Like most other policies, health policy relies on constitutional or statutory authority. Consider the process of enacting The Patient Protection and Affordable Care Act, also known as ACA or simply Obamacare. The law’s path to passage was tortuous with many detours and, at times, almost written off because of shifting political winds(Cannan, 2013).
The law did not follow the traditional way legislation typically does, as covered in the book chapter and highlighted by Cannan’s writing on ACA’s legislative history(refer to pages 137-169). First, a member did not introduce the Bill; instead, in the House, three chairmen of the Education and Labor, Energy and Commerce, and Ways and Means committees worked jointly to draft legislation by each committee(Cannan, 2013; Hayes, 2011). In the Senate, the Committee on Health, Education, Labor and Pensions (HELP), and Committee on Finance took the lead in crafting the legislation. This and many other peculiarities made ACA complex legislation to shepherd through Congress.
Once the Bill was signed into law by President Obama, opposition and legal challenges were instantaneous. Texas and other Republican-led states sued the federal government the same day the legislation was signed. ACA has the dubious distinction of being “the most challenged-and the most resilient-statute in modern American history” (Gluck & Scott-Railton, 2020). The law has been challenged in courts hundreds of times, made several trips to the Supreme Court, and dozens of repeal efforts, and yet the law stands with its core reforms stands(Gluck & Scott-Railton, 2020; Goldstein, 2020; Persily, Metzger, & Morrison, 2013).
As you review the assigned reading, the book chapter, and any other material on the passage of ACA, what were the unusual ways the legislation was passed through Congress instead of how the book describes the typical passage of a law? (I counted at least four major peculiarities). What were the political considerations of the Democrats and Republicans in shaping and opposing the legislation, from Committee drafting to the choice of reconciliation as opposed to conference committee? Lastly, the Courts and Congress have had unusually intense oversight of ACA post-enactment. How has its oversight and politics of it shaped vital provisions such as Medicaid expansion, contraception coverage, and payment of subsidies for insurance coverage?
References
Cannan, J. (2013). A legislative history of the affordable care act: How legislative procedure shapes legislative history. Law Library Journal, 105(2), 131-173.
Gluck, A. R., & Scott-Railton, T. (2020). Affordable Care Act Entrenchment. Georgetown Law Journal, 108(3), 495.
Goldstein, A. (2020). Affordable Care Act returns to Supreme Court as virus cases spike. The Washington Post, A.8.
Hayes, K. (2011). OVERVIEW OF POLICY, PROCEDURE, AND LEGISLATIVE HISTORY THE AFFORDABLE CARE ACT. NAELA Journal, 7(1).
Persily, N., Metzger, G. E., & Morrison, T. W. (2013). The health care case : the Supreme Court’s decision and its implications [1 online resource]. Retrieved from http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780199301058.001.0001/acprof-9780199301058
These are the questions that need to be answered.
As you review the assigned reading, the book chapter, and any other material on the passage of ACA, what were the unusual ways the legislation was passed through Congress instead of how the book describes the typical passage of a law? (I counted at least four major peculiarities). What were the political considerations of the Democrats and Republicans in shaping and opposing the legislation, from Committee drafting to the choice of reconciliation as opposed to conference committee? Lastly, the Courts and Congress have had unusually intense oversight of ACA post-enactment. How has its oversight and politics of it shaped vital provisions such as Medicaid expansion, contraception coverage, and payment of subsidies for insurance coverage?
Also please ask a question at the end related to the topic.
