Nobody Knew How Complicated: Constraining the President’s Power to (Re)shape Health Reform

American Journal of Law & Medicine, Vol. 45, No. 2-3, Pp. 106-–29 (2019)

25 Pages Posted: 15 Jan 2020

See all articles by Sallie Thieme Sanford

Sallie Thieme Sanford

University of Washington - School of Law; University of Washington - School of Public Health

Date Written: July 24, 2019

Abstract

Beginning on inauguration day, President Trump has attempted an executive repeal of the Affordable Care Act. In doing so, he has tested the limits of presidential power. He has challenged the force of institutional and non-institutional constraints. And, ironically, he has helped boost public support for the ACA’s central features. The first two sections of this article consider the uses of the President’s tools to advance and to subvert health reform. The final two sections consider the forces constraining the administration’s attempted executive repeal. I argue that the most important institutional constraint, thus far, is found in multifaceted actions by states – and not only blue states. I also highlight the force of public voices. Personal stories, public opinion, and 2018 election results – bolstered by presidential messaging – reflect growing support for government-grounded options and statutory coverage protections. Indeed, in a polarized time, “refine and revise” seems poised to supplant “repeal and replace” as the conservative focus countering liberal pressure for a common option grounded in Medicare.

Keywords: Affordable Care Act, ACA, Obamacare, health care reform, executive action, politics

Suggested Citation

Sanford, Sallie Thieme, Nobody Knew How Complicated: Constraining the President’s Power to (Re)shape Health Reform (July 24, 2019). American Journal of Law & Medicine, Vol. 45, No. 2-3, Pp. 106-–29 (2019). Available at SSRN: https://ssrn.com/abstract=3345293 or http://dx.doi.org/10.2139/ssrn.3345293

Sallie Thieme Sanford (Contact Author)

University of Washington - School of Law ( email )

William H. Gates Hall
Box 353020
Seattle, WA 98105-3020
United States

HOME PAGE: https://www.law.washington.edu/directory/profile.aspx?ID=261

University of Washington - School of Public Health

Seattle, WA
United States

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