Details

Autor(en) / Beteiligte

• Sparer, Michael S.

Titel

Federalism and the Patient Protection and Affordable Care Act of 2010: The Founding Fathers Would Not Be Surprised

Ist Teil von

• Journal of health politics, policy and law, 2011-06, Vol.36 (3), p.461-468

Ort / Verlag

United States: Duke University Press

Erscheinungsjahr

2011

Link zum Volltext

Quelle

PAIS Index

Beschreibungen/Notizen

• There are many political tales to tell following the enactment of the Patient Protection and Affordable Care Act of 2010 (ACA). One story, about effective presidential leadership, focuses on President Barack Obama, especially his decision to delegate to Congress the task of developing the actual plan, while simultaneously pushing congressional Democrats and key interest groups to enact legislation that expands health insurance coverage for millions without disturbing the basic architecture of the nation's health care system. A second story focuses on institutional politics within the federal branch: had Scott Brown won his Massachusetts Senate seat in November 2009 instead of January 2010, the Republicans might well have successfully filibustered and defeated the entire reform legislation. Then of course there is the role of America's political culture (from anti-government Tea Parties to the president's seeming reluctance to embrace the moral argument for universal coverage). Deeply embedded in each of these stories, however, was the long-standing debate over which level of America's government should do what, especially in a polity in which nearly all politics takes place within the context of a complicated and constantly evolving intergovernmental partnership. This is not a new political dynamic. Indeed, federalism was at the core of the initial debate over the very nature of the American republic: nationalists like Alexander Hamilton argued for a powerful federal government (fueled by a strong executive branch), while small-government aficionados like Thomas Jefferson feared that Hamilton would move the country toward monarchy. Somewhere between these two poles was James Madison, who preferred a large but relatively weak federal government, with its power limited by institutional checks and balances. How did the framers resolve the debate? They didn't. Instead, the constitution provides support for each view, leaving to each political generation the task of reframing the intergovernmental balance. Adapted from the source document.