When Congress was considering the Patient Protection and Affordable Care Act (PPACA) in the spring of 2010, then House Speaker Nancy Pelosi (D-CA) made this now-famous statement: "But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy."[1]

Although many poked fun at Pelosi's gaffe at the time, the reality is that she was right. We are still finding out what is in PPACA, even 18 months after its passage. Above all, the on-going regulatory process has perpetuated this journey.      

A key challenge facing the White House and U.S. Department of Health and Human Services (HHS) is that many people who would potentially benefit from PPACA's future entitlements do not understand the details of the legislation or the emerging overlay of regulatory guidance. This confusion is documented in a recent August 2011 poll released by the Henry J. Kaiser Family Foundation. The researchers note: