1. The Affordable Care Act

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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?

8. 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?