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Passage of the Patient Protection and Affordable Care Act

Discuss the nature of the interaction between the House and Senate during the development and passage of the Affordable Care Act. What are the calculations that each chamber's leaders made? Why did each chamber's leaders act as they did? What are the different constraints under which each chamber operates?

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Timeline:

-President Obama Inaugurated into Office (Jan. 2009)
-President Obama addresses joint session of Congress on health care reform (Feb. 2009)
-President Obama presents the outline and some specific elements of his reform proposal to another joint session of Congress (Sep. 2009)
-House passes its version of health care reform legislation by a vote of 220-215 (Nov. 2009)
-Senate passed its version by a vote of 60-39 (Dec. 24, 2009)
-House passed Senate version of the bill with promise to pass amendments later (March 21, 2010)
-House passed series of amendments to the bill (March 2010)
-Senate approved the House amendments (March 2010)
-President Obama signed into law the House approved Senate version (March 23, 2010)
-President Obama signed into law the House and Senate approved amendments (March 30, 2009)

Background to Passage of Patient Protection and Affordable Care Act (PPACA):

When President Obama took office there were an estimated 45 million people in the United States without health insurance. The President addressed a joint session of Congress only one month after his inauguration to call for comprehensive health care reform. Both the House and Senate had Democratic majorities at the time. In September 2009, President Obama addressed a joint session of Congress again to further elaborate his reform proposal. And in March 2010, he signed the PPACA into law. PPACA is considered by many to be the most far-reaching health care reform act since Medicare in 1965. (Encyclopedia Britannica online)

Leadership Structure and Decision-making in the House and Senate:

Regarding the interactions between the two congressional chambers and the calculations of each chamber's leadership, consider focusing on the differences in how the two chambers operate.

In the House, the leadership (Speaker, Majority Leader, Majority Whip, and Committee Chairs) has full control over how ...

Solution Summary

This solution provides a brief history of The Patient Protection and Affordable Care Act's (PPACA) passage and uses this case to highlight the many differences between the U.S. House and Senate. The final bill, signed into law by President Obama, was largely shaped by these differences.

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