thought it best to hedge bets for the reader. For the other two, the problem is that since you had the concepts are only being alluded and then referenced, I thought it made sense to reference them both - that way readers could realize and follow a link to an alluded concept and not be mystified by the lack of link to the concept once referred if they didn't check the former? Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)

I see your point. As a commentator overtly makes the link to "death spiral" I don't think there's a need for the implicit link. Fair enough for CBO; this is a long article and readers might not get to the other links. Some of the allusions (for example 'free-rider problem') are actually quite illuminating. I think in order to reduce the wikilink load and enhance readability it would be best to remove the second reference to "adverse selection," which is more oblique and already alluded to anyway. LT90001 (talk) 01:46, 1 October 2013 (UTC)

• I have mentioned below some long sentences which could be split up for readability purposes.

Specific suggestions:

•  Fixed "fill out a form to the government that will determine their eligibility for subsidies"... suggest add "fill out a form that will be used to..." for clarity
•  Fixed? For neutrality, suggest change from "( contrary to some rumous" -> "Although there has been some controversy, Members of congress..." and remove parenthesis.
•  Fixed Suggest remove "etc." as it is not very encyclopedic. There might be more reasons but I'm confident you've listed the main ones.
• ? "And price regulations " -> "Price regulations"

 Question: I really think that the 'And' is necessary to signal the end of the list (of ways to make it affordable - subsidies, competition, price regulations)? Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)

All right. I don't like starting sentences with conjunctions, but as this is a MOS issue it's not part of the GA review and I'm happy to demur. LT90001 (talk) 01:46, 1 October 2013 (UTC)

I appreciate where you're coming from, as I used to feel the same. But as I looked into it, it seemed its use is justified if used sparingly and not to create sentence fragments (see: 1, 2, 3) Sb101 (talk|contribs) 06:34, 1 October 2013 (UTC)

•  Fixed "The aforementioned regulations " -> "These regulations" (aforementioned is a little too technical)
•  Fixed? New sentence "enrollment,[129][130] without which" -> "Without this, "

 Note: Created a new sentence from "got sick; in such a situation." Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)

Much better. More time for the brain to breathe. LT90001 (talk) 01:46, 1 October 2013 (UTC)

• "and the limits on open enrollment" not quite sure what this means

 Note: One can't enroll at any time in the year, only within certain (limited) windows. Sb101 (talk|contribs) 14:19, 29 September 2013 (UTC)

Ah, ok. LT90001 (talk) 01:46, 1 October 2013 (UTC)

•  Fixed? For readability, suggest flip sentence to be: "Without this, a vicious cycle could occur, in which ..." and new sentence "This could result in insurance death spirals."
• Do you mean the failure to enroll penalty: "six million will pay the penalty in 2016.[154][155] "?

 Note: Yep! =) Sb101 (talk|contribs) 13:41, 29 September 2013 (UTC)

•  Fixed For readability, suggest split "Under the law, setting-up an exchange..." into 2-3 sentences.
•  Fixed "discretion; and " -> "discretion (comma) and"
•  Fixed Consider integrating parenthesis into text and starting a new sentence here: "functions), whereas "

Change in insurance standards

Change in insurance standards  Done

Fixed "their 26th birthday.[168][169][170]" has the primary source, the press release documenting the primary source, and a secondary source. Suggest remove one of them and bundle for readability.  Note: Deleted the press release. Sb101 (talk|contribs) 15:23, 29 September 2013 (UTC)  Fixed Suggest new sentence "essential benefits,[166][171] which cover"  Fixed Suggest reword "Among the essential health benefits; preventive care, childhood immunizations and adult vaccinations, and medical screenings[175][176] will have co-payments, co-insurance, and deductibles eliminated - these services will be covered by an insurance plan's premiums.[21][177][178] " -> "Among the essential health benefits (comma) ... will be covered by an insurance plan's premiums, and have co-paments, co-insurance and deductables elimiated." This one sentence has five citations. I suggest remove one or two, and bundle the rest at the end of the sentence.  Fixed Suggest "Specific examples of benefits covered include:" so as to remove the confusion that you gave some examples (preventative care...) previously.  Fixed? This sentence "Insurers are required to implement an appeals process for coverage determination and claims on all new plans.... policyholders if this is violated.[182][183][184]" suggest remove "and" as start of the new sentence, remove a citation and bundle the other two.  Fixed Suggest move citation here "These regulations[187]" in contraceptives section to the end of the sentence.

Effects on insurance premiums

I will more-fully review this section in several days' time. Would it be possible for you to run your eyes over the paragraphs, particularly paragraphs 2 and 3, and decrease the intensity of the technical language? For example, "The analysis forecasts that by 2016, for the non-group market comprising 17% of the market, premiums per person would increase by 10 to 13% but that over half of these insureds would receive subsidies that would decrease the premium paid to "well below" premiums charged under current law. " For the purposes of readability, I would also request that would add a topic sentence to paragraphs 2, 4 and 6, as I find it a little confusing to work out how they fit into the overall section given the technical language. Sorry, I am just a meek medical reviewer! Kindly, LT90001 (talk) 09:18, 22 September 2013 (UTC)

Happy to do this - apologies for not having done so sooner; as you may have noticed, it got busy here recently, but things seem to have settled done so I've been able to get back to resolving the issues you've been highlighting. But I won't do that tonight after having worked on the rest (Sorry, I need sleep - I'm only human! =P) =) Sb101 (talk|contribs) 15:23, 29 September 2013 (UTC)

No worries, I'll await your changes before I get to this section. I'm aware of the discussions on the article and admire your perseverance and dedication in improving this article. LT90001 (talk) 01:47, 1 October 2013 (UTC)

Thanks! =)

I've tried making it a bit less technical, so hopefully it's more readable now. Sb101 (talk|contribs) 09:45, 7 October 2013 (UTC)

Much more readable. LT90001 (talk) 07:57, 9 October 2013 (UTC)

Edit Request (Resolved)

9/29 @ 6:20pm eastern - Request an update to the following: From: "excluding those with incomes above four times the poverty line, about $94,000" To: "excluding those with incomes above four times the poverty line, about $94,000 for a family of four" Reference, see original source from which the $94,000 originated from. $94,000 for a family of one is significantly different than $45,960 for a family of one, with the latter being the actual number for a family of one. — Preceding unsigned comment added by 162.72.32.86 (talk) 22:22, 29 September 2013 (UTC) Done! =) Sb101 (talk|contribs) 02:43, 30 September 2013 (UTC)

Feedback

• Much easier to read.
• For readability suggest replace "individual market" as "market for individuals" and then put in brackets for small and large groups the % of the market, eg: "the market for indivduals would comprise 17% of the total health insurance market... the market for small groups (17% of the market)..." and so on.
• Sentence "The bulk of the savings were in reduced premiums " is uncited

Healthcare cost inflation

Having read the section on the federal deficit below this section, would it make more sense to move most of the content here? As it is the content is quite similar.

The following should be changed as it could be constued as NPOV and/or WP:UNDUE:

• The two quotes from Jonathan Cohn and Joanathan Gruber. These should be paraphrased in text: for example, "The CBO estimate has been criticised as failing to take into account..."

The following are small grammatical gripes:

• Here: "requires numerous pilot programs and demonstrations that may affect healthcare costs", "requires" is an intransitive verb and needs an object ("requires... to")

Other comments include:

• This list: "Several studies have attempted to explain the reduction in the rate of annual increase. Reasons " and the paragraph below is a off-topic, as it appears to be talking about reasons that healthcare cost inflation has not increased in the period 2002-2009, whereas the section and article relate to the PPACA. If you retain, I suggest cut it by at least a paragraph and alter to explain why this is relevant.
• The two images are too big. I suggest either remove one (the first image most likely, as this graph simply shows healthcare costs rising with respect to GDP, which is expressed in the text), or put them as thumbnails with a caption along the lines of "Rising healthcare costs as a percentage of GDP, 2000-2011 (click to view larger image)", so that readers still know that the full image exists, but so that the images don't stand out like sore thumbs in this article.
• The phrase about having a track record of underestimating is repeated in the section on "federal deficit"; suggest you delete here and retain there.

Federal deficit

A good mix of opinions.

The following are small grammatical fixes:

•  Fixed "total outlays (expenditure) and "total receipts (revenue), maybe use the intrawikilinking to remove this paraphrasing, it is odd to see an article paraphrase itself.
•  Fixed "on the ACA, which enabled " -> "that enabled" (without comma preceding)
•  Fixed? "period (because " suggest integrate into text: "(comma) because..."
•  Fixed Suggest reword "editors Noam Scheiber (an economist) and Jonathan Cohn (a healthcare policy analyst), " to "editors Noam Scheiber and Jonathan Cohn" with no introduction (as they have been introduced already); if retain introduction, suggest integrate into text, eg. "editors economist Noan Scheiber and health-care policy analyst Jonathan Cohn"

Other notes include:

•  Fixed This paragraph "found to be overpaid (relative to government Medicare); and reductions in Medicare reimbursements to hospitals that do not meet standards of efficiency and care." is uncited.
• ✗ Suggest reword "- omitting its cost from the ACA is no different than omitting the cost of the Bush tax cuts" to a passive voice, such as "However, it has been argued that not including ... is no different to..."

 Note: I have wondered whether a different example should be used, or whether the sentence is equally understandable with a generic "no different than omitting the cost of any other law" (I thought 'no'). However, the suggested reword "it has been argued" implies a degree of ambiguity whereas the intent of the sentence is to address a common misunderstanding. That's why I included the CBO letter that explicitly notes that it's looking at the cumulative effect of two bills, as requested by Paul Ryan, even though they are different + the more plain language source (Chait) and external analysts (CBPP) to verify. Given that the cost of the doc fix would remain even if the ACA were repealed, I feel any ambiguity is too misleading. Sb101 (talk|contribs) 09:22, 7 October 2013 (UTC)

All right. I still feel that this sentence reads quite strongly and I think that comes from this phrase "is no different than ". Perhaps you could replace it with "has precedent in?" or "is similar to" to decrease its intensity. LT90001 (talk) 08:12, 9 October 2013 (UTC)

• ? Image's caption " CBO: Deficit reduction under ACA; the "bump“ is a little unclear. Suggest reword and cite the CBO heritage. For example, "Deficit reduction under the PPACA [cit]". Also, this might benefit from a sentence in text explaining healthcare costs will go up before they go down (which I assume is the function of this image)

 Note: I added the citation but I'd prefer to keep ACA>PPACA, it's consistent with the article and with the CBO i.e. the title in the image + they, as I read it, use 'ACA' to refer to the 'PPACA as amended (by the Health Care and Education Reconciliation Bill, subsequent related judicial decisions, statutory changes, and administrative actions)' - See footnote #1.

OK. LT90001 (talk) 08:12, 9 October 2013 (UTC)

 Question: Actually, the main purpose of including image was to have a visual aide to easily show that the CBO estimates net-deficit reduction (even after the coverage expansion starts); the reason I added the 'bump' text to the citation is to make sure that any readers wondering why the deficit reduction is not uniform in the first ten years is because of the one-off expansion of coverage. I thought "The CBO separately noted that while most of the spending provisions do not begin until 2014, revenue will still exceed spending in those subsequent years." was sufficient? Sb101 (talk|contribs) 09:22, 7 October 2013 (UTC)

From what I understand and you have said, this image has been included to show the impact of the ACA on the US budget (and thus the debt). So a clearer title might be "CBO: heathcare budget impact of the ACA 2010-22. The 2015-18 inflection reflects the initial expansion of healthcare coverage." LT90001 (talk) 08:12, 9 October 2013 (UTC)

Sorry, one more:

• "commonly heard " -> "commonly-heard" or just "common"

Employer mandate and part-time working hours

Citations

•  Fixed This assertion "stay in place." is uncited.
• ? "As of yet, however, only a small percent of companies have shifted their workforce towards more part-time hours (4% in a survey from the Federal Reserve Bank of Minneapolis).[254]" This is a primary source and I am not sure that the FRB of Minneapolis is representative of the entire country.

 Question: The FRBM study was conducted within the 9th district (out of the 12 Federal Reserve Bank system districts); which covers MT, ND, SD, MN, and parts of WI and MI. That said, it may be the study is not representative. Although I've been meaning to read several articles, when I have some free time, which might give me something to add; the problem is that there seem to have been few studies providing hard data on the issue, so this is one of the few pieces of evidence we actually have, so I thought it better to include it along with context and evidence provided by the other sources? Sb101 (talk|contribs) 11:17, 7 October 2013 (UTC)

There is a guideline for medical articles (WP:MEDRS). This study would be called a "primary study" and we actively try and avoid using these, because the results can be easily misinterpreted or distorted, can be specific to the area or group that was studied, and may simply be the result of statistical variation. So I think it might be best to remove this study whilst we await the release of results from a larger secondary study. LT90001 (talk) 08:18, 9 October 2013 (UTC)

• Y "Workers who do not receive insurance from an employer plan will still be able to purchase insurance on the exchanges." is uncited.

