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.