Party politics and enactment of "Obamacare": a policy-centered analysis of minority party involvement

J Health Polit Policy Law. 2014 Feb;39(1):57-95. doi: 10.1215/03616878-2395181. Epub 2013 Nov 5.

Abstract

The Patient Protection and Affordable Care Act of 2010 (ACA) passed with no Republican votes and was accompanied by intense criticism that the reform was "rammed through" the legislative process by the majority party. By contrast, many Democrats emphasized the extensive yearlong debate over health care reform and argued that the final bill represented a compromise of good ideas from both parties. We undertake a policy-centered analysis to help reconcile these conflicting reports of this legislative episode. Drawing on real-time accounts published in the Capitol Hill newspaper Roll Call, we compare the success of Democratic and Republican Parties' policy proposals in terms of centrality to the policy agenda and inclusion in the enacted legislation. Our findings indicate that Republican-backed proposals were more present on the policy agenda than in the final legislation--although both were dominated by Democratic policy proposals. In this case, the major limit on majority party power seemed to be intraparty conflict, rather than opposition from the minority party.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Health Care Reform / legislation & jurisprudence
  • Health Care Reform / organization & administration*
  • Humans
  • Medicaid / organization & administration
  • Patient Protection and Affordable Care Act / legislation & jurisprudence
  • Patient Protection and Affordable Care Act / organization & administration*
  • Policy Making*
  • Politics*
  • Taxes
  • United States