 Question: I included this mainly to clarify for any unsure readers, but the substance itself seems well established from both the 'change in number of uninsured' and 'insurance exchanges...' sections - I figured with those (well-referenced) preceding sections, this sentence didn't need a citation as it would be unlikely to be challenged? (I have none-the-less copied one over). Sb101 (talk|contribs) 11:17, 7 October 2013 (UTC)

Glad to see the citation. Particularly important to be meticulous in this review. LT90001 (talk) 08:18, 9 October 2013 (UTC)

•  Fixed? "law.[262][263][264][265][247] " has six citations (two are bundled); suggest you remove 2-3.

 Note: Since the sources are referencing different things, I've moved them to their corresponding statements. Sb101 (talk|contribs) 11:17, 7 October 2013 (UTC)

Great, much more readable. LT90001 (talk) 08:18, 9 October 2013 (UTC)

Grammar & readability:

•  Fixed Suggest remove "and the employer mandate was a part of this attempt" as meaning is clear from position in paragraph.
•  Fixed Suggest move "(44% of the total population) " to after the 54% statistic for consistency and readability
•  Fixed? "situation; however " new sentence -> "situation. However, "
•  Fixed "medically related " -> "medically-related"
•  Fixed "employer’s " -> "employers(apostrophe)"
•  Fixed "political rationale of " -> "rationale for"

Other:

•  Fixed This sentence seems a little off-topic: "(At the same time, though, some analysts ... rather than using the 50-employee and 30-hour cut-offs).[253][262]" ; if retain, suggest reword to "Some analysts have suggested an alternate 'pay or play' system..." Either way, this entire sentence shouldn't be in parentheses.

Update: yep, you mention alternate systems in the sentence below, so this follows nicely. LT90001 (talk) 00:37, 1 October 2013 (UTC)

• (Update note: I will go over the 'Healthcare cost inflation,' 'MOS issues,' and remaining 'Insurance Coverage' bits asap (but no more tonight) whilst I await your replies/reviews of other sections.) Sb101 (talk|contribs) 11:44, 7 October 2013 (UTC)

I will stop here, review "political" in one chunk, and "opposition and resistance" in another chunk.

• Virginia is a Commonwealth, not a State per se. As in the Commonwealth of Virginia, the, "State of Virginia" is incorrect. — Preceding unsigned comment added by Willmcm (talk • contribs) 20:37, 7 October 2013 (UTC)

More MOS issues

Also, there may be too many external links. I'm not sure the NYT and WSJ topic pages are necessary, and the article from the Atlantic seems a bit random (there are hundreds of magazine articles on the subject; why is this the most relevant?) -- Ypnypn (talk) 14:59, 1 October 2013 (UTC)

Political

Right! Getting to the end of the review. I've reviewed the two sections and lede as well.LT90001 (talk) 08:53, 9 October 2013 (UTC)

Public opinion

• "Polls indicate" -> "US polls indicate"

 Done –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)

• The Reuters-Ipsos poll results, as mentioned earlier, are out of place in bullet form. I feel that this impacts on readability and gives undue weight to a particular source. However, I understand that this is provided as an example of US public opinion illustrating what has been noted in the first and second paragraphs. However, in-text it is out of place. Some suggestions might be to include it in a quote or table stucture.

 Done –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)

• The last two items should not be bulleted (other polls... other specific ideas...) as these weren't from the R-I poll. This may fix the readability concerns above, as the list would then be much shorter.

 Done –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)

• Style-related only: (52%–34%) normally reported small-> big (34-52%)

Feel free to correct me if I'm wrong, but I'm fairly certain that when a question is presented for/against, the results are reported "for -> against" and not "big -> small". I'm certain that's how bill vote totals in legislatures are stylized, but I'm not entirely sure that this applies to opinion poll results, so I could be wrong. –Prototime (talk · contribs) 23:28, 19 October 2013 (UTC)

Obamacare

• "for the uninsured (comma) according to "
• "without having government take over healthcare (question mark)'. " Although have seen both styles used in nested quotes
• "most common colloquial term to " -> "term used to"
• "Stuart Seidel, NPR's managing editor, said that the term "seems to be straddling somewhere between being a politically-charged term and an accepted part of the vernacular." is uncited.

All of the above -  Done –Prototime (talk · contribs) 23:39, 19 October 2013 (UTC)

Myths

• "Independent Payment Advisory Board " suggest wikilink

 Done –Prototime (talk · contribs) 23:49, 19 October 2013 (UTC)

• "advance(hyphen)care ". Wikilink?

 Done –Prototime (talk · contribs) 23:49, 19 October 2013 (UTC)

• I have moved the opinion by Ypnypn here:

The section titled "Myths" violates WP:WTW: "Avoid myth in its informal sense, and establish the scholarly context for any formal use of the term." -- Ypnypn (talk) 13:23, 1 October 2013 (UTC)

Ypnypn points out that "myth" is a "contentious label" (WP:LABEL) and a "word to watch" (WP:WTW). Such words "should be used with care...". However, it is also noted that the WP:WTW policy "should not be applied rigidly" and "There are no forbidden words or expressions on Wikipedia" (quotes taken from WP:WTW). I believe that here the use of the word "myth" falls within the OED definition (" a widely held but false belief or idea") and, specifically, that the scholarly context has been established, so it is reasonable to use it. As I am quoting from the policy, to ensure that I am not selectively paraphrasing or misinterpreting the policy, consult it directly here: WP:WTW. LT90001 (talk) 09:01, 9 October 2013 (UTC)

Correct me if I'm wrong, but I think the "formal use of the term" means a myth as in mythology (i.e. a traditional story, usually involving gods or other supernatural things). For example, Genesis creation narrative is described as a creation myth. The OED definition is the "informal sense", probably. -- Ypnypn (talk) 12:54, 9 October 2013 (UTC)

I tend to agree with LT910001's view of this; scholarly context has been established for its use, and I believe "formal use" of the term refers to the accuracy of using the term, rather than referring to stories in mythology. –Prototime (talk · contribs) 23:49, 19 October 2013 (UTC)

Opposition and resistance

• Legal challenges great to see a child article.

State rejections of Medicaid expansion

• "of the poverty level " suggest remove wikilink from "the"
• "However, the Supreme Court ruling created the potential... and the subsidy eligibility threshold" contains assertions that should have adjacent citations, rather than grouped at the end.
• "below 100% of the poverty line" suggest remove "100%", as this is implied when you say "below the poverty line"

All of the above  Done –Prototime (talk · contribs) 00:04, 20 October 2013 (UTC)

Noncooperation

• suggest rename to "Non-cooperation" (OED spelling)
• "required by federal law to functioning " -> "to the functioning of..."

Both of the above  Done –Prototime (talk · contribs) 00:06, 20 October 2013 (UTC)

Congressional opposition and government shutdown

• contains a "citation needed"
• suggest de-wikilink "APAB" as you have wikilinked it above.

Both of the above  Done –Prototime (talk · contribs) 00:15, 20 October 2013 (UTC)

Repeal efforts

• "None of the bills were considered by either body." is uncited

I simply removed this sentence. It seems like more trouble than its worth to find a source saying that these two specific bills, out of the many repeal efforts, were not considered by either body. The more important point is that these bills were the first repeal bills to be proposed (and clearly they failed). –Prototime (talk · contribs) 00:15, 20 October 2013 (UTC)

Job consequences of repeal

• "once they have health insurance outside of their jobs." is uncited (although I would hesitate to guess it is covered by the in-sentence citation).

Correct; I placed the cite at the end of the sentence. –Prototime (talk · contribs) 00:15, 20 October 2013 (UTC)

Re-review of Lede

Having now reviewed the entire article I will re-review the lede:

• The lede covers the law, its provisions and challenges.
• Using citations in the lead, whilst not always recommended stylistically, is a wise choice considering the contentious nature of the article.

Conclusion

Prototime, thanks so much for helping out. I will shortly conclude this review, but there's one outstanding issue, and that's the two very large images. I suggest that you put them in a gallery format with labels, that allows users to click to view more, or put them in captioned images. The current state is not readable and preventing nomination. I would welcome any of your thoughts, this issue has previously been discussed by Sb101 and myself in this review. LT910001 (talk) 00:54, 20 October 2013 (UTC)

Glad to help, LT910001. I've turned the images into thumbnails with captions; let me know if they still need some work. –Prototime (talk · contribs) 01:35, 20 October 2013 (UTC)

Rate	Attribute	Review Comment
1. Well-written:
	1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct.	Very
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.	Yes.
2. Verifiable with no original research:
	2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.	Yes, see comments below.
	2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose).
	2c. it contains no original research.	Yes, see comments below.
3. Broad in its coverage:
	3a. it addresses the main aspects of the topic.	Yes, see comments below.
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).	See comments below.
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.	See comments below.
	5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.	See comments below.
6. Illustrated, if possible, by media such as images, video, or audio:
	6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content.
	6b. media are relevant to the topic, and have suitable captions.
	7. Overall assessment.	A solid article. Well done.

Comments

Will be updated shortly, when the issue with images is resolved. LT910001 (talk) 01:16, 20 October 2013 (UTC)

I am promoting this article to GA status and commend the primary nominator, Sb101, on their continued and persistent improvement to the article. This nomination has been a very long process with extensive discussion on numerous points, and has been thoroughly looked-over by myself and several other reviewers. I would strongly encourage any commentator to read the above discussions before offering commentary on this review. I will note some particular points with regard to this article for future reviewers or readers of this review:

• Firstly, I would like to (again) commend the primary nominee, Sb101, who's been working tirelessly on the article's talk page and on this review. And thanks to Prototime for taking over at the last minute.
• I find this article to be readable and concise. This issue of length has been raised above, and as discussed, considering the contentious and broad nature of the issue covered, I feel that the current length is adequately broad without being excessively specific. This is warranted to give adequate coverage to each portion of the article.
• This article contains numerous citations. There is a risk of citation overload. However, at the current stage, and considering the contentious nature of the article, I think this is a reasonable and suitable choice.
• Neutrality. This article receives a large view count (9 million plus per year) and in society at-large, there is a notable debate. I find the article provides a NPOV analysis and portrayal of the bill, its provisions and history, whilst acknowledging the debate and the primary reasons for it.
• Stability. With the exception of a user who makes continually-reverted edits to the article, this article is in-the-main, stable. By this I mean there are continual edits around the edges of the article, but there are no sizeable reversions, additions or removals. A team of interested Wikipedians is monitoring the page and directly contention to the talk page, where consensus is reached for change.
• No problems with images.

In consideration of the above, I am promoting this article to GA status and congratulate the contributors for their well-written article. Kindly, LT910001 (talk) 01:39, 20 October 2013 (UTC)

All right!!! Congratulations to all of the editors who helped make this article what it is today, especially Sb101. And thank you, LT910001, for doing a great job with this extended GA review process. This is quite an accomplishment. –Prototime (talk · contribs) 01:49, 20 October 2013 (UTC)

Thank you, LT910001 and Prototime. Sorry for my recent absence - just been swamped with some work of mine, unfortunately. I do intent to return shortly to help maintain the page - I already noticed some changes I want to make to the Public Opinion section, for example - and close down a few of the edits that we were in the middle of, though I suspect Prototime has dealt with most of them. This month has been (and still is) just hectic for me but I'm hoping to enough time by Friday to read over/edit the remaining things so we can close/format them (like 'Lede + Provisions Done').

They shouldn't, however, upset the article new status. =D I really appreciate the kind words from people. But obviously a lot of people (far too many to mention) have put a lot of work into getting this far and maintaining it. In particular, though, thank you LT910001 and Prototime for your work on the review, and also to DrFleischman and George Orwell III who have done a great job maintaining the page! Great work. =) Sb101 (talk|contribs) 12:40, 21 October 2013 (UTC)

Just a general gripe

Out of 300+ citations, I'm more than a bit disappointed this article only cites Health Affairs and the NEJM once each. I would expect a quality version of this article to give much more due weight to those sources. To me, it suggests the article may not meet the broad or neutral requirements of the WP:GACR. Biosthmors (talk) 13:25, 13 September 2013 (UTC)

Can you explain a bit more why those two sources deserve more citations in this article? Do these sources contain information or views that this article is lacking? GACR's breadth and neutrality guidelines concern content; they don't mandate that such content come from any specific sources. But if there are notable views or information that this article is missing that is contained in these sources, we should give due weight to them. –Prototime (talk · contribs) 19:39, 14 September 2013 (UTC)

I strongly agree with Prototime: WP criteria (such as due weight, neutrality) pertain to content and its verifiability. I'm certainly not opposed to people adding more citations from Health Affairs and NEJM; they are good sources. I would be concerned if we were missing notable content that those journals cover. But, as far as I can tell, that's not the case and there is wide range of reliable, neutral sources cited. Sb101 (talk|contribs) 03:32, 19 September 2013 (UTC)

I think central concepts such as national health expenditure as a % of GDP (with or without the ACA) coming from peer reviewed studies generated by the CMS actuary[7] are crucial and missing. But considering I'm largely ignorant of the literature, I can't confidently say other things are missing. But can anyone confidently say they're not?

My concern remains that this article is a significant departure from where it could/should be for a GA, in my opinion, due to an over-reliance on popular press and an under-reliance on more scholarly (reliable and weighty) sources.

