It seems as if everything that has anything to do with PPACA has worked differently than I’ve expected so far, and it seems reasonable to expect my lack of PPACA clairvoyance to continue.
If space aliens come and replace PPACA with the health insurance system now in place in the Alpha Centauri B Empire, that would surprise me less than if the exchanges all start on time, have a few hiccups, then work pretty well (with the occasional exchange collapse, qualified health plan insolvency and sick patient dumping scandal).
One prediction that I think I can make is that PPACA will have a permanent effect on the way many Americans use and think about the English language.
Five years ago, I had not heard of PPACA. I was a simpler person. I used simple, declarative sentences, such as, “The sun will rise in the morning.”
Today, I would probably write something more like, “The sun seems likely to rise in the morning,” “The sun is set to rise in the morning,” or “Some Republicans and a few Democrats are continuing to fight in Congress, in the courts and in state legislatures to block the ability of the sun to beam harmful ultraviolet radiation at the earth. If the sun continues to operate as it has in the past, it will rise in the morning. Solar specialists expect it to be shiny. Some predict that it will be bright.”
Because of PPACA, I’ve had to learn more about the “subjunctive mood.”
The editors of Wikipedia state that, “Subjunctive forms of verbs are typically used to express various states of unreality such as wish, emotion, possibility, judgment, opinion, necessity, or action that has not yet occurred.”
“The subjunctive is an irrealis mood (one that does not refer directly to what is necessarily real),” the Wikipedia editors go on to add
To me, it seems as if this discussion of the subjunctive mood has plenty to say about the language of PPACA.
Members of the Obama administration and other people who have committed to loving PPACA, sudden collapses of risk pools for the desperately ill and all, no matter what, because their political and financial survival depend on PPACA, use a lot of the indicative mood.
The Affordable Care Act helps millions of young adults get coverage. The ACA helps women get “free”
birth control pills
. (Except that whoever is paying the premiums is actually paying for the birth control pills.) The ACA is terrific.
Ardent enemies of the act also use many indicative mood verbs.
Obamacare destroys jobs. Obamacare crushes freedom. Obamacare is satanic.
They can write great, punchy sentences because they know what’s real, or think they do. I just want to avoid writing sentences that will look hilariously wrong in the cold, hard light of 2023.
Another important consideration for users of PPACA English is vocabulary.
Should I use the term “qualified health plan” (QHP) to refer to the plans that a PPACA public exchange will sell, so that readers will learn what a QHP is? If I don’t teach you what a QHP is, who will? If I do teach you to use the term “QHP,” does that make me a bad person? Will George Orwell come out of the grave and yell at me for being a barbarian?
What about the Pre-existing Condition Insurance Plan (PCIP), or the “employer shared responsibility” program? (That’s the employer coverage mandate.)
Are some of those terms so bureaucratic that using them is the equivalent to voluntarily sticking my neck in a government slave collar?
The bottom line is this: I’m writing for agents and brokers — the people who try to translate insurance gobbledygook for employers and consumers, and to translate what the customers say they need into language that the insurers can understand.
The market has needed those translators’ communication skills for more than a century.
In any world in which a consumer has to know what a QHP is, and an employer has to know what a year-round full-time equivalent is, it seems safe to think their communication skills will continue to be in demand for many years to come.