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The "Obamcare" bill was passed by a narrow 220-215 vote in House with no Republican support. And this was accomplished using legislative tactics such as "deemed passage." Parts of the bill, seem to not be fulfilling its stated purpose. For instance, people were assured that they could keep the insurance they wanted; now it turns out that they can't.

  • Why was the bill passed so quickly?

  • Did these reasons trump "efficiency" arguments?

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    It looks like you have two or three questions here. It seems that you are most interested in why it was passed so quickly. I would drop all the, "has it been effective " info.
    – user1873
    Nov 17 '13 at 2:10
  • @user1873: Fine. Thanks for the edit. Yes, to paraphrase Michael Dukakis, my concerns were more with the "competence" of the bill than the "ideology."
    – Tom Au
    Nov 17 '13 at 15:23
  • Actually, the bill was not passed through "Deem and Pass". They considered passing it through Deem and Pass, but they ultimately decided against it. Nov 28 '13 at 21:11
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Obamacare was forced though so quickly because it never would have passed otherwise, or would have been significantly changed before passing. The Democrats had a super-majority in congress until Ted Kennedy Died in August of 2009. Then Scott Brown, a republican, would be elected in the special election which would end the super-majority in the Senate and allow the Republicans to filibuster. This forced the Senate to act fast so they passed their version on December 24 and Scott Brown was Elected in January and sworn in on February 4th. The House then had to pass the senate bill as is in order to avoid sending a bill back to the now deadlocked Senate, this lacked any real support from most democrats as well so they did some creative parliamentary procedures to turn the bill in to a budget bill which is subject to reconciliation which blocks filibuster in the senate. This also limited and House changes to budgetary concerns which required the executive order about abortions to be created to satisfy some hold out Democrats.

The reasons for all this were mostly political, this was supposed to be Obama's signature reform and his legacy. The Democrats weren't interested in negotiating with republicans because the had won big in the 2008 elections and this was also partly their victory legislation. The bill was also getting more and more unpopular as the "debate" went on and got uglier and it started becoming apparent that anyone who voted for the bill that wasn't in a totally safe district would face major challenges in reelection bids, especially for republicans, for supporting the bill, so passing fast there was hope that the public's short memory would forget the worst transgressions. The bill was also passed quickly because it has huge welfare spending in it in the form of medicaid expansions and premium subsidies, which once implemented would be nearly impossible to repeal. The spending in the bill was huge and it needed years of extra taxes being collected to build up a cash reserve in order for the bill to be rated as budget neutral.

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    You might want to source your second paragraph. Perhaps give some reelection numbers between 2008 and present, or quotes from incumbents regarding the bill. As for the wealth transfer, you might want to quote CBO numbers showing the increased spending under the ACA.
    – user1873
    Nov 18 '13 at 15:43
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I would argue that the most glaring problems with the Affordable Care Act came from the overly lengthy process that it went through. By the time Obama announced his push for healthcare reform to a joint session of congress in Feb, 2009 most of the issues were already well-understood and it was just a matter of choosing from existing proposals. By July, the House had already passed several competing options through committee. The Senate held hearings for months hashing out various provisions. The House passed their final version in November and final passage in the Senate was Dec 24th.

From starting gun to final passage was nearly a year. That was enough chewing over for every possible special interest to take a bite. This, to address a problem that Teddy Roosevelt recognized, using a conceptual framework (universal insurance) proposed in the Nixon administration and using the precise mechanism from Romneycare that had been working since 2007.

Between intense, ongoing special interest lobbying, and the pushing and pulling to try and gain individual votes, the hashwork left in November wasn't at all pretty. In addition to the looming change in Senate control with Scott Brown's election, December meant the end of the 111th Congress so after an exhausting year of work Congress would have had to start all over. So, they took what they had and went with it. A much cleaner version of the same bill could've passed in July and would probably not have given the impression of passing a hastily put together piece of crap. Go figure

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