Meanwhile, the article focuses much much more on giving us long quotes and reactions to old CBO numbers: Patient_Protection_and_Affordable_Care_Act#Health_care_cost_inflation. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 21:08, 19 September 2013 (UTC)

Re:Biosthmors (talk · contribs) Re: expenditure - you don't think the section on the federal deficit covers that sufficiently (referenced with the CBO and CBPP)? As for the quotes and opinions - they still seem representative of opinion on the fiscal impact of the bill. And like my point about indirect references, at least for references I've added, many such popular sources are covering studies with language that is more accessible ensuring the content is more easily verifiable. That said, you're welcome to supplement existing sources with such studies. Forgive me since I think I'm phrasing this imprecisely, but shouldn't the onus be around giving examples (which we can then incorporate) of studies that aren't now but should be included rather than a generalized lack of assurance that everything is included? Sb101 (talk|contribs) 10:10, 20 September 2013 (UTC)

I cited a study as an example. Peer reviewed CMS actuary numbers from 2012 are much more relevant that 2009 or 2010 CBO numbers—to the extent that the old CBO numbers are made nearly obsolete, in my opinion. And who cares about old commentary? This isn't the "history of the American debate about the PPACA" article. I think the burden is on the person who proposes an article for GA status to demonstrate that their literature searches were comprehensive enough to find recent reliable sources. =) Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 10:54, 20 September 2013 (UTC)

And {{user}} isn't set to notify, by the way, it's {{U}}. So Sb101 and Sb101 should both work, FYI (unless you've disabled this preference). Best. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 10:58, 20 September 2013 (UTC)

Re: Biosthmors I don't see how the CBO is out-of-date since the CBO reaffirmed the numbers last year and, as far as I'm aware, the data hasn't significantly deviated; but I'm happy to add the CMS reference (NB: I'm working on LT90001's stuff just atm). As for the commentary, like I said the opinions on the fiscal impact of the Act included do seem representative even of current opinion. And I realize the burden is on the nominator to demonstrate comprehensive and reliably verifiable content, which I've done my best to ensure; among the prominent 'weighty' sources are references from CBO, CBPP, Kaiser, Rand Health, Gruber, Cohn, CMS - and there are in turn further references to other studies within the 'popular' articles that are referenced (I know several Cohn, NYT, and Rand references include additional studies from Health Affairs and NEJM, and I would presume more). My point wasn't that I don't have an obligation to ensure the article is up to scratch, but that you can't demonstrate insufficiency by saying we can't be confident that there isn't some important thing missing - no one can reasonably claim that. In terms of the substance, I think it is accurate and comprehensive. Sb101 (talk|contribs) 13:14, 20 September 2013 (UTC)

Inflation Images

Re: Biosthmors image removal; I'm inclined to keep them included. I realize that health inflation and its share of GDP are broader than the ACA, but that's what the written paragraphs put into context: both in term of motivation for and impact of the Act, these details are crucially important. I thought I'd leave it here for people to give their opinion. (Sorry; Belated signature) Sb101 (talk|contribs) 11:41, 20 September 2013 (UTC)

Correlation does not mean causation and these captions did not adequately explain the impact of the ACA per WP:GACR 6b. I found them to be WP:OFFTOPIC. Feel free to create the Cost of American healthcare article. It should exist, but it doesn't. Who am I talking to, by the way? Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 11:04, 20 September 2013 (UTC)

I realize correlation does not mean causation, which is why, in the paragraphs above the images, we've been very clear to put the changes in context i.e. the reasons for reduction + the studies implicating the structural changes. But the images so easily convey relevant information that I thought they worth including - by which I mean cost control was a big motivator in producing the act, and therefore it's impact on it is likewise significant. Sb101 (talk|contribs) 11:41, 20 September 2013 (UTC)

And those reasons are better explored somewhere else in depth. Of course they can be here covered briefly, that's what "Background" sections are for. This is Wikipedia where about 900 pages are created a day. =) Well if the pictures are reinstated, could we use better captions, at least? I still don't find them helpful, really, as the section is titled: Affordable_Care_Act#Impact. The CMS study cited above actually shows impact graphically. Can we not actually graphically represent this information, the relevant information that corresponds to the section heading? That's part of the WP:GACR. When I brought DVT up to GA status, I found big holes in Wikipedia's coverage, such as with prothrombin G20210A and endothelial activation, so I created those articles. I notice there is not a single WP:RED link in the article. So I think this article is "WP:Underlinked" in that regard. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 12:42, 20 September 2013 (UTC)

Re Biosthmors Having read over it, the CMS image isn't ideal. National health expenditures doesn't convey either the net-deficit impact nor the impact on inflation. The CBO picture covers the deficit. And on the inflation front we don't have pictures for the impact; we have pictures of the change in health inflation and studies that say that the law plays a part. So I've included those both. As for new captions, what would you have in mind? And regarding red links, I'm not sure which concepts you think need pages but don't have them, but you're welcome to add red links to signal that - as far as I'm concerned, I just link where possible and appropriate. Sb101 (talk|contribs) 04:06, 22 September 2013 (UTC)

Red links are more than appropriate. =) They're a helpful signal. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 09:30, 24 September 2013 (UTC)

Re: Biosthmors; Sorry, I didn't mean to imply that red links weren't appropriate. I meant, 'I try to link where appropriate, but only when links are available.' =P Sb101 (talk|contribs) 09:16, 25 September 2013 (UTC)

Sb101, generally speaking (and this goes to everyone on Wikipedia), please put links on important things (without WP:overlinking, of course). It generates useful redirects, creates a record of articles that need creating, and stimulates progress. State of the Future is a good current example of an article that uses red links the right way. Thanks for all your contributions. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 09:30, 25 September 2013 (UTC)

Obstruction Section

I removed the Obstruction section because of severe NPOV violations, Original Research, and outright lies. The section was beyond fixing, even the heading was a blatant violation of NPOV. Their own website lists some suggestions and they have presented bills to delay the individual mandate. The first sentence of the section of clear Original Research and at the minimum a biased presentation of the sources. Granted, Republicans are very much against the law in general, but to this point they have not actually obstructed (much to the dismay of many I am sure) any actual aspect of the law. Arzel (talk) 17:58, 21 September 2013 (UTC)

Can you specify any specific original research? As you may be aware, the House just passed a continuing resolution which defunds PPACA and are threatening to shut down the government if the law isn't effectively killed. The article and section is well-cited and makes no judgments for or against the obstruction, but notes that it exists. The Republican party is not ashamed of their position, so I don't see why this is POV or unfair in any way. II | (t - c) 19:05, 21 September 2013 (UTC)

I think the root of the problem might be the title of the section. It's less about obstruction than continued opposition in this case. Thargor Orlando (talk) 19:31, 21 September 2013 (UTC)

Agree; the section needs a "better" title than one using the term 'obstruction', but the notion the section "was beyond fixing" and thus, needed to be completed removed, is hard to justify. If anything, it seems to me the infered alternatives or reforms being mentioned simply need to be added, inter-linked &/or cited if Contributors feel they aren't currently in there. -- George Orwell III (talk) 23:18, 21 September 2013 (UTC)

Re: Arzel; NB: That suggestion page isn't improvements to the law, the first words you see are 'repeal and replace'. The first sentence of this section very closely mirrors language in the NYT articles - not OR at all. The obstruction refers to modifications, funds, and nominees - all elements of the law that they have attempted to obstruct as the sources identify. Sb101 (talk|contribs) 04:13, 22 September 2013 (UTC)

Is there a common title that could also cover the GOP alternative system? Hcobb (talk) 20:52, 21 September 2013 (UTC)

I think having it either in the opposition section or as its own separate section (Even under "Alternative proposals" or something) makes sense. Thargor Orlando (talk) 21:01, 21 September 2013 (UTC)

Well since anything short of a full & outright repeal of the entire enacted PPACA statue(s) would make any proposal (passed or not) just an amendment to/of the PPACA, we can also go with something like "Proposed amendments" ("Proposed changes" even). -- George Orwell III (talk) 23:18, 21 September 2013 (UTC)

I would disagree that they belong in this article. If and when they introduce a 'replace' bill, then you could create that a page. At most, I'd suggest including it on the 'repeal' bill's page. The suggestions listed are, from a policy point of view, not particularly compatible with the ACA; indeed, they're offered not as 'proposed changes' to ACA but 'repeal and replace' and this isn't the page to list any and all alternatives. Sb101 (talk|contribs) 04:13, 22 September 2013 (UTC)

Respectfully disagree. We can include Republican alternatives in my opinion. for those interested I'd like to see the draft. II | (t - c) 04:55, 22 September 2013 (UTC)

From above: suggestions - Well, I'll reemphasize being careful about undue weight. Sb101 (talk|contribs) 05:20, 22 September 2013 (UTC)

Let me be clear - my earlier point was simply on renaming the section &/or adding a formal interlink, with the assumption (on my part) that a "jump" to some other page (like "Alternative proposals to the current PPACA reforms" or similar) was going to follow that.

I wasn't advocating for anything like the replacement-over, the inclusion-of or the merging-with any of that alternative proposal subject matter stuff into the current article at all (well, not anything more than brief line or two describing what readers might find if they followed that "jump" maybe). It was my fault for assuming as much; sorry any confusion. -- George Orwell III (talk) 08:07, 22 September 2013 (UTC)

Lets break down the wording.

• As with all complex legislation, the act contains provisions that must be tweaked to make the legislation work well in practice, and avoid unintended consequences. Strong opposition in Congress by Republicans opposed to the act has resulted in gridlock, preventing these routine adjustments to programs.[328][333]

OR and NPOV. The section starts out as an accusation against Republicans that all would be just fine if they would simply agree to work with Democrats. This is a vast misrepresentation of the problem and Democrats/Obama have thus far been unwilling to solve the 30 hour week issue. Republicans and Democrats worked together regarding the CLASS aspect and there has been bi-partisan work on the Medical Devices section and other "routine" adjustments.

I see no opening accusation implying "all would be fine if..." whatsoever. Basically, it's an atypical cause & effect literary setup where the desired effect is presented first. Your assessment seems to be borne from some other interpretation imo.

As far as the alleged problem goes - the trend for anything less than full-time (a 40 hour work week) was well on its way to becoming a "new benchmark" long before Obama (or even Bush II) took office. However, one can legitimately argue (if a corresponding citation can be found) that with the passage of the PPACA, a renewed focus on lowering the weekly work standards was/is taking place but, again, this was the trend prior to anything having to do with the ACA so it really doesn't belong here. -- George Orwell III (talk) 17:53, 22 September 2013 (UTC)

While there may have been a trend to a less than 40 work week, there has not been any law which has encouraged it before now. Federal law still defines 40 hours as the cutoff for overtime. It is well documented that the law is causing companies to reduce hours below 30. It is disingenuous to suggest that the ACA has nothing to do with it when the facts are so plainly obvious. Arzel (talk) 19:22, 22 September 2013 (UTC)

Then I suggest you try building that correlation using the standards, with citations and so on. Until then, at least my position rejecting you're advocacy for removal is clearly documented at the start. Help me to help you change my mind. -- George Orwell III (talk) 21:20, 22 September 2013 (UTC)

Here is one of many. I only desire for WP not to be used for Political advocacy, which is often the case and clearly the case here. Arzel (talk) 21:26, 22 September 2013 (UTC)

• Many Congressional Republicans and supporters argue against improvements to the law on the grounds that it will weaken the arguments for repeal.[334][258]

That sentence is not bad.

• In addition to refusing to make routine technical corrections;

NPOV violation/OR. The statement that they are "routine" is purely opinion and the opinion of Obama and Democrats.

Not true. Since the ~1973 passage of Budget & Impoundments Act & the creation of the CBO , the premise since has always been to not budget from just one year to the next as was the general motivation before it was enacted, but to plan the budget(s) years out in advance based on predicted & continually revised scoring as the core rationale behind most major &/or regular legislation. At the start, nobody ever expected CBO's 10 year prediction to be anything more than putting us in the same ball-park, so legislation was drafted to be more open to amendment as economic conditions were being re-scored & refined. This premise was working fine from Reagan on thru Clinton right up until the Bush tax cuts started to be debated. That's the point where the timely changes to standing laws that needed to made to reflect new economic conditions, etc., and the eventual new scoring as result of those revised realties, started to get worse and worse with every passing year (and yes both sides added to this neglect once it was started) right on thru to this month's latest avoidance.

To get into the weeds on this point/counter-point would be beyond the scope of this single article. We'd need to make a dozen or so additions elsewhere to give it the justice needed to properly explain this, imho. -- George Orwell III (talk) 17:53, 22 September 2013 (UTC)

The sentence claims that they are refusing. You can take issue with one or the other, but together is it opinion. Plus it is documented as fact that they are not refusing to make what you would call routine technical corrections. your argument that you would need to make many additions elsewhere to make it balanced is one of the reasons why I said it was hopelessly unfixable. Thanks for agreeing with me. Arzel (talk) 19:22, 22 September 2013 (UTC)

For the record, I said it's outside the scope of this article -- not contributing to an un-balanced condition -- but I still urge you to build that framework where it's apporiate as support for where ever it is within an article's scope. Fwiw, Stonewalling over correcting various technicalties discovered since the law's enactment... is how I would have described it but I'm too lazy/distracted to change the current wording until today's games are over. -- George Orwell III (talk) 21:20, 22 September 2013 (UTC)

When you only include one side of the story it is un-balanced. It is quite disingenuous to say that balancing the article is not appropriate because you believe that this balance is outside of the scope of the article. I didn't realize that this article was "The Liberal view of the Patient Protection and Affordable Care Act". Arzel (talk) 21:26, 22 September 2013 (UTC)

• Republicans have also attempted to defund its implementation[328][335]

True.

