摘要：
The Affordable Care Act (ACA), legislated under the Obama administration, will be fully implemented by
2014. The premise of this health care reform is to make insurance coverage available to a majority of the nearly 50 million
uninsured Americans. Cost containment is integral to the viability and longevity of such a significant endeavor. To date
85% of the U.S. population enjoys employer based health care benefits. As part of health care reform, the insured are being
pushed to be more responsible consumers of health care services. The insured are also being asked to be better stewards
of health behaviors. Under the premise of reform, employers are seizing the opportunity to mandate enrollment in
newly established Accountable Care Organizations (ACOs). Thus there may be greater involvement of employing agencies
into what was once considered private personal health information. When employers oversee and monitor the health
behaviors of employees there becomes a potential conflict of interest, loss of individual autonomy, and discrimination becomes
apparent. The end result could be a greater paternalistic role for the employer. There is a possibility of job loss and
consequential lack of health insurance for those who are most in need.
