The story of the Affordable Care Act is as twisted and bizarre as anything ever written by Stephenson, Kafka, or Orwell. It is an Act that saw the President oppose his signature legislation, before he supported it, and that saw the President’s challenger sire the Act, before he disowned it. The Act sparked conservative outrage around the country, though it was conceived in the heart of the conservative movement. It passed only through handouts to some States, but was partially stricken as violating the financial free will of all the States. And, of course, it is an Act that raised no taxes, but that survives as a valid exercise of the taxing power.
In Unprecedented: The Constitutional Challenge to Obamacare, Josh Blackman tells the story of Obamacare with the flair of a novelist and the eye of a historian. Blackman, a law professor who helped coordinate the legal challenges to the Act, describes the Act’s full history: as a policy innovation, a political machination, a campaign football, a media spectacle, and, last but not least, a legal drama. Throughout, Blackman conveys both the historical sweep of the transformative law and a minute-by-minute, insider look into the series of events – some would say accidents – that have allowed the Act to survive numerous political and legal challenges. Despite (or perhaps because of) the book’s insights, after reading it, the reader is still left asking a very basic question: How on earth did the Affordable Care Act become the law of the land?
I’m still asking that question.