• (including threats to shutdown the government unless the law is defunded),[329][336]

Vast overstatement and NPOV. While Liberal reporters like Jonathan Cohn make these statements, but Boehner (and many others) have stated that they do not want to shutdown the government.

Sort of agree the sentence is over stating what was actually said & what is only being signaled by some or contrived by the pundits. -- George Orwell III (talk)

• and block appointments to relevant agencies (like the IPAB[337]

This is a policy issue which Republicans think needs to be addressed because Republicans believe it will dangerously hurt health care in general. This is separate from the larger issue and it is Synthesis to connect with the previous.

• and CMS[338]).[339]

All the opinion of Liberal reporter of Jonathan Cohn. And why is this whole section littered with little more than Liberal sniping? Where is the objective views which would promote a neutral section? Arzel (talk) 15:58, 22 September 2013 (UTC)

I agree that many of the things you pointed out appear to be POV, and I have made some edits that I believe cure most of the concerns. However, I have not had the time to investigate the veracity of whether congressional Republicans have actually called for a government shutdown to defund Obamacare, or who those Republicans may be, so I have left that material in and tagged it with for the time being. Others are welcome to conduct this research. –Prototime (talk · contribs) 17:44, 22 September 2013 (UTC)

Again, anyone can add anything at anytime if they feel it is currently missing. I just don't see the things Arzel is having a problem with being entirely (or just primarily) falling under the sphere of this PPACA article much more. If anything, policy shifts or whatever folk's like to call it should be developed in a new article or on one of the existing "Health Care in the U.S." type of articles instead. -- George Orwell III (talk) 17:53, 22 September 2013 (UTC)

This is not so much an issue of what is missing, it is the clear biased presentation of sources and use of biased opinion as fact and original research. Arzel (talk) 19:13, 22 September 2013 (UTC)

Just a comment: I'm really glad to see that cooler heads have prevailed and the section has been restored and is being discussed and edited piecemeal. A LOT of work by many editors has gone into hammering out this very controversial section. If there are indeed pervasive NPV issues then the correct approach is to address them and fix them rather than to erase a lot of hard work in one fell swoop. I understand there are times for that but this is definitely not one of them. --Dr. Fleischman (talk) 19:44, 25 September 2013 (UTC)

Removal of the Provisions of the Law

Initial discussion

We really need to write in more details what is actually in the law, it is more important than history or some people opinions about the law. The provision were there for many years, so please do not remove them without of the discussion. Innab (talk) 18:09, 22 September 2013 (UTC)

I'm open to expanding the current "Overview of provisions" section and reducing the "Background" section (even moving parts of it to another article, perhaps) in an attempt to balance the article's content, but we did have a discussion in the GA review about moving the "Provisions by effective date" section to its own section given its gargantuan size, and I am not in favor of wholesale restoring the "Provisions by effective date" section or the wholesale removal of the "Background" section (much of which has also been there "for many years"). If you have more targeted suggestions to improve these sections though, I'm sure they'd be appreciated. –Prototime (talk · contribs) 18:17, 22 September 2013 (UTC)

There should of been a normal discussion on the Talk page before the provisions were removed. People come to this page to find out what is in the Law, this is main part of any law article, not the history of the debate or opinions of different politicians and journalists about it. Innab (talk) 18:38, 22 September 2013 (UTC)

@Innab: Your justification for continuing to ignore the discussion on this talk page is nonsensical, there is no Wikipedia definition of a "normal" discussion, and a consensus that develops in the process of a GA review is not invalid because it occurs in that context. I have approached 3RR, but another editor is sure to come along and revert your changes. If you continue to edit war instead of first discussing your proposed changes here, as I have attempted to do with you, then you will likely face disciplinary action. –Prototime (talk · contribs) 18:43, 22 September 2013 (UTC)

GA review is not an appropriate place for discussion. It should have been discussed on the Talk page. Article is about the Law, and what written in the Law is the most important, not what other people think about it. Innab (talk) 18:48, 22 September 2013 (UTC)

You repeating the same thing over and over again does not constitute discussion. There was a consensus on this talk page (in the GA review section, yes, but still on this talk page) to split the "Provisions by effective date" section into a new article, whether you choose to accept that or not is irrelevant; your refusal to engage in discussion on that point before reverting is unacceptable. Furthermore, there was NO consensus to remove the "Background" section, which you have done anyway. Your clear disregard for Wikipedia policies will not go unnoticed. –Prototime (talk · contribs) 18:54, 22 September 2013 (UTC)

• The provision were there for many years, even when the article just started and no history or debate sections existed, because what actually in the law is the most important part of any article about a specific law. The exchanges are going to open on October 1 this year, and most people want to know facts of what is the law says about subsidies and benefits, so it is very important to keep the section now. Moving this main section to the sub-article does not make any sense to me, because the sub-article always has less views, and if you look at the statistics, the sub-article "Provisions of the Patient Protection and Affordable Care Act by effective date" had only couple hundred views per day on average ( http://stats.grok.se/en/201309/Provisions%20of%20the%20Patient%20Protection%20and%20Affordable%20Care%20Act%20by%20effective%20date ), while the main article "PPACA" has several thousands views per day ( http://stats.grok.se/en/201309/Patient%20Protection%20and%20Affordable%20Care%20Act ). Innab (talk) 19:19, 22 September 2013 (UTC)

Thank you for finally engaging in discussion on this point. Per WP:CONSENSUS and WP:NOCONSENSUS, while this discussion is ongoing, the article should be restored to reflect the consensus that developed before your recent edits, and as a show of good faith, I'd like to ask you to revert your recent edits (before another editor reverts them, anyway).

Now, as I said before, personally, I am open to expanding the "Overview of provisions" section, but the "Provisions by effective date" content is simply too large; that's why it was originally moved. The concept of the "Overview" section is to summarize a bill that is over 1000 pages long, in accordance with Wikipedia page size limitations. Perhaps the "Overview" section can be expanded to be more detailed, but the "by effective date" section should not be restored. Also, can you please explain more why you completely removed the "Background" section? –Prototime (talk · contribs) 19:41, 22 September 2013 (UTC)

As Prototime has pointed out, the discussion on this talk page (see GAR review above) created consensus (with input from several reviewers) that the article was too long and that the provisions therefore needed to be moved. Now, I did initially make the case on your behalf for retaining the Provisions as a subsection of PPACA, and linked to your previous comments in the talk page archive the last time the section was formatted. But the reviewers persuaded me of the wisdom of changing it. (The discussion must have been there for more than a week).

I'm glad you point out the statistics, as I was about to do the same. In the last 7 days, PPACA has been viewed nearly 80,000 times (78,892), whereas the Provisions article has been viewed 2374 times. Now, having kept the provisions for those interested is great, but the detailed list is clearly not considered, by readers, to be essential to their understanding. For one, in terms of the facts of what the law does, I'd like to the Policy#Impact section satisfies most people; but also if it were so important to the readers of PPACA, I'd expect more cross-over views. Yes, I might expect drop-off, but IF it were so important, it wouldn't be a 97% drop-off (i.e. 3% cross-over, 2374/78892). Sb101 (talk|contribs) 03:26, 23 September 2013 (UTC)

• The traffic to the articles created by the links which are point to it. All the links on Google and most of the links on the other websites are pointing to this article. The reason why there so may links to it was that for many years this article was the best place to tell people in understandable language what is actually in the Law. So if you remove now any section, even "Impact", the traffic will not fall in one day, it will still come here for a long while, because there are a plenty of the links pointing here. For example, if you type "PPACA" on the Google search, this wiki link will be on the top, and all people who want to find out what is written in the Law will come here, and become disappointed. If person would be ready to buy health plan on the exchange on October 1 this year, he/she would want to know what is actually Law says about the subsidies, not what some random politicians think about it. Innab (talk) 02:48, 24 September 2013 (UTC)
• Problem why this article become too big, it because this article talks about too many things that are not directly relevant to PPACA, and have their own articles. It is not just "Background" only, a lot of the text from "Healthcare debate" belongs to the Health care reform debate in the United States or Health care reform in the United States articles. Text about history of the health care efforts (Medicare, Nixon's HMO Act, and Clinton's reform) should go to the History of health care reform in the United States. Most of the statistics about number of uninsured, and high healthcare cost should be in the Health care in the United States and Health care reform in the United States. Only short blocks should be appropriate for these loosely relevant things, with a link to the main article. We have here everything loosely related, but throwing away the provisions of the actual law. This makes no sense to me. Innab (talk) 02:48, 24 September 2013 (UTC)

The statistics don't support your proposition. If people were coming here for the provisions, there is the {{main}} link - if people were looking for the provisions, and came to this page, one would expect many more to make that one extra click. But 97% of people who come here do not go to that page, despite the prominence of the redirect, suggesting that most aren't disappointed with what they find. And, once again, everyone else who was looking at it agreed that that was the most appropriate way to deal with the article - due not only to the length of the Provisions but the difficult readability - being organized by time (as in Provisions) rather than type of effect (as in the Impact section) does not help people find out what the law does. Having the details that the Provisions article has is great but only if you know what you're looking for. I think this was the optimal solution. Sb101 (talk|contribs) 06:55, 24 September 2013 (UTC)

• Most of the people just do not notice the tiny link to main article, because they use to ignore them in the wiki articles. This will happens with any wiki article that sub-article has much less traffic. Innab (talk) 17:38, 24 September 2013 (UTC)

Innab, there is no consensus for what you're doing wholesale since you're the first and only person to object since the change was made. More to the point simply deleting content which has been worked for quite a while and replacing with copy-pasted material that isn't summarized and has lots of superfluous information doesn't help convey the most important provisions: e.g. the dates the provisions start are not notable enough for an overview - they are almost all about to take effect, making it more important what they are; you add a lot of repetition within that section, and repetition when compared with other places in the article (e.g. exchange details, Medicaid details + list of states, dependents on plans, banning rescission).

Simply put, what's there in the overview summarizes the major provisions much more concisely, without anywhere as much unnecessary and unreadable details; and yet much of the information is covered - not just in the Provisions article, but in various places in the impact section of this article in summary style. So there isn't reason to be concerned of people having to go to another page to get the info you were adding in the overview. Sb101 (talk|contribs) 12:57, 25 September 2013 (UTC)

Innab, please discuss before reverting the consensus to reduce the size of the "Overview of provisions" section. Multiple editors oppose what you are doing. If there are specific provisions you would like to expand upon or add to this section, please post your reasons why here, and we can discuss them. You might even convince other editors that some of your ideas are worthwhile ways to improve the article. But your "my way or the highway" approach isn't convincing anyone of anything. –Prototime (talk · contribs) 13:53, 25 September 2013 (UTC)

Seconded. Innab, I believe your intentions are good, but you can't force your will over consensus. This article is better with a summary of the provisions, and the detail is best kept in the provisions article. If there is something essential that should be in this article, I'm sure we can discuss it and come to a new consensus. - MrX 14:07, 25 September 2013 (UTC)

Ok, I cleaned it up a bit, removed the dates. You can clean it more, but the "provisions" section needs to be expanded. Innab (talk)

I'll repeat what Prototime and MrX said: please discuss before making such changes away from consensus.

The only thing I'll add is that you seem to keep implying that that the content you're adding has been 'dropped' if it's not included in the Overview. But this isn't true - much of the content you seem to be concerned with (minus a few details) are included; if not in the Overview, then in the impact section. For example, the <26-yr old dependents - change in number of uninsured; exchanges - insurance exchanges section; Medicaid - (in addition to the overview) State rejections of Medicaid section; banning rescission - change in insurance standards. But rather than being contained in a Wall of Text, they are now organized by effect, but are still included. Sb101 (talk|contribs) 02:55, 26 September 2013 (UTC)

Provisions need to be expanded, irrelevant things should be taken out

Provisions need to be expanded, and irrelevant things should be taken out. This article become a dump for anything loosely realated to health care, but things that are directly relevant to the subject of the article are thrown away. Provisions is the main section of any law article. This article is about PPACA, and loosely relevant things like Medicare, Clinton reform, history of health reforms, and high cost of medical care in US - have their own main articles. What is written in the Law cannot be thrown away. I think we should take this issue to the admins. Innab (talk) 20:13, 25 September 2013 (UTC)

Are you sure administrative intervention is appropriate? Engage in WP:BRD and WP:CONSENSUS-building. When those fail WP:DR is an option. But getting admins involved? You'll only piss everyone off. --Dr. Fleischman (talk) 20:44, 25 September 2013 (UTC)

The question of what-content should go under which-article & why has been an increasingly reoccurring meme around here as the years since PPACA's enactment have gone by. Over time, the PPACA article has steadily grown in content and, as a result, it has expanded well beyond what I'd consider the normal scope of a U.S. law article/stub (i.e. statute) into the realm of a major-reform effort on one side and the opposition to those same reforms on the other (i.e. policy). As it stands today, I'm more & more inclined to start agreeing with Innab - the issue with the PPACA article today is that it has developed well beyond the scope of what I'd consider 'just a piece of legislation enacted into standing law' into some sort of mash-up that now includes the background/history/effort by lawmakers, advocates & the Administration to normalize/nullify health care related reforms as part of accepted U.S. national policy.

