Washington Elder Law Practice Report (#15) / Dealing with client issues related to the Affordable Care Act

April 2, 2014

Washington Elder LawThis is #15 in a continuing series of Washington Elder Law Practice Reports.

Elder law and health care law attorneys in Washington are exploring how to best work with clients on issues involving the Affordable Care Act (ACA).

The ACA is very complex and has turned out to be highly state-specific at this point. When representing individuals and organizations, it is challenging for attorneys to make use of the right mix of explanations and strategies.

Too much information is confusing, while not enough information results in client decisions that are not fully informed.

There are a few guidelines that may be useful in this situation.

The first step is to view the ACA from the perspective of the general type of client being considered and the specific implementation features of the Health Plan in Washington.

One approach is to look at clients as individual members of groups in similar situations, or as organizations of various types.

A list can then be prepared of issues and questions that are likely to be of interest to members of a given group, or to the organizations that will be involved.

Discussion topics can then be built around the issues and questions most likely to emerge for such potential clients.

The key is to look at the Affordable Care Act from the point of view of specific clients, and customize all materials to be most appropriate and effective in the situations that they face.

A general “tutorial” will have many elements that are too far afield, and is likely to result in “glazed-over” responses. The ACA is so complex that some aspects must be targeted for discussion, and some discarded, as appropriate for the audience.

This is a situation in which “more” information may detract from client understanding of the specific issues and options of interest. Attorneys must thus understand the ACA in sufficient detail to know what to leave in and what to take out.

In each situation, the information to be presented, and the method chosen for providing this information, must be carefully tailored. When narrowing down from the general to more limited views, attorneys are required to understand all of the Act as the basis for the choices they are making.

Attorneys may start with such targeted materials and then progress to specific options, uncertainties and unresolved issues, cost-benefit tradeoffs, and proposed approaches to problem solving that meet the needs of the clients at hand.


For further reading, draft outlines of ACA issues for various clients may be found in Chapter 14 of Legal Practice Implications of the Affordable Care Act, Medicare and Medicaid, available on www.store.westlaw.com.

More about elder law and the ACA in Washington may be found in Elder Law and Practice: Basic to Advanced, volume 26 of Washington Practice, also available on www.store.westlaw.com.

And related materials prepared by Mitchell Law Office may be found on their web pages at www.legalpracticehome.com and www.savingmoneylaw.com.