ObamaCare and U.S. Political Structure: Checks and Balances

Introduction

ObamaCare is a law that President Obama was extremely passionate about. He built a large part of his political career around healthcare reform. This law allows millions of Americans who cannot afford health insurance — or cannot qualify for health insurance — to obtain affordable coverage. Millions of Americans live with treatable diseases because they cannot afford the cost of healthcare. In 2009, 16.7% of the U.S. population was uninsured (50.7 million people). Of this population, 7.5 million were children under the age of 18 and 676,000 were senior citizens (Kondro, E756).

ObamaCare is a law that was passed in March 2010, allowing this uninsured population to obtain health insurance at an affordable cost. This paper discusses the U.S. political structure and some of the processes that ObamaCare passed through — going from a bill to a law, and then the question of whether that law was constitutional.

Checks and Balances and Separation of Powers

Checks and balances is a system put in place by the founding fathers to prevent the president or any one branch of government from becoming too powerful. The government is divided into three branches — the executive branch, the legislative branch, and the judicial branch — in an arrangement known as separation of powers. Separation of powers was established to ensure that no single division of government could function entirely independently; each branch depends on the others.

If Congress passes a bill that the president believes is harmful, the president has the power to veto it, preventing it from becoming law. Congress can then attempt to override the veto by securing a two-thirds vote. The president has the power to make treaties with other countries, but must first obtain a two-thirds vote from the Senate. The president serves as commander-in-chief of the military, yet Congress controls the federal budget. Although the president can make some decisions independently, most major decisions require approval from Congress and the Senate.

The Supreme Court can also prevent the president from becoming too powerful by declaring executive acts unconstitutional. The president appoints members of the Supreme Court when a seat becomes available, subject to congressional approval. This system of checks and balances was designed to ensure that no single person or branch accumulates excessive power. In order for the ObamaCare bill to become law, it required a majority vote in Congress followed by the president's signature.

The Presidential Branch and ObamaCare's Passage

President Obama centered his 2008 election campaign on healthcare reform. Once ObamaCare received the necessary votes in Congress, it was signed into law on March 23, 2010. This law extended coverage to millions of Americans who had previously been uninsured. Although the law was controversial and faced significant opposition in the media, in Congress, and among the general public, it also attracted substantial support. For a law to be nullified after passage, the Supreme Court must declare it unconstitutional.

The Doughnut Hole and Key Provisions

Judicial review means that presidential and congressional actions are subject to scrutiny by the Supreme Court. This process was established by the framers of the Constitution in 1787 to prevent the accumulation of unchecked power. The judicial branch holds the authority to declare the ObamaCare law unconstitutional. For most laws, the process moves through two branches — from Congress to the executive branch. It is only when a law is challenged that it moves to the judicial branch for review.

The Medicare Part D coverage gap, commonly known as the "doughnut hole," has been a significant problem for senior citizens since Medicare Part D was introduced in 2004 (Weintraub, 2008). Under this structure, Medicare beneficiaries would stop receiving prescription drug benefits once they had spent $2,830 on prescriptions and would not resume receiving benefits until their out-of-pocket expenses exceeded $4,550. Patients who fell into this gap found their monthly medical bills at least doubled. Prescription costs became so burdensome that patients were forced to make difficult choices between buying food and buying medication. Weintraub found that 15% of elderly people with chronic illnesses stopped taking their medications when they fell into the doughnut hole due to cost. Although some private insurance companies would cover prescriptions during this period, most plans were too expensive and covered only generic drugs. The doughnut hole was created because the government could not secure sufficient funding for Medicare Part D, and the prescription costs for the elderly were depleting the available funds.

ObamaCare is a bill that was signed into law in 2010 by a vote of 219 members of the House of Representatives (Roller, 2011). In the process of becoming law, no Republicans voted for the bill; 34 Democrats voted against it, while 219 Democratic members of Congress voted in favor, and 212 members voted against it. This law provides health care coverage to approximately 32 million previously uninsured Americans. It also prevents insurance companies from denying coverage to individuals with pre-existing conditions. As stated in the law, "insurance companies will be prohibited from denying coverage based on pre-existing conditions" (Roller, 2011). Furthermore, the law closes the Medicare Part D doughnut hole, providing improved prescription drug benefits to elderly patients. ObamaCare also requires all companies to provide health insurance coverage to their employees and mandates that all individuals enroll in health insurance or face significant tax penalties. The law was designed to ensure that every American could afford and obtain health insurance, effectively eliminating the uninsured population in the United States.

In order for this bill to become law, it passed through multiple steps and branches of government. Congress played a central role in drafting the bill (Yehle, 2010). Once the bill was written, lobbying for votes began. The president, alongside supportive members of Congress and various outside agencies and lobbyists, worked to build support for the bill. The bill moved through Congress quickly, without all members having the opportunity to read it. Speaker Nancy Pelosi urged members of Congress to sign the bill, indicating they would have the opportunity to read it afterward — a widely criticized procedural decision. Pelosi recognized that sufficient supporters existed to secure the necessary signatures and used that advantage to push the bill through without allowing it to follow its customary legislative process. Congress exercised its constitutional authority when it secured the 219 votes needed to pass the ObamaCare bill. Even so, under the system of checks and balances, Congress alone could not transform the bill into law — the president's signature was required.

Conclusion

As an analyst of government structure, political systems, and ObamaCare, it is clear that separation of powers and checks and balances are essential components of the U.S. governmental system. These principles were put in place to prevent any single person or branch of government from accumulating excessive power. While ObamaCare has merit as a policy, the manner in which the president and Congress pushed the bill through raises legitimate concerns about an abuse of the legislative process. Members of Congress should always act in accordance with the Constitution to ensure the rights of the American public are protected.

The judicial branch exercised its power to check Congress and the president when it declared the law unconstitutional in 26 states. This demonstrates that the checks and balances system functions to protect the American people and prevents the president from making decisions that have not received broad democratic approval. Citizens elect their congressional representatives to speak on their behalf; therefore, each representative's vote reflects the voice of their constituents. Representatives should be given the opportunity to read bills before signing them, because their signatures represent their districts and the people who elected them. Their votes should always reflect what is best for the citizens they serve.

The founding fathers created a government built on separation of powers and checks and balances to ensure that no single branch or person becomes too powerful. A bill becomes a law by securing a majority vote in Congress and then receiving the president's signature. Once enacted, a law can be declared unconstitutional by the Supreme Court, provided well-documented reasons and recorded constitutional deficiencies in the legislative process are established. The ObamaCare bill moved from bill to law in a manner that the Federal Court ultimately ruled was unconstitutional, rendering the law inapplicable in 26 states. This outcome stands as a significant example of how congressional overreach can be documented and addressed through the judicial branch.

ObamaCare has gone through all three branches of government. It began in Congress, where it received the majority vote needed to advance to the executive branch. The president signed it into law in 2010. The law was then challenged in Federal Court, where it was declared unconstitutional. This sequence is a clear example of how the U.S. government operates to protect the rights of its citizens. Although many people were disappointed that the law was found unconstitutional in 26 states, it affirmed that the system of government works and that mechanisms exist to safeguard the rights of American citizens.