The Affordable Care Act, or Obamacare, could pass into law because the Democratic Party briefly held the White House, a majority in the House of Representatives and a supermajority in the Senate in 2010.
Origins of Obamacare
Officially known as the Affordable Care Act, Obamacare was President Barack Obama's overhaul of the health insurance system. The concept of affordable care goes back to the 1980s, when conservative economists and senators championed a healthcare reform on the basis of individual responsibility.
In 1993, president Bill Clinton proposed a healthcare reform bill, and in 2006 the state of Massachusetts enacted a state-level insurance expansion bill. By 2008, most Democrats backed the Massachusetts model as the basis of state reform, and the topic was one of the most important during the 2008 Democratic primaries. During the general elections, Obama committed to fixing healthcare during his presidency.
Passing Obamacare Into Law
The Patient Protection and Affordable Care Act needed to pass through both chambers of Congress to become a law. The seeds for this passing were sown during the 2008 elections. That evening, the Democratic party came away with a 257 to 199 seat advantage in the House, and Obama was elected president.
In the Senate, the Democrats gained eight seats to hold 57 out of 100 seats. At the time, there were two Independent senators, and each was expected to vote for the law. The Democrats needed one more seat in the Senate to gain a supermajority, which is 60 seats, and ensure that the Republicans would be unable to block the passage with a filibuster.
This 60th seat would come unexpectedly, when Senator Arlen Specter of Pennsylvania switched his party affiliation from Republican to Democrat on April 28, 2009. On December 24, 2009, the Obamacare bill passed in Senate with a 60 to 39 vote. Three months later, the House and Senate bills were finally reconciled. President Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010.
Attempts to Repeal Obamacare
The Republicans started to attempt to repeal Obamacare immediately after it was passed in Congress. The Republican slogan "Repeal and replace" was coined in March 2010. During the 2016 elections, the Republicans vowed to repeal the Affordable Care Act if they won. On his first day in office, President Donald Trump signed an executive order to ease the burden of Obamacare before repealing and replacing it. In March 2017, the House Republican leadership announced a comprehensive plan to replace Obamacare with a system of block grants to states based on the number of patients served. Even though the Republicans controlled both chambers of Congress and the White House, they couldn't pass the repeal of the Affordable Care Act in September 2017.
Impact of Obamacare
The result of passing the Affordable Care Act in Congress was a significant reduction in the number of Americans without health insurance. According to figures released by the Department of Health and Human Services, approximately 20 million adults between the ages of 18 and 60 gained access to health coverage by February 2016.