I'm not 100% sure what to do about that or how to go about rectifying it but my initial instincts are to follow the CBO's approach when it comes to defining a standard...

"The Affordable Care Act comprises the Patient Protection and Affordable Care Act and the health care provisions of the Health Care and Education Reconciliation Act of 2010 and, in the case of this document, the effects of subsequent related judicial decisions, statutory changes, and administrative actions."

— CBO, Analysis of the Administration's Announced Delay of Certain Requirements Under the Affordable Care Act, footnote #1.

So the above CBO defined standard applied to our current content would be depicted graphically somewhat as:

• Affordable Care Act ( policy )
  • • Patient Protection and Affordable Care Act ( statute )
    • Health Care and Education Reconciliation Act of 2010 ( statute )
    • National Federation of Independent Business v. Sebelius ( judicial decisions )
    • Comp. 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011 ( statutory changes )
    • the delay of certain requirements until 2015 ( Administrative actions )
  • fiscal outlook & analysis
  • opposition vs. acceptance
  • etc. etc.

... with additional sub-branches for each as needed. I'm thinking that a move from the current PPACA to ACA, with copy-back of just the PPACA (statute) related portions trimmed from the new ACA back to PPACA would alleviate much of the overlap/good-article issues being raised lately while at the same time, narrowing the focus for each in moving forward. -- George Orwell III (talk) 02:44, 29 September 2013 (UTC)

I'm still thinking over this, but my initial reaction is a skeptical one, depending on what you're advocating. I could happily get behind a rename from PPACA->ACA and clarify that the article is looking at PPACA as amended (i.e. including HCERA, NFIBvS, 1099, Admin), but in doing so I don't see the justification for changing/moving a great deal of current content, nor the need to create a separate PPACA article (unless I've misunderstand what copy-back is). Truth-be-told, in retrospect I feel like I've been working off the assumption that the article is the ACA (PPACA as amended), in terms of how I've treated the article and how I thought other editors had viewed it. Sb101 (talk|contribs) 14:36, 29 September 2013 (UTC)

Ummm... there is no such legal thing as ACA. No such 'Act' was passed by roll-call vote in either CHamber of Congress. No assigned Public Law Number. No mention in the U.S. Code. No citation in the Statutes at Large. Not even a recognized Popular name by the House's Law Revision Council. In other words, there is no [legislative] infobox for ACA - it's a made-up term, broken off from [PP]ACA just like ObamaCare was (without the ~10 point swing in the polls for having Obama's name in it of course). So we would need to both have an ACA article as the primary umbrella article and a separate proper PPACA article falling "under" it. -- George Orwell III (talk) 17:42, 29 September 2013 (UTC)

On your other point, though, about the article expanding beyond the normal scope of a U.S. law article - well, I'd say that most pieces of law aren't this significant (in what they change, their amendments, or their reaction to them), and we're just appropriately dealing with what real life is chucking at us? Sb101 (talk|contribs) 14:36, 29 September 2013 (UTC)

Not blaming anyone - just pointing out that there is an unusually intense ideological and political element to this reform and its of no benefit to it being born the digital age whereas other major reforms enjoy the peace and quiet of being born in the age of newspaper and radio & only poked every decade or so by some supreme court ruling or something. I'm of the mind that its still not a justification to blur the lines for statute & policy is all. -- George Orwell III (talk) 17:48, 29 September 2013 (UTC)

A major piece of legislation like the PPACA typically has its own Wikipedia article that serves as an "umbrella" article, summarizing subsequent legislative amendments and court cases. Even though this article is large, I disagree with the idea of creating an "Affordable Care Act" article that is separate from PPACA to serve this "umbrella" purpose; it would add only further confusion and disarray for readers, and it would likely spawn even more never-ending debates about what content is appropriate for which particular article. –Prototime (talk · contribs) 03:42, 1 October 2013 (UTC)

Background section

The section comes off reading like a history of the individual mandate. The text itself is great and all, but that's only one of several parts of the bill and it really belongs in the individual mandate article instead. Ideally, the section should be about the history of this entire bill and this bill only, probably except for minor references to Medicare, Nixon's HMO Act, and Clinton's reform attempt. --Kurykh (talk) 04:00, 23 September 2013 (UTC)

I totally agree. This article talks about too many things that are not directly relevant to PPACA, and have their own articles. It is not just "Background" only, a lot of the text from "Healthcare debate" belongs to the Health care reform debate in the United States or Health care reform in the United States articles. Text about history of the health care efforts (Medicare, Nixon's HMO Act, and Clinton's reform) should go to the History of health care reform in the United States. Most of the statistics about number of uninsured, and high healthcare cost should be in the Health care reform in the United States. Only short blocks should be appropriate for these loosely relevant things, with a link to the main article. We have here everything loosely related, but throwing away the provisions of the actual law (see discussion above). This makes no sense to me. Innab (talk) 02:23, 24 September 2013 (UTC)

Re:Kurykh - Since the mandate-subsidies-regulation approach is the core of the reforms, it make sense to focus on the preceding proposals that prompted this approach as the history of the whole bill. And rather than the generalized 'individual mandate' (which doesn't just deal with health insurance individual mandate), it deals with those parts of the US health care policy history that are directly relevant to the ACA which would constitute undue weight in the individual mandate article. In contrast, Nixon's HMO Act was largely employer based so it has very little relevance to the PPACA, which is why it isn't included. At least with Clinton's reform, it makes sense to include it not only because of the 1994 Republican Senate alternative proposal, but also the backlash that helped kill Clinton from industry which lead reformers to try to divide industry by winning the support of some of those actors. If you think relevant history of the law is missing, feel free to add, but I would argue that what's there merits being there.

Re:Innab - I strongly disagree. To move content you've cited away from this article wouldn't make sense; either because it can't, unlike the provisions, justify it's own article imo, or if it were transposed to, say, 'health care reform debate' it would give undue weight to PPACA-related debate when it is adequately addressed and contextually appropriate here. And as for statistics included in this article about the number of uninsured and high health care costs - they're not generalized exposition (which is the kind of content I would expect in the general 'health care reform in the US') but more narrow: ACA's impact on them. That's highly relevant - indeed, a clear, concise explanation of those impact is, I would expect, one of the main drivers of traffic to the page. The provisions needed their own article due to the how much there was. Plus, given it was a timeline, rather than summary style, I would argue the impact section is better at conveying the information people are after whereas the provisions show when + details; but for just a relatively clear and concise summary they're not effective. Sb101 (talk|contribs) 07:18, 24 September 2013 (UTC)

That's an overly narrow focus, quite frankly. What of the insurance exchanges? That's completely absent from the section. It's not as if insurance exchanges were first conceived in 2009.

One other issue: the section seems intent on pointing out Republican flip-flopping on the individual mandate, which may explain the disproportionate focus on said mandate. I don't mind that from a partisan point of view, but this is an encyclopedia. I've cleaned up that part a bit along with other language, but there's a ways to go. --Kurykh (talk) 09:27, 24 September 2013 (UTC)

The biggest precedent of the exchanges is the Massachusetts reform. I wouldn't have a problem with you adding more detail on the Health Insurance Connector as a precedent for the exchanges. But as for the Republican stances on the individual mandate - that's completely relevant to show the precedent in support of the policy prior to the debate of the PPACA; is a big part of the reason that said approach was adopted. Sb101 (talk|contribs) 10:05, 24 September 2013 (UTC)

Then why no mention at all to any level of previous Democratic support for the mandate? Why the attention on almost exclusively Republicans, and why the need to identify only certain Republicans who were serving in both 1993 and 2009? The current presentation is extremely problematic: it's more partisan calling out than encyclopedic writing. --Kurykh (talk) 10:08, 24 September 2013 (UTC)

Because aside from the bipartisan support of the Massachusetts mandate, prior Democrats reforms didn't support (which isn't to say they opposed) the individual mandate, but rather if you look at the Clinton plan, or the Kennedy plan circa 1970s, they were employer-based; other Democrats where looking at expanding Medicare. The individual mandate was primarily a Republican alternative initially then became bipartisan (2006 MA, 2007 Senate), before becoming 'Democratic'. If that makes sense. Sb101 (talk|contribs) 10:35, 24 September 2013 (UTC)

I get that, but I think you're concentrating on what is factually correct so much that you're missing the broad perception of the section. Sure, what you say is right, but it's reading like a partisan screed. That might get you past GA, but I certainly hope that's not the highest you're aiming for.

Regarding the "having gone through a reviewer": Wikipedia is an ongoing project. I don't think the reviewer brought up the issue of titles, but everyone did talked about length. Adding stuff like "(R-KY)" doesn't add anything substantive to the article; instead, it clutters it up and lengthens it unnecessarily. I'm only doing this and other edits to tighten wording, take out unnecessary stuff, and what comes off as partisan slant. Look, I know the article is in the midst of a GA nom and stability is a criterion, but I don't see how removing titles and unneeded sentences just because the reviewer said nothing about them would detract from the nomination. I've done FLs and made changes without the behest of reviewers, and that wasn't a problem. --Kurykh (talk) 10:48, 24 September 2013 (UTC)

No, I understand that that GA, whilst a goal (and a means for improvement), is not the be all end all. I think my point of raising it is more of a 'slow down' these changes aren't as unobjectionable as you seem to think, at least in my mind. For example, in addition to my concern about length (in terms of wondering if notation is actually shorter for readability), it seems necessary information to identify party-membership at several points i.e. Republican strategy was lead by McConnell or noting that the former majority leaders where bipartisan (although on that point I suppose we could forgo identifying each individually so long as we said the group was bipartisan, given the wikilink to each one's own page?).

Also, as for the instances of naming those still in Congress 1993-2009 is because if you say Republicans supported it, now oppose it, it may not be the same individual Republicans. Only by showing that it's the same Republicans do you identify the change in policy/party strategy as opposed to internal disagreements. That too seems like a reasonable fact to convey? Sb101 (talk|contribs) 11:18, 24 September 2013 (UTC)

If you want to slow down on the changes, sure, I'll do that.

I've answered the notation part on my talk page, but for the sake of everyone else I'll repeat it here: is there a need to say "Republican senators Mike Enzi (R-WY), Chuck Grassley (R-IA)," etc.? First, it merely repeats that they're Republicans and second, what state they're from is immaterial to this article. I'm not saying forgo party ID entirely, but don't pile it on like it's extra frosting.

I disagree that you have to name the senators to identify policy changes. Saying that the idea came from conservative sources and that past Republicans first proposed this bill should be sufficient to convey that idea. --Kurykh (talk) 20:02, 24 September 2013 (UTC)

Ok, I see your point about redundancy, and the non-notability of the states given wikilinks. I've restored your edit for that that (and a few of your other tightening changes, some I slightly tweaked). Sb101 (talk|contribs) 11:27, 25 September 2013 (UTC)

Regarding titles: my interpretation of WP:JOBTITLE was that if we were saying "Senator Clinton did so-and-so," then the title is capitalized because it is used as if it is part of the name. If we're talking about senators in a way like "proponents included senators Clinton and Obama," it would be lowercase because it is not used as if it is part of the name. --Kurykh (talk) 22:45, 25 September 2013 (UTC)

So, whilst I'm not 100% grammatically sure, I'm happy to work off the distinction: singular = capitalized, plural=not, if I understand you correctly? (I corrected a few changes to be consistent with this interpretation). Sb101 (talk|contribs) 01:52, 26 September 2013 (UTC)

Not exactly. Let's use Barack Obama as an example. For my interpretation of WP:JOBTITLE:

"Canadian prime minister Stephen Harper spoke with American president Barack Obama today." (lowercase since it's a description of his position)

"Canadian prime minister Stephen Harper spoke with President Barack Obama today." (uppercase since the word "president" is used to address him)

Does that make sense?

Also, I understood "opt-in" and "opt-out" are nouns, but "opt in" and "opt out" are verbs. Correct me if I'm wrong though. --Kurykh (talk) 02:11, 26 September 2013 (UTC)

From my reading of it, it would be:

"Canadian prime minister Stephen Harper spoke with American President Barack Obama today." (it's still a title since it precedes his name; in contrast too:)

"Canadian prime minister Stephen Harper spoke with Barack Obama, the American president." ?

