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In many ways, 2014 was a pivotal year for PPACA, as most major reforms came online in the past 11 months. Among the facets implemented were the Health Insurance Tax, subsidies, state and federal exchanges, minimum standards, health care co-ops, Medicaid expansion and new rules for wellness programs, minimum waiting periods and several market reforms. There were lots of problems, and the government tacked on plenty of last-minute changes and extensions in an effort to smooth the implementation. It all resulted in a flood of negative press for PPACA. Public perception has fallen so far that polls now consistently show that around 60 percent of Americans don’t favor the law.

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