POL 201
Affordable Care Act and the American National Government
POL 201 – American National Government
University of Arizona Global Campus
The Affordable Care Act and the American National Government
The Affordable Care Act has had a lasting effect on impacting the lives of American
citizens. Americans, regardless of financial status, can procure and attain health care that was not
attainable before the law being signed. Popularly called Obamacare, President Barack Obama
signed the act into law on March 23, 2010, making the most significant changes and reforms in
the United States healthcare system.Through the passing of the ACA, hundreds and thousands of
Americans had the ability to afford and obtain health insurance for the frst time. In this paper, I
will be highlighting how the Affordable Care Act (ACA) is a pivotal policy that made sweeping
overhaul in healthcare system and how key factors related to the signing that include: the
historical and Constitutional basis of the American Government, check and balances involved in
the process and the effect of elections to the policy
Historical and Constitutional Background
The ACA was signed into law in March 2010. President Obama signed the law that
helped Americans the ability to attain health insurance. Although President Obama is credited for
rallying the passing of the policy, he was not the first President to introduce and attempt to
reform the health care system in the United States of America. In 1933, President Franklin D.
Roosevelt drafted the Social Security legislation that included a publicly funded health care
program. It was later removed from the final version of the legislation. Other Presidents,
President Harry S. Truman in 1949, President Lyndon B. Johnson in 1965, and President Bill
Clinton, all made attempts for health care reforms and universal health care. However, they
failed to pass the policy into law (Manchikanti, Helm, & Hirsch, 2017).
, The ACA’s main component on how to increase the number of available applicants for
Medicaid. The expansion of Medicaid to adults with incomes at or under the poverty line
increased access to health care insurance and services (McMorrow & Holahan, 2020).
The expansion of Medicaid through the ACA is an example of Federalism. Federalism is
the relationship of state and national government “where the states were subordinate to the
supreme power and authority of the national government” (Fine & LevinWaldman, 2016). The
individual states hold and control its own Medicaid program. States have flexibility on how they
operate and manage their respective Medicaid program. The federal government provides all
states and their citizens protection from State implementation of the policy. This federal
protection includes protecting people who have preexisting health conditions to obtain and keep
health insurance. Additionally, the federal government can provide financial assistance to low-
income individuals below 400 percent of the federal poverty level mandates each individual and
employer to ensure people gain and keep health care coverage. Although the ACA outlined what
the federal government and State the components of the law, each State can control how its
implemented. Examples of differentiating implementation of the ACA include California
expanding the eligibility for Medicaid while also establishing its marketplace. In contrast,
Mississippi did not establish its marketplace.
Checks and Balances
Check and balance is enforced in the U.S. government to prevent a total complete control
of one branch of the government. System of checks and balances within government is necessary
for enforcing constitutional constraints because it divides power among elites with competing
interests and enables one group of elites to check the power of others (Holcombe, 2018).
President Barack Obama’s leading policy reform in his first term was health care reform.
To achieve his promise in his campaign, check and balance was present in the creating, passing,
Affordable Care Act and the American National Government
POL 201 – American National Government
University of Arizona Global Campus
The Affordable Care Act and the American National Government
The Affordable Care Act has had a lasting effect on impacting the lives of American
citizens. Americans, regardless of financial status, can procure and attain health care that was not
attainable before the law being signed. Popularly called Obamacare, President Barack Obama
signed the act into law on March 23, 2010, making the most significant changes and reforms in
the United States healthcare system.Through the passing of the ACA, hundreds and thousands of
Americans had the ability to afford and obtain health insurance for the frst time. In this paper, I
will be highlighting how the Affordable Care Act (ACA) is a pivotal policy that made sweeping
overhaul in healthcare system and how key factors related to the signing that include: the
historical and Constitutional basis of the American Government, check and balances involved in
the process and the effect of elections to the policy
Historical and Constitutional Background
The ACA was signed into law in March 2010. President Obama signed the law that
helped Americans the ability to attain health insurance. Although President Obama is credited for
rallying the passing of the policy, he was not the first President to introduce and attempt to
reform the health care system in the United States of America. In 1933, President Franklin D.
Roosevelt drafted the Social Security legislation that included a publicly funded health care
program. It was later removed from the final version of the legislation. Other Presidents,
President Harry S. Truman in 1949, President Lyndon B. Johnson in 1965, and President Bill
Clinton, all made attempts for health care reforms and universal health care. However, they
failed to pass the policy into law (Manchikanti, Helm, & Hirsch, 2017).
, The ACA’s main component on how to increase the number of available applicants for
Medicaid. The expansion of Medicaid to adults with incomes at or under the poverty line
increased access to health care insurance and services (McMorrow & Holahan, 2020).
The expansion of Medicaid through the ACA is an example of Federalism. Federalism is
the relationship of state and national government “where the states were subordinate to the
supreme power and authority of the national government” (Fine & LevinWaldman, 2016). The
individual states hold and control its own Medicaid program. States have flexibility on how they
operate and manage their respective Medicaid program. The federal government provides all
states and their citizens protection from State implementation of the policy. This federal
protection includes protecting people who have preexisting health conditions to obtain and keep
health insurance. Additionally, the federal government can provide financial assistance to low-
income individuals below 400 percent of the federal poverty level mandates each individual and
employer to ensure people gain and keep health care coverage. Although the ACA outlined what
the federal government and State the components of the law, each State can control how its
implemented. Examples of differentiating implementation of the ACA include California
expanding the eligibility for Medicaid while also establishing its marketplace. In contrast,
Mississippi did not establish its marketplace.
Checks and Balances
Check and balance is enforced in the U.S. government to prevent a total complete control
of one branch of the government. System of checks and balances within government is necessary
for enforcing constitutional constraints because it divides power among elites with competing
interests and enables one group of elites to check the power of others (Holcombe, 2018).
President Barack Obama’s leading policy reform in his first term was health care reform.
To achieve his promise in his campaign, check and balance was present in the creating, passing,
