Abortion in the ACA: A Treacherous Deal
With an effortless stroke of his pen, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23rd, 2010. Yet the deal-making process leading to the ACA’s passage was anything but quick and simple. The road to success involved overcoming interest group opposition, ensuring that the reform satisfied fiscal conservatives in the Democratic Party, and tailoring the bill within the narrow constraints of the budget reconciliation process to avoid a filibuster (Cohn). After reaching many agreements and carefully balancing myriad elements of the ACA, abortion emerged as the final roadblock to the ACA’s passage. Numerous factors, including legislative constraints …show more content…
Unlike many other advanced industrialized countries, the United States does not have a single-payer healthcare system, in large part because of public apprehension of governmental involvement in health decisions (Campbell 4). This made it difficult to bring all the necessary elements together. Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill, wrote that, in one sense, “the adoption of health reform is a story about contingency; after all, it could have failed, and it almost did” (1113). From this perspective, every deal deployed in the ACA is integral to the bill. This makes sense for a large legislative reform effort: every cog in the wheel must be present to succeed. As the final cog put in place, the last-minute deal in which President Obama issued an executive order on abortion, in exchange for pro-life Democratic votes in the House of Representatives, is significant because reform proponents had so much to lose and since most Democrats hated abortion restrictions, however …show more content…
A Guttmacher Institute review found that 25 states have banned abortion coverage on exchanges (Hasstedt 1). Each time legislatures debated these abortion rules, politicians’ and the public’s eyes turned to the ACA, opening multiple policy windows in which opponents could fight the ACA or try to derail its implementation. In addition, after a 2012 U.S. Supreme Court ruling allowed states to opt out of Medicaid coverage expansion, many Republicans states have refused to expand Medicaid. In Alaska, where the governor has expanded Medicaid, the Republican legislature is now suing him to stop the expansion (Forgey 1). This comes amid fears among pro-life organizations that Medicaid expansions like Alaska’s will increase abortion rates
With an effortless stroke of his pen, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23rd, 2010. Yet the deal-making process leading to the ACA’s passage was anything but quick and simple. The road to success involved overcoming interest group opposition, ensuring that the reform satisfied fiscal conservatives in the Democratic Party, and tailoring the bill within the narrow constraints of the budget reconciliation process to avoid a filibuster (Cohn). After reaching many agreements and carefully balancing myriad elements of the ACA, abortion emerged as the final roadblock to the ACA’s passage. Numerous factors, including legislative constraints …show more content…
Unlike many other advanced industrialized countries, the United States does not have a single-payer healthcare system, in large part because of public apprehension of governmental involvement in health decisions (Campbell 4). This made it difficult to bring all the necessary elements together. Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill, wrote that, in one sense, “the adoption of health reform is a story about contingency; after all, it could have failed, and it almost did” (1113). From this perspective, every deal deployed in the ACA is integral to the bill. This makes sense for a large legislative reform effort: every cog in the wheel must be present to succeed. As the final cog put in place, the last-minute deal in which President Obama issued an executive order on abortion, in exchange for pro-life Democratic votes in the House of Representatives, is significant because reform proponents had so much to lose and since most Democrats hated abortion restrictions, however …show more content…
A Guttmacher Institute review found that 25 states have banned abortion coverage on exchanges (Hasstedt 1). Each time legislatures debated these abortion rules, politicians’ and the public’s eyes turned to the ACA, opening multiple policy windows in which opponents could fight the ACA or try to derail its implementation. In addition, after a 2012 U.S. Supreme Court ruling allowed states to opt out of Medicaid coverage expansion, many Republicans states have refused to expand Medicaid. In Alaska, where the governor has expanded Medicaid, the Republican legislature is now suing him to stop the expansion (Forgey 1). This comes amid fears among pro-life organizations that Medicaid expansions like Alaska’s will increase abortion rates