The Road Ahead for the Affordable Care Act (New Eng Jour Med)
Interesting analysis of the ACA, politically and functionally. Worth a read, imo. ~ pinto
The Road Ahead for the Affordable Care Act
John E. McDonough, Dr.P.H.
July 2, 2012
The Affordable Care Act (ACA), the U.S. health care reform law enacted in 2010 and upheld as constitutional by the U.S. Supreme Court on June 28, 2012,1 has survived a series of life-threatening obstacles since its congressional consideration began in mid-2009.
The most dramatic threat involved the surprise election of Massachusetts Republican Scott Brown to the U.S. Senate on January 19, 2010, which deprived Democrats of their 60-vote Senate majority and left most observers convinced that continued hopes for comprehensive health care reform were delusional.
Until the oral arguments before the Supreme Court this March, few analysts believed that the Court's decision would be another life-threatening episode. But from the dissent issued by Anthony Kennedy, Antonin Scalia, Clarence Thomas, and Samuel Alito, we now know that four of the nine justices wanted to overturn the entire statute.1 The stakes, in other words, were all or nothing.
The now-completed judicial process was the latest obstacle and not the last. The next mortal challenge comes with the November 6 elections. Although many issues, especially economic ones, will determine the outcomes of the presidential and congressional races, the policy consequences of the election will be most immediately and compellingly felt in connection with health care reform.
http://www.nejm.org/doi/full/10.1056/NEJMp1206845?query=TOC