And my mistake on the verb usage of opt in/out, and others to which that applies (again, not 100% sure myself, but happy to go along with your benefit of the doubt); I'll change later (unless you get to it first) - I'm just about to shoot off. Sb101 (talk|contribs) 03:05, 26 September 2013 (UTC)

I'll change the opt in/out part, but I'm going to leave the titles with your version; it's not a big deal either way. --Kurykh (talk) 03:32, 26 September 2013 (UTC)

FDA provisions in PPACA

Most people don't know it but the PPACA included some major reforms to the Federal Food, Drug, and Cosmetic Act. This includes the Biologics Price Competition and Innovation Act of 2009, which created the path for generic biologics, the Menu Labeling Provisions of Section 4205 (that require calorie counts on all restaurant menus to be displayed), the Medical Device Manufacturers Fee, which medical device manufacturers have hated and have continued to fight against. I haven't seen this mentioned in the article. While this shouldn't be discussed extensively, I figured that it should be mentioned in passing. Here is more about the provisions of the PPACA that affected FDA - [8]. Remember (talk) 12:18, 24 September 2013 (UTC)

I now see that these issues are discussed in the Provisions of the Patient Protection and Affordable Care Act article. Perhaps there just needs to be more disclaimer language in the article that PPACA has lots of provisions and that this article will only focus on certain main provisions. Remember (talk) 12:30, 24 September 2013 (UTC)

Opposition and resistance section

Compared to the other sections, this one is particularly short and fractured. I was thinking of combining the Medicaid rejection and noncooperation sections into one (since they both deal with state-level opposition) and the congressional opposition and repeal sections into one (since they both deal with the congressional level). I would have pulled a WP:BOLD, but thought it would be best to run it through here first. --Kurykh (talk) 00:47, 26 September 2013 (UTC)

I had considered this in passing before. However, it seemed to me that there's several distinct aspects to the opposition: Legal, Congressional (Repeal and other), and State-based (State Governments + Private efforts). The problem with Medicaid is that it flows on from the legal whilst being State discretion, meaning it didn't easily seem to fit under either. I had trouble thinking how to tighten and combine whilst maintaining the flow AND establishing those distinctions; however, I imagine you have an idea?

As for Congressional opposition and repeal, depending on what you had in mind, I can imagine that being done more easily (and I have at least lowered repeal under Congressional opposition in the meantime).

In either case, the actually substance of what's there (if not the organization you're alluding) seems reasonably settled, although I wanted to note to be cautious of the preceding controversy over the cong. opposition section. Otherwise, I would be interested to hear what you were thinking of doing. Sb101 (talk|contribs) 13:00, 26 September 2013 (UTC)

"and some, including Senators Rand Paul, Ted Cruz, Mike Lee, and Marco Rubio, have expressed a preference for allowing the federal government to shut down rather than maintaining the law's funding.[331][340][341][342]" ^^^ — Preceding unsigned comment added by 69.173.6.5 (talk) 15:54, 27 September 2013 (UTC) In this section it is claiming four politicians are advocating a government shutdown, however the sources they cite are either opinion pieces or do not quote the four politicians being mentioned. This part needs to be removed unless a quotes can be found from each of these politicians supporting a government shutdown or default. — Preceding unsigned comment added by 69.173.6.5 (talk) 15:49, 27 September 2013 (UTC)

Here is a direct quote from the Washington Post article

"Sens. Ted Cruz (R-Tex.), Mike Lee (R-Utah), Rand Paul (R-Ky.) and Marco Rubio (R-Fla.) are leading the so-called Defund Obamacare movement, whose supporters say they won't vote to fund the government if the budget funds Obamacare."

It's not so much that they "expressed a preference" as much as they simply "led the movement". There's no need to cite quote the senators. I have adjusted the wording in the article to reflect what the sources say. - MrX 03:51, 28 September 2013 (UTC)

Edit request on 26 September 2013

Please change this: http://www.nationalaglawcenter.org/assets/crs/R41664.pdf to this: http://www.nationalaglawcenter.org/wp-content/uploads/assets/crs/R41664.pdf

The link has been changed. Thanks!

Erumley (talk) 17:44, 26 September 2013 (UTC)

Done! =) Sb101 (talk|contribs) 04:21, 27 September 2013 (UTC)

How income is calculated to figure your subsidy

A self employed person with an adjusted gross income of say $45k and a taxable income of half that (due to business deductions) will (more or less) use the $45k as the basis to figure their health care subsidy:

Exchanges will calculate enrollees’ household incomes using Modified Adjusted Gross Income, or MAGI. The MAGI calculation includes such income sources as wages, salary, foreign income, interest, dividends, and Social Security. MAGI calculation does not include income from gifts, inheritance, and Survivors Benefits, and some other income sources are partially excluded. More information on MAGI is available [here]. Raquel Baranow (talk) 22:41, 27 September 2013 (UTC)

Not that this is really the place to discuss this, but I'm reasonably sure this isn't true? MAGI is based on AGI, and if you're a freelancer the income in your AGI comes from your Schedule C, where you deduct your business expenses. In other words, the "input" into AGI from your self-employment is your net profit as a freelancer, and thus already includes those deductions. --Jfruh (talk) 19:03, 29 September 2013 (UTC)

Not if you don't have any Schedule C income, CPAs told me to take business deductions on Schedule A. Anyway, no where in the article is MAGI mentioned, thought I'd bring it up here for someone who would know where this would fit in. Raquel Baranow (talk) 00:22, 30 September 2013 (UTC)

Requested move (September 2013)

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: no move. -- tariqabjotu 01:01, 6 October 2013 (UTC)

---

Patient Protection and Affordable Care Act → Obamacare – Per WP:COMMONNAME (Wikipedia does not necessarily use the subject's "official" name as an article title; it prefers to use the name that is most frequently used to refer to the subject in English-language reliable sources.).

I really dont think the term "Obamacare" is POV because there's nothing negative about that per se. A similar analogy may be that Reaganomics, named after President Reagan, may be highly controversial but that's still the common name after all and that's why we use it here A1candidate (talk) 11:43, 28 September 2013 (UTC)

• Comment - Do you have evidence to show that Obamacare is used more than ACA, Patient Protection and Affordable Care Act, or PPACA? I'm under the impression that all of these terms are frequently used in our sources. Given that Obamacare redirects to this article, are there other convincing reasons for changing the title? - MrX 12:14, 28 September 2013 (UTC)
• We had this discussion less than a month ago, and there was no consensus to move it. Thargor Orlando (talk) 17:33, 28 September 2013 (UTC)
• Strong Oppose – For the reasons (particularly those by BarrelProof, Famspear, and George Orwell III) given at the last move request which ended less than a month ago, but most of all, because there was just a move request less than a month ago. Is there reason to suspect that, in the last 27 days, consensus would have changed so much as to result in a different outcome? Egsan Bacon (talk) 19:01, 28 September 2013 (UTC)
• (Still) Oppose - see recent discussion above for the same requested move's results. And with all due respect to Thargor Orlando, I'd say a consesus was reached clearly opposing the requested move to ObamaCare. -- George Orwell III (talk) 22:47, 28 September 2013 (UTC)
• Support as nominator. Perhaps I should explain myself more clearly: I am concerned that the previous move was rejected based on the false assumption that "Obamacare" has a derogatory meaning, and may therefore lead to POV issues. This is certainly not the case - even the White House uses it (Obamacare in Three Words: Saving People Money). Take a look at President Obama's speech a few days ago and notice:

Number of times Obama mentions "Affordable Care Act": 22

Number of times Obama mentions "Obamacare": 12

Number of times Obama mentions "Patient Protection and Affordable Care Act": 0

And with that, I rest my case. -A1candidate (talk) 23:41, 28 September 2013 (UTC)

• Strongly Oppose Whether the nominator believes Obamacare is derogatory or not, it is simply not the name of the law that is being dealt with. If Obamacare referred to a larger program of which the PPACA was merely one facet, then this argument might have weight. As it is, "Obamacare" has no usage beyond being a shorthand (and overwhelmingly negative) reference to PPACA. Eggishorn (talk) 05:12, 29 September 2013 (UTC)
• Speedy close - I suggest re-propose in the next five years. This is way rushed. --George Ho (talk) 05:33, 29 September 2013 (UTC)
• Oppose. Less than a month since this was last rejected. Zarcadia (talk) 08:51, 29 September 2013 (UTC)

Collapsing comment by sock of indefinitely banned user.--Cúchullain t/c 20:33, 2 October 2013 (UTC)

Comment. On Highbeam for the last two years (excluding press releases), I get 25,362 hits for "Affordable Care Act", 19,777 for Obamacare, and 5,270 for "Patient Protection and Affordable Care Act." Most readers are searching for "Obamacare", and almost no one is typing in "Patient Protection and Affordable Care Act" as a search term, according to Google Trends. Mound of the Dead (talk) 09:11, 29 September 2013 (UTC) Support. "Obamacare" is obviously not derogatory if Obama himself uses the term repeated in a major speech. It's certainly better than the current title, which is most awkward to say the least. Mound of the Dead (talk) 11:58, 30 September 2013 (UTC)

• Speedy procedural close: We just had this discussion a couple of weeks ago. Please give it a rest. —BarrelProof (talk) 03:17, 30 September 2013 (UTC)
  • Oppose: Since nearly a full week has gone by and this hasn't been closed, I suppose I must guess that there won't be a speedy procedural close and we'll all be forced to reiterate what we said last time. As noted above, the term "Obamacare" does not refer to a specific institution or government program. It also seems inappropriately informal, and carries particular polarizing connotations. My personal impression is that the term primarily originated as a (mostly pejorative) term for any healthcare reform supported by Barack Obama or the U.S. Democratic Party or anyone generally perceived as "liberal" or "progressive". It may have since been embraced to some limited extent by others, but I would still generally not expect to find it outside of quote marks in sources that try to maintain a dignified encyclopedic tone. Such sources seem more likely to refer to the law in question as the Affordable Care Act, or using some phrase that is not a proper name, such as "the 2010 healthcare reform act". A couple of extra weeks hasn't changed that. This recent edit (and the article that it references) also shows that some respected news organizations have also recently concluded that the term is polarizing and non-neutral. My impression is that the way people on the left have started using the term is they have done so only as a defensive maneuver, not because they actually find the term appropriate (e.g., see Queer). I also have the impression that people sometimes use the term because it is short and will therefore fit into a headline (but we have no shortage of ink on Wikipedia), or because it is polarizing and thus conveys controversy and attracts attention. When writing articles for the Internet, people get paid by the click. Wikipedia doesn't need to be a click farm. —BarrelProof (talk) 00:20, 6 October 2013 (UTC)
• Oppose: I still haven't seen evidence that "Obamacare" is the most commonly used term "as determined by its prevalence in reliable English-language sources" (per WP:COMMONNAME and WP:NC-GAL). This means, exclude all the op-ed pieces, blog posts, and White House references. If someone can provide evidence of such prevalence then I might change my mind. --Dr. Fleischman (talk) 18:43, 30 September 2013 (UTC)
  • What's wrong with op-eds? The guideline says we can determine common name by collecting data from "major English-language media outlets" using a search engine, which I did with Highbeam above. Mound of the Dead (talk) 20:02, 30 September 2013 (UTC)
    • The same "guideline" (actually a policy, not a guideline) says that the determination should be based on reliable sources. Op-eds generally aren't considered reliable per WP:RS and specifically WP:NEWSORG. --Dr. Fleischman (talk) 21:23, 30 September 2013 (UTC)
      • You know that a policy outranks a guideline? Mound of the Dead (talk) 00:55, 1 October 2013 (UTC)
        • Yes, and the policy requires us to consider only reliable sources. --Dr. Fleischman (talk) 05:25, 1 October 2013 (UTC)
• Support primarily per my nomination last month, though Reaganomics is a very good analogy. "Obamacare" may be more popular among detractors, but its usage is by no means limited to them, as I believe I already showed, with centrist media and left-wing sources, including Obama himself, using the term as well (I would also argue that WP:POVTITLE applies). If it makes anyone feel better, I'll say that my personal biases are in favor of the president and the law, lest anyone think I'm trying to carry out some sort of political hatchet job. --BDD (talk) 21:31, 30 September 2013 (UTC)
• Strong oppose - Not that I mind reopening discussion, but we just had this conversation a few weeks ago, so please see my comments in that discussion here. –Prototime (talk · contribs) 01:58, 1 October 2013 (UTC)
• Strong Oppose - FWIW - official names, rather than otherwise, seem more appropriate to encyclopedic presentations (per WP:NC-GAL, WP:NPOV and related) - in any case - Enjoy! :) Drbogdan (talk) 14:00, 2 October 2013 (UTC)

You might think so, but this is contradicted by policy. Compare WP:ON and WP:COMMONNAME. --BDD (talk) 20:21, 2 October 2013 (UTC)

@BDD - Thank you for your comment - nonetheless, "the official name will be the best choice" (per WP:ON) seems best to me here as well - Thanks again - and - Enjoy! :) Drbogdan (talk) 20:34, 2 October 2013 (UTC)

• Oppose -- it's about affordable healthcare, and that's in the official name of the bill, so we should stay with it. Once Obama is out of office, it's sure to be referred to less and less by the slang title, and more by the official name, so why change it twice when it's already at the right place? --SarekOfVulcan (talk) 04:40, 3 October 2013 (UTC)
• Comment - Can you withdraw the nomination please? --George Ho (talk) 05:58, 3 October 2013 (UTC)
• Speedy Close - My position is still conditional support: given the current consensus, any change will require time to prove that 'Obamacare' is durable and dominant. As it is, it seems to be in a tie with 'Affordable Care Act' (as an abbreviated version of PPACA). Atm, ACA is less politicized (WP:TONE, WP:POVTITLE); plus Obamacare does redirect to this article (on Google and Wikipedia). But one misperception that I need to emphasis is that Common Names, whilst uncommon, can be used: e.g. Medicare (whose full title is never used - WP:NC-GAL, WP:COMMONNAME). Sb101 (talk|contribs) 16:44, 3 October 2013 (UTC)
• Strongly oppose – Even though it's commonly called Obamacare, remember that Obamacare is only three days old (at the time of writing), so we can't really say the name has "stuck" yet. "Reaganomics" is decades old now, so the analogy doesn't quite fit. --Article editor (talk) 03:56, 4 October 2013 (UTC)

Parts of the law have been in effect for a while now, and the subject has been discussed for years prior to its full implementation anyway. You can't just say there's no common name because the law hasn't been implemented long enough. --BDD (talk) 18:49, 4 October 2013 (UTC)

• Comment: Can we at least agree that "Patient Protection and Affordable Care Act" is plain jargon that almost nobody uses, except in official documents? -A1candidate (talk) 00:14, 6 October 2013 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Bipartisan support for changes

The following sentence currently appears in the "Congressional opposition" subsection:

However, a few changes have received bipartisan support.[1][2]

[1]: "AdvaMed CEO: Obamacare device tax repeal has 'broad bipartisan support'". bizjournals.com. September 19, 2013. Retrieved September 23, 2013.

