The Affordable Care Act

The 1992 Presidential Election and its aftermath In 1992, more people voted against Bill Clinton than for Bill Clinton Electoral College and popular vote far apart Clinton promised health care reform In 1993, introduced health care reform, putting First Lady Hillary Clinton in charge of effort Never voted on by Congress Clinton’s efforts to fulfill campaign promises resulted in critical Congressional losses in 1994

The 1994 Midterm election Both houses of Congress changed party majorities Newt Gingrich became Speaker of the House “Contract with America” Clinton ran for re-election in 1996 Signed Temporary Aid for Needy Families in August 1996, just before being renominated by his party later that month

The 2008 Election and Health Care Reform Obama promised health care reform which was soon challenged as unconstitutional The concern about rising health care costs is largely in response to: Greater life expectancy Greater health care costs, especially toward the end of one’s life (i.e. Alzheimer’s, cancer) As medical treatments become more advanced, they are also more expensive

The Supreme Court and Health Care reform The U.S. Supreme Court upheld the Affordable Care Act as constitutional Focused on provisions other than the Commerce Clause Will likely have political implications

Major provisions? Everyone must purchase insurance If you cannot afford insurance, subsidies will be provided for you to purchase insurance State health care exchanges will be created as a market for individuals to purchase insurance Employers of a certain size must provide insurance for employees No one can be denied insurance due to a pre-existing illness A person can remain on their parents’ insurance until 26 There can be no lifetime maximum amount of coverage provided

Environmental Policy Environmental Protection Agency (EPA) created in 1970 as the chief watchdog agency Really was not an issue of concern until 1970s Silent Spring (Rachel Carson) Clean Air Act, Water Pollution Control Act – stricter standards Cap and trade? Climate change?

Energy Policy Gas crisis in 1970s – OPEC tactic Department of Energy created by Carter in 1977 Nuclear energy – fear due to accidents Fracking? Keystone Pipeline?