Obamacare Policy-Making in the Federal System | Free Essay Example

Obamacare Policy-Making in the Federal System

Words: 895
Topic: Politics & Government

More often than not, the structure of the government in the United States makes it quite daunting to effectively implement policies, especially the policies that are developed at the federal level. One of the policies that have been subjected to criticism and failed to live up to the expectations of the citizens of the United States is the Obamacare policy or the Affordable Care Act. The Obamacare policy is termed disastrous because of the seeming incompatibility of the policy with the policies that had been developed at the state and county levels in the U.S.

To begin with, it is imperative to note that irrespective of being one of the benchmark countries in terms of embracing a federal style of government, the system faces a significant number of challenges, more so when it comes to the fulfillment of the expectations of the United States citizens through policy. According to Rothman (2014), the Obamacare health policy has been subjected to a substantial number of criticisms from the American public because it was developed and supported by the Democrats, led by President Obama in the year 2010.

From the outset, it seems that there are a lot of issues surrounding the policy, most of which denote the flexing of the political muscles between the democrats and the republicans. However, the most intriguing thing about the dimension of the Patient Protection and Affordable Care Act is that the policy is resented in a substantial number of states in the United States because of the seeming incompatibility between the state laws and expectations of the public at the state level. Perhaps, it is imperative to observe that the United States federal government has become less popular, especially because of the difficulty to make the exchange programs between the federal government and the state governments realizable and beneficial to citizens across the United States (Rothman 2014).

Rothman (2014) opines that Obamacare was a broad policy, yet it could hardly materialize because of the difficulty to align policy implementation structures at the federal level and the state and county level. At this juncture, it is worth observing that several Democrats who had backed the policy from the beginning had to rethink about the policy, owing to the pressure that piled on them from the respective Americans in the states that they represent. An example that can be given here is the pressure that mounted on the Oregon Democrat Governor John Kitzhaber from the public in the state of Oregon.

According to Thompson (2014), the citizens of Oregon have assessed the implication of the enforcement of the Patient Protection and Affordable Care Act and most of them have resorted to the dismissal of the Act, terming it a faulty law. What invigorates such a reaction from the citizens of the state of Oregon is the difficulty to enforce the proposed exchange programs.

The governor of Oregon has been placed at the center of the controversy surrounding the problems of implementation that face Obamacare in the state of Oregon. The citizens of Oregon have in the recent times called upon the governor to own up to the responsibility for supporting the Act without considering issues of federalism and their impact on policy across the United States (Thompson, 2014). The developments in Oregon is just but one of the indicators of a substantial number of states across the United States that are battling with the realities that face the enforcement of Obamacare.

It is imperative to note that, “Perhaps the most striking limitation on federal power in the decision endorsed by seven members of the court is its reinvigoration of constraints on Congress’s spending power, Congress’s ability to induce states to adopt policies” (Olson, Waxman, Katyal & Starr, 2012, p. 43). What comes out here is that the federal government is making attempts to coerce states to comply with the provisions of Obamacare. From the legal perspective, it makes sense to note that the federal government has mounted pressure on states, thereby influencing the opinion of the public in one way or another. However, this is bound to result in protests from the public, especially within states and counties.

According to Dinan (2011), Obamacare sets the ground for states in the United States to evaluate their positions in the development and implementation of legislation that are developed at the federal level. What comes out here is the issue of consciousness on policy discourse by the officials across the states in the United States, particularly the need for them to understand the implications of policy, especially the risks that appertain to the policies that are developed at the federal level. This is in line with the complex issue of aligning programs at the national level and the state level because the federal constitution of the United States allows states and counties to pursue their laws and policies about critical areas of development, like healthcare.

Obamacare has been subjected to criticisms because of the issues of capturing the legal and other issues that appertain to the compatibility of state and federal policies on healthcare. With healthcare seen as a primary good, meaning there is need to harmonize policies at the federal, state and county levels in the U.S, it is obvious that most of the challenges that hinder the enforcement of Obamacare across the U.S revolve around federalism as an impediment to policy across the U.S.


Dinan, J. (2011). Shaping health reform: State government influence in the Patient Protection and Affordable Care Act. Publius: The Journal of Federalism, 41(3), 395-420.

Olson, T. B., Waxman, S., Katyal, N., & Starr, K. (2012). Deliverance or disaster? (Cover story). Time, 180(3), 42-45.

Rothman, N. C. (2014). A brief history of the ObamaCare disaster. Commentary, 137(1), 26-32.

Thompson, J. (2014). Kitzhaber’s Obamacare disaster in Oregon: It’s getting bad.