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Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform

Samuel Y. Sessions, MD
JAMA. 2012;307(11):1202-1203. doi:10.1001/jama.2012.308.
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Shortly before midnight on March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. The landmark health care reform statute had passed only after a protracted and tortuous legislative process, culminating in an unconventional parliamentary maneuver involving a second bill amending the act and approved by Congress 2 days later. This represented the first time major US social legislation had been enacted on a strictly partisan basis. Reaction on this occasion was remarkably swift and dramatic. Within minutes of the President's signing of the act, 13 state attorneys general filed a lawsuit asking that it be declared unconstitutional. These and other challenges leave the ultimate fate of the act in considerable doubt.


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