On March 25, 2010, both chambers of Congress passed the Health Care and Education Reconciliation Act (HCERA).“H.R. 4872 — Health Care and Education Reconciliation Act of 2010,” https://www.congress.gov/bill/111th-congress/house-bill/4872 (March 1, 2016). The story of the HCERA, which expanded and improved some provisions of the Patient Protection and Affordable Care Act (ACA), also known as Obamacare, is a complicated tale of insider politics in which the Democratic Party was able to enact sweeping health care and higher education reforms over fierce Republican opposition (Figure). Some people laud the HCERA as an example of getting things done in the face of partisan gridlock in Congress; others see it a case of government power run amok. Regardless of your view, the HCERA vividly demonstrates public policymaking in action.
Each of the individual actors and institutions in the U.S. political system, such as the president, Congress, the courts, interest groups, and the media, gives us an idea of the component parts of the system and their functions. But in the study of public policy, we look at the larger picture and see all the parts working together to make laws, like the HCERA, that ultimately affect citizens and their communities.
What is public policy? How do different areas of policy differ, and what roles do policy analysts and advocates play? What programs does the national government currently provide? And how do budgetary policy and politics operate? This chapter answers these questions and more.