There is great controversy over whether a patient will be able to retain or choose his or her doctors with the advent of the PPACA. In addition, many existing plans are being ruled as incompatible with the requirements of the PPACA and discontinued or canceled as a result. Explore and explain whether the patients will be able to continue with their physicians and the rationale behind the plan cancelation. Additionally, identify the effect of expanding state Medicaid roles and the impact it has upon cost and non-reimbursable care.