[2]:"House Vote on Authority for Mandate Delay Act, July, 2013". Office of the Clerk of the House of Representatives. July 17, 2013.

• I removed it with the comment: "rm "bipartisan support" sentence as unsupported by reliable secondary sources"
• Arzel reverted with the comment: "I don't think you read the source. The Medical Device Tax, for example, does."

It's not a matter of whether the change has bipartisan support, it's whether the claim that it does is reliably sourced. The Flook source about the Medical Device Tax doesn't say the tax repeal has bipartisan support; it says a medical device industry lobbyist says the repeal has bipartisan support. Huge difference. Obviously the lobbyist is pushing for the repeal so he's not reliable. The other source is just a roll call. It can't be used because it's not a secondary source and it using it to say there was bipartisan support is original research. Everyone knew the bill wouldn't become law so Democrats could vote however the wished and not have to fear any policy implications. Who knows how they would have voted if their votes actually mattered. --Dr. Fleischman (talk) 19:13, 30 September 2013 (UTC)

I agree with DrFleischman. In the most recent vote on the device tax, only 17 Democrats voted "yes" while 174 voted "no". Democratic support for a repeal, low to begin with, has been eroding since 2012 ([9]). So it's clearly false to claim that a device-tax repeal has broad "bipartisan support". As DrFleischman points out, credulously repeating a lobbyist's spin is a lapse in editorial judgement which one hopes will not be repeated. MastCell ^Talk 19:27, 30 September 2013 (UTC)

Here, now revert yourself for not even taking the time to look. Arzel (talk) 20:10, 30 September 2013 (UTC)

A title for a blog post that doesn't even use the word "bipartisan" in its body? Seriously? Not to mention that it seems you're retreating on the two sources that are currently cited. Am I correct? --Dr. Fleischman (talk) 21:33, 30 September 2013 (UTC)

Myth or not, using "Obamacarefacts.com" as a source doesn't seem really worthwhile. Thargor Orlando (talk) 23:27, 30 September 2013 (UTC)

(Separate issue. We're talking about "Congressional opposition," not "Myths." --Dr. Fleischman (talk) 23:36, 30 September 2013 (UTC))

I simply provided another source since you didn't like the other two, but that is just one example. The CLASS Act had bipartisan support for it's removal as well. The point is that the section "claims" that Republicans have been unwilling to change to fix anything, when that is simply not true. Arzel (talk) 02:31, 1 October 2013 (UTC)

Well if you find a reliable source to support the statement, then by all means let's put it in. In the meantime I'm removing the two (unreliable) sources and adding a cn tag. And if you think the preceding sentence overstates its sources, then we can work on that too. Maybe that's a better way to address your concerns. --Dr. Fleischman (talk) 05:21, 1 October 2013 (UTC)

Thanks for the new source, Arzel. Since the article only says the medical device tax has received bipartisan support (rather than "a few") I changed the sentence to reflect that. --Dr. Fleischman (talk) 17:14, 10 October 2013 (UTC)

I'm more convinced than ever that it's a mistake to describe the device-tax repeal as a bipartisan issue. From today's New York Times: "Any provision to delay or repeal a tax on medical devices—a sticking point in the negotiations—will almost certainly be excluded from the final deal, Senate aides said. Republicans sought to have the tax eliminated or pushed back, but Democrats strongly resisted." It sounds like the device-tax repeal is a pretty clear-cut partisan issue. MastCell ^Talk 22:12, 14 October 2013 (UTC)

This article reads like Obama's campaign workers wrote it

WP:NOTFORUM

And how in the hell is this law even legal? It was originally titled the,"Service Members Home Ownership Tax Act of 2009." They took a completely unrelated bill from the house and totally transformed it into Obamacare to bypass the requirement that revenue-related bills originate in the House. That's completely against the spirit and letter of the Constitution, but I guess everyone is used to Obama violating the law to do what he wants at this point. — Preceding unsigned comment added by 71.32.122.15 (talk) 02:15, 1 October 2013 (UTC) "This is not a forum for general discussion of the article's subject." Kindly fuck off. 95.113.216.6 (talk) 03:54, 1 October 2013 (UTC) Totally agree, unbiased it isn't. Where are the references to huge corporations cutting spousal insurance from their employee insurance plans, in anticipation of Obamacare? http://www.huffingtonpost.com/2013/09/11/health-coverage-spouses-_n_3908786.html 172.10.236.215 (talk) 06:11, 1 October 2013 (UTC) My suggestions are pretty fucking obvious aren't they? 1. Ban the campaign workers who have obviously written this article. 2. Talk about how this bill is illegal because it violates the Originality clause of the Constitution. Case in point, ban this SB asshole who says on his user page he is some Barack Obama lackey and who seems to think my suggestions need to be hidden from view.

Welcome to Wikipedia! If you have particular changes you'd like to suggest, please do so. If you're here to rant, please review WP:NOTFORUM first. --Dr. Fleischman (talk) 05:06, 1 October 2013 (UTC)

User_talk:71.32.122.15 Your misconduct has been referred to Wikipedia Administrators for personal attacks on my User page, for verbal abuse in edit changes on this talk page, and disregard for policy (WP:Forum). Sb101 (talk|contribs) 07:35, 1 October 2013 (UTC)

Needs section addressing corporate restructuring of insurance to exclude spouses as a repercussion

This article seems incomplete and even biased without addressing the current and probable future repercussions on corporate insurance coverage. Several recent news articles have highlighted UPS (among others) declining continuation of spousal insurance now that Obamacare is being positioned as a viable alternative for uninsured. http://blogs.marketwatch.com/health-exchange/2013/08/21/new-obamacare-effect-working-spouses-taken-off-ups-health-plans/ 172.10.236.215 (talk) 06:23, 1 October 2013 (UTC)

This isn't particularly notable when you read the whole story. --Dr. Fleischman (talk) 20:58, 1 October 2013 (UTC)

The link you recommend above leads to a "page not found" error at the time of this talk edit. That UPS and other corporations are dropping spousal support is a notable fact. Each spouse insuring themselves as an individual through separate plans is significantly more expensive for a family than adding a spouse onto an existing plan traditionally has been. It seems this article is avoiding presenting any negative facts or consequences of Obamacare, even those that are valid, documented and newsworthy. This suggests a bias and possible NPOV violation. 172.10.236.215 (talk) 06:20, 2 October 2013 (UTC)

IP, I'm having no issues opening that link. The article points out that Cruz's statement about UPS isn't correct. If a spouse is working at a company that offers insurance the spouse needs to get insurance from that company. If the spouse isn't working, is on Medicare or is working but their company doesn't offer insurance they can continue to get coverage through UPS. Cruz's statement deliberated ignored that point to make a partisan attack. Shocking, really, that Cruz would do that, isn't it? Also worth noting is that many companies well before this would charge extra if you wanted to include a working spouse that was offered coverage at their job. Basically, companies were already penalizing employees under this scenario, well before Obamacare. Ravensfire (talk) 16:25, 2 October 2013 (UTC)

Sen. Cruz's quasi-myths

Can anyone find more reliable sourcing for this apparent conflict of facts?

Sen. Cruz (R-Tex) claims, "President Obama has already granted Obamacare exemptions to big corporations and Members of Congress."[1] However, re: exemption for Congress, "The ObamaCare Exemption for Congress is a myth. It turns out Congress can't shut down Obamacare and reports that members of Congress will be exempt from ObamaCare are without merit. Members of Congress will have to buy their health insurance on the exchanges along with millions of other Americans including low to middle income individuals and employers."[2] And, re: exemption for big corporations, "The ObamaCare employer mandate / employer penalty, originally set to begin in 2014, will be delayed until 2015. The ObamaCare 'employer mandate' is a requirement that all businesses with over 50 full-time employees provide health insurance for their employees or face a tax penalty. The employer mandate is officially referred to as a 'shared responsibility fee' (as with Romneycare in Mass.), as employers tax will go to help fund tax credits to Americans using the health insurance exchanges and to compensate for unreimbursed emergency health care provided to the uninsured."[3] Attleboro (talk) 19:54, 1 October 2013 (UTC)

1. http://politicalticker.blogs.cnn.com/2013/09/18/house-republicans-question-cruzs-obamacare-defunding-fervor/

2. http://obamacarefacts.com/congress-obamacare.php

3. http://obamacarefacts.com/obamacare-employer-mandate.php

This article isn't an appropriate place to refute each and every individual politician's statements about the ACA. There are simply too many statements/misstatements by members of Congress about the law for each one to be mentioned, let alone discussed. And you'd have WP:BALANCE issues if you included this content without misstatements by other politicians. Thus, even if we were to find reliable sources for you, this content wouldn't belong here. Perhaps it would be appropriate on Sen. Cruz's page. --Dr. Fleischman (talk) 20:52, 1 October 2013 (UTC)

Stating increase coverage and overall affordability as fact

Not sure why it is controversial to include that the bill "intends" to increase coverage and overall affordability as oppose to just implying that it "does". It was reverted a few times and I'm not sure if it was intentional or accidental. There are many sources that dispute this (short and long term), so we should qualify it based on the intent (like we do with the word "aims"), which doesn't imply a fact on if it does or does not increase coverage or affordability. Morphh ^(talk) 21:52, 1 October 2013 (UTC)

Oh and for the inclusion of "(see Effects on insurance premiums below)" in the lead, it's bad WP:MOS. I meant WP:LEAD, not WP:SELF during my earlier revert (sorry). "lead should not "tease" the reader by hinting at content that follows" The lead is a summary and shouldn't self link to content in the body. Morphh ^(talk) 21:59, 1 October 2013 (UTC)

"provides a number of mechanisms to..." already implies "designed to" or "intended to", so specifically including "intended" seems a bit pointy. It would be different if the original wording said "provides a number of mechanisms that..." or "that will...".

(I agree with you on the link from the lead to other parts of the article. Everything on the lead is supposed to be covered elsewhere in the article, so providing a link to just one particular passage is somewhat WP:UNDUE.) Fat&Happy (talk) 22:49, 1 October 2013 (UTC)

Hmmm, I can kinda see that. "The ACA provides a number of mechanisms to increase coverage and overall affordability" reads like a statement of fact to me if I don't overly parse the language, that we're saying those mechanisms increase coverage and affordability. I'm having difficulty seeing that "provides a number of mechanisms to" implies an opinion. Morphh ^(talk) 00:37, 2 October 2013 (UTC)

I like Morphh's "intended" language. There's nothing wrong with a bit of extra emphasis that this is the purpose of the law rather than its effect. --Dr. Fleischman (talk) 04:25, 2 October 2013 (UTC)

After rereading the sentence prior to this one, it seems we're not being concise and often repeat the same thing. "The ACA aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of healthcare for individuals and the government. The ACA provides a number of mechanisms—including mandates, subsidies, and insurance exchanges—intended to increase coverage and overall affordability." In these two sentences, we say that it reduces cost / affordability three times and increase coverage twice (though if we consider "lowering the uninsured rate" means the same as "expanding insurance coverage", that's three times as well). I concede that cost is not the same as affordability, but we suffix it with "for individuals" which seems to imply affordability. Then we have unnecessary words, like "expanding public and private insurance" where you could just say "expanding insurance" or extra verbiage like "for individuals and the government" unless we're excluding "business". A sentence later we say "Additional reforms aim to reduce costs and improve healthcare outcomes by shifting the system towards quality over quantity..." which again repeats the first sentence. The lead should be concise (WP:LEAD), so this paragraph should probably be reworded. Morphh ^(talk) 13:11, 2 October 2013 (UTC)

I agree with Fat&Happy that the intended language is redundant (as intent is implied + 'aims' covers uncertainly) - especially on the issues of coverage and affordability where there's much less ambiguity about the net-impact (due to insurance expansions and subsidies) as opposed to say health inflation.

