Three years into the Patient Protection and Affordable Care Act (ACA), the biopharma industry, like much of corporate America, is struggling to assess whether it gains from the Act or loses. The negatives for pharma are clear: givebacks to the federal government of tens of billions of dollars a year. Harder to gauge have been the potential benefits, notably those stemming from the Act’s biggest and most visible initiatives – the health insurance exchanges (HIXs) and expansion of Medicaid coming on line January 1, 2014 that will provide insurance to currently uninsured adults.
When Congress passed the legislation in March 2010, the Congressional Budget Office (CBO) projected it would enable 35 million previously...