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The Affordable Care Act: At the Nexus of Politics and Policy

James M. Brasfield
The Affordable Care Act: At the Nexus of Politics and Policy
ISBN: 978-1-955055-23-9
ISBN: 978-1-955055-29-1
2022/325 pages/LC: 2021047876
"Excellent.... Brasfield's comprehensive account of the Affordable Care Act and its aftermath brings together a wealth of information on the legislation's formation, implementation, and successes/failures in the years since its enactment." —Laura Olson, Lehigh University


In the more than a decade since the enactment of the Affordable Care Act, questions about the law continue to be vigorously debated. What political dynamics led to its passage? Why has it been subject to so many existential threats? What accounts for its survival and growth? How can its performance best be evaluated?

Addressing these questions, James Brasfield eschews partisan rhetoric to provide an in-depth discussion of the politics and policy of the ACA—from its origins to the present—assess the success of the law in achieving its goals, and project possible future scenarios.


James M. Brasfield is professor emeritus at Webster University.


  • The Origins of the ACA: A Century of Debate.
  • The Promised Land: Health Reform at Last.
  • The Hard Work Begins: ACA Implementation.
  • The Dog Caught the Car: Now What?
  • The Trump Administration's Sabotage Strategies.
  • An Assessment: What Has Been Achieved?
  • The Verdict: Public Opinion, Legal Opinions.
  • Cost Control: An Elusive Goal.
  • The ACA Today ... and Tomorrow.