NEJM October 18, 2017
At the end of the 2017 Obamacare repeal-and-replace legislative battle (and before the next one begins), it is worth taking stock of why — defying the odds — the Affordable Care Act (ACA) still stands. From my perspective as an Obama administration veteran of every near-death experience of the law to date, this one is notable for its unlikely heroes.
Pundits primarily attribute the end of the latest attempt to repeal and replace the ACA to a political failure. With the Republicans in charge of both the White House and Congress, voting to keep the promise of repealing the ACA was, in the words of Senator Chuck Grassley (R-IA), “as much of a reason as the substance of the bill.”1
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