RT Journal A1 Kraemer JD, Gostin LO T1 The power to block the affordable care act: What are the limits? JF JAMA JO JAMA YR 2012 FD November 21 VO 308 IS 19 SP 1975 OP 1976 DO 10.1001/jama.2012.51175 UL http://dx.doi.org/10.1001/jama.2012.51175 AB Health care reform remains precarious in the United States, with intense political disagreement about the Affordable Care Act (ACA). Former Governor Romney vows to “repeal and replace” President Obama's signature domestic achievement.1 Although repeal would face potentially insurmountable political barriers,2 a Republican president could selectively enforce the ACA, effectively blocking full implementation. The president has wide discretion in implementing legislation, so understanding the scope of executive powers is important—not only for the ACA but also for a broad range of social welfare legislation.