However, I think you miss the point of the construction of the lead. The 'aim's sentence says 'here are the goals of the law' and the following sentences of that paragraph refer or allude to specific provisions intended to achieve those goals that the article will elaborate on.

And as for the last two bits - 'public and private' is to emphasize both methods, and 'individuals and the govt' is to explicitly prevent an assumption that this 'only' attempts to address either the deficit or subsidies or inflation. Also, I'd include business under the individuals, mentally - at least in the sense that there's a clear difference between private/individual affordability and public/government deficit reforms (although inflation affects both), and the private affect individuals and business but the benefits to business seem incidental rather than a special focus like the other two, so I thought the construction was sufficient? Sb101 (talk|contribs) 17:45, 3 October 2013 (UTC)

Phone number

I don't know if this should be included in the article, but it's been getting a lot of attention, so I'm posting it here to let people know about it:

http://dailycaller.com/2013/10/03/need-health-care-coverage-just-dial-1-800-fuckyo-to-reach-obamacares-national-hotline/

Xshq5672 (talk) 05:38, 3 October 2013 (UTC)

It seems obviously both not notable enough for inclusion, as well as skirting non-NPOV. It doesn't demonstrates intent and strains to even get it's reading (i.e. it ignores the '1', per it's own article, and is happy pretending that 'You' is spelt without a u. There's no reason to give air to hacks, and it's not prominent enough to warrant refutation. Sb101 (talk|contribs) 17:24, 3 October 2013 (UTC)

Given that the piece has in fact received zero coverage so far, the inflammatory, far-fetched, and highly non-neutral content of the piece (removing a digit? come on), and the profane and inflammatory header Xshq5672 chose, I'm going to go out on a limb, question Xshq5672's good faith, and hat this discussion. I could be wrong, but this seems more like an exercise in bomb-throwing than an attempt to improve the encyclopedia. If the piece does end up getting coverage in reliable sources then feel free to un-hat, AFTER changing the header to something more appropriate. --Dr. Fleischman (talk) 17:28, 3 October 2013 (UTC)

I think Xshq5672 probably just copied the title of the article and I've also seen it references by several sites. I don't think we're at a level of inclusion, but I don't see a problem with Xshq5672 bringing it up. Morphh ^(talk) 17:58, 3 October 2013 (UTC)

Is it notable yet? http://worldjournal.com/bookmark/23770152-1-800-F1U-CKYO- Shii (tock) 15:35, 5 October 2013 (UTC)

Nope. --Dr. Fleischman (talk) 04:38, 8 October 2013 (UTC)

Edit request on 4 October 2013 to include Vote Totals as a section in Legislative History

 Partly done:

Please include Vote Totals as a section in Legislative history like was done for the article on another landmark law, The Civil Rights Act of 1964 http://en.wikipedia.org/wiki/Civil_Rights_Act_of_1964#Vote_totals

Vote totals

Totals are in "Yea–Nay" format:

• None [10] [11] [12]
• Cloture in the Senate: 60–39   (60–39%). [13]
• The Senate version: 60-39   (60–39%). [14]
• The Senate version, as voted on by the House: 219–212   (50–49%). [15]

By party

The original House version:

• None [16] [17] [18]

The Senate version: [19]

• Democratic Party: 58–0   (100–0%)
• Republican Party: 0–39   (0–100%)
• Independent : 2-0   (100-0%)

The Senate version, voted on by the House (became law): [20]

• Democratic Party: 219–34   (87–13%)
• Republican Party: 0–178   (0–100%)

161.253.101.26 (talk) 11:49, 4 October 2013 (UTC)

I'm fine adding this information, but I prefer it be in paragraph format rather than bullet-list format. The bullet list approach will further increase this article's large size and draw undue attention to the vote tallies. –Prototime (talk · contribs) 16:21, 4 October 2013 (UTC)

I agree with Prototime: formatting the information in this way is not appropriate for this article - the vote totals are included in the text. What I have done is, instead, to add the vote numbers to the images. Sb101 (talk|contribs) 13:25, 5 October 2013 (UTC)

Section on rollout

I'm shocked there's no section on the rollout of the new law. This is a pretty big deal, considering the new law affects so many millions of people and, ultimately, ~18% of the U.S. economy. I'll be doing some research, puling cites, drafting text and such, but if anyone wants to get a headstart, be bold. :) -- Cirrus Editor (talk) 23:45, 5 October 2013 (UTC)

Re: Cirrus Editor Speaking for myself, I haven't been motivated to add anything on the rollout because it doesn't seem to be worth adding GIVEN length and impact sections. In particular, the latter covers the effects on "many millions of people and, ultimately, ~18% of the U.S. economy." And my concern with adding a new section explicitly for rollout (which doesn't change any of the facts of the law that, again, seems sufficiently covered by Impact and the 'State rejections of Medicaid') is that it's Template:Recentism. It adds little now and definitely won't be noteworthy latter. What kind of content do you think is both notable and absent? Sb101 (talk|contribs) 03:41, 6 October 2013 (UTC)

There is so much information out there that it's a tidal wave on the topic. When I read that Maryland had hired 5,000 people to help users negotiate the new law[21] and that 100 people have now signed up for the new law[22], that's a bizarre ROI of taxpayer funding. And noteworthy.--Cirrus Editor (talk) 23:41, 7 October 2013 (UTC)

Just to be clear, is your interest motivated by your personal view that the PPACA is a "bizarre" use of federal funds, or by actual reliably sourced coverage of the rollout? The article you've cited makes clear that technical difficulties have limited the number of people who have been able to sign up online thus far, despite widespread interest. It also states that an estimated 250,000 currently uninsured Marylanders will receive coverage through the PPACA by the go-live date of January 1. Given the personal and systemic cost of uninsured care, that seems like a reasonable return on investment - at least, none of the sources seem to describe it as "bizarre". MastCell ^Talk 02:18, 8 October 2013 (UTC)

Ah. Mast Cell. I understand. My apologies. Never mind. Please do me no harm. -- Cirrus Editor (talk) 21:22, 8 October 2013 (UTC)

ACA waivers

There's nothing about waivers that the HHS has allowed for the ACA. Maybe add a new subsection titled "Regulatory waivers" under the Legislative History heading? -- Cirrus Editor (talk) 02:17, 8 October 2013 (UTC)

It doesn't seem particularly notable. Can you post some reliable sources here please? --Dr. Fleischman (talk) 05:05, 9 October 2013 (UTC)

Is this what you're talking about? --Dr. Fleischman (talk) 05:07, 9 October 2013 (UTC)

Nope. Nope. I'm good. Moving along. I understand completely. -- Cirrus Editor (talk) 02:01, 11 October 2013 (UTC)

Myths vs. contentions

Please stop edit warring over myths vs. contentions. Izuko, if you have a problem with the article then please explain here so we can resolve the dispute in a civil manner. --Dr. Fleischman (talk) 21:35, 14 October 2013 (UTC)

• Comment a case could be made that there is still no proof that these issues are considered myths. And since this is a political issue, basic reliable sourcing is no help because sources are usually all over the political spectrum. It's hard to call something a myth that hasn't been tested. This act hadn't even been fully implemented yet. "Contentions" seems to be a very neutral enough word for the moment. JOJ ^Hutton 21:41, 14 October 2013 (UTC)

The reliable sourcing says these "contentions" are widely held and verifiably false. Myth: "a widely held but false idea or contention." We have more than ample sourcing to establish that these are myths. --Dr. Fleischman (talk) 21:48, 14 October 2013 (UTC)

And we have sources showing that they are not. You're doing your own cherry-picking, while accusing me of it. Izuko (talk) 21:53, 14 October 2013 (UTC)

Those sources aren't reliable. Tell me what sources you're talking about. --Dr. Fleischman (talk) 21:56, 14 October 2013 (UTC)

I'm fine with the ones I cited. They are as reliable as others in this entire article. If you find them to be unreliable, show me why I should accept that they're not. Also, show me why using a less contentious word, like "contentions" as opposed to "myths" is wrong and worthy of being reverted in the first place. I was the one who went with "be bold." You're the one reverting. Prove to me that you're right. Izuko (talk) 22:00, 14 October 2013 (UTC)

Reliability isn't based on what you're fine with or not fine with; it's based on WP:RS. I added a source-by-source analysis below. --Dr. Fleischman (talk) 22:46, 14 October 2013 (UTC)

And as I said, sources will differ because this is a partisan issue. You can't debate sources because there are sources saying both, depending on what side of the political issue one falls on to. JOJ ^Hutton 23:54, 14 October 2013 (UTC)

Just because sources differ doesn't mean all must be given voice, let alone equal voice (per WP:EQUAL). We have to look at the relative reliability of the sources. In this case the much more reliable sources say these contentions are both widely held and false. The sources presented by Izuko are WP:QUESTIONABLE and presented in a biased manner. --Dr. Fleischman (talk) 00:11, 15 October 2013 (UTC)

• If you wish to discuss, that's one thing. But you're participating in what you call an edit war, even while you demand that others cease. How do you justify that? If you REALLY want a discussion, leave the text that I left in, and then discuss it here. I have expanded the section and added references. All you do is revert. You have no ground to stand on. Izuko (talk) 21:45, 14 October 2013 (UTC)

Please read WP:BRD. --Dr. Fleischman (talk) 21:58, 14 October 2013 (UTC)

Let's dissect Izuko's sourcing:

• Viebeck - cited for "While supporters of the ACA were quick to vehemently reject Palin's claims of Death Panels, there have been some who have given credence to it, such as Howard Dean": Nowhere in that article does it say that Dean or anyone else has given credence to the death panel claim. This is pure original research.
• Lowry & Costa - for long Palin quote: Whether Palin actually said this aside, the issue isn't verifiability as much as neutrality. We don't need a long quote from Palin explaining her position on death panels. Palin said it, and there's a whole article on it. Putting it here heavily skews the WP:BALANCE of our analysis.
• WND - for attributed claim to having "fact-checked the fact checker": Since this is attributed as a "claim" its impact is partially mitigated, but the problem is that WND isn't nearly as reliable as the fact checkers it purports to fact check. PolitiFact, Snopes, etc. are basically the gold standards in reliability. These guys have been around forever with a sterling reputation for accuracy and they double and triple check everything. WND is known for pushing conservatively biased material (such as Obama citizenship conspiracy theories). Including WND with equal weight as the sources it purports to refute is outrageously unbalanced.

--Dr. Fleischman (talk) 22:35, 14 October 2013 (UTC)

I think these sources illustrate the problem; the last two in particular are low-quality, partisan sources. "Death panels" were described as a myth/lie by reputable, independent, non-partisan fact-checking organizations, among others. To "rebut" those high-quality sources, we're being offered the National Review (which, as Dr. Fleischman notes, simply quotes Palin at length) and WorldNetDaily, which is an extreme and unreliable source in virtually any context. It's silly to present these sources as if they're equally weighty as those which call out "death panels" as a myth. As with most Wikipedia content disputes, this one can be solved by adhering to proper sourcing standards as articulated in basic site policy and guidelines. MastCell ^Talk 22:56, 14 October 2013 (UTC)

PolitiFact's role as an unbiased sourced is questionable at best. Arzel (talk) 01:14, 15 October 2013 (UTC)

The only truly bad source of those three are WND. Whether the balance is out of whack is a different discussion, but why not just call the section "Myths and contentions" or "Contentions and myths" and thus hit a middle ground? Thargor Orlando (talk) 00:15, 15 October 2013 (UTC)

Behind closed doors

I cannot understand why this article makes no mention of the fact that the final bill was crafted in secret behind closed doors, that few if any of the Democrats voting for it had read it, that Speaker Pelosi had famously uttered, "But first we have to pass the bill so that we can see what is in it" and the very real and now emerging evidence that when The President repeatedly declared directly to the American People that, "If you like your plan, you can keep it" he was not telling us the truth. — Preceding unsigned comment added by InterpreDemon (talk • contribs) 22:51, 14 October 2013 (UTC)

All of these things have an element of truth but aren't quite accurate:

• The final bill wasn't drafted entirely "in secret behind closed doors." Some of the committee bill writing sessions were open, but the most substantial negotiations took place privately. (source)
• I can't find any reliable sourcing for the contention that few if any of the Democrats voting for the bill had read it. Here's an article saying that Baucus didn't read the entire thing.
• Pelosi didn't say, "But first we have to pass the bill so that we can see what is in it." She did say, "But we have to pass the bill so you can find out what is in it, away from the fog of controversy." (source)
• Obama's statement "If you like your plan, you can keep it" was not a lie, but it was a "questionable" statement. According to ABC the law doesn't prevent insurers from dropping coverage but Obama says he didn't mean that, he meant it doesn't force them to drop coverage.

The pattern across all of these claims by InterpreDemon is that they're all semi-true. More importantly, they've been pushed largely in the blogosphere and on op-ed pages but not in the reliable sources. If we can find sufficient reliable sources for these then I support including them in a neutral way (rather than in InterpreDemon's oversimplified way). --Dr. Fleischman (talk) 00:03, 15 October 2013 (UTC)