70 Changes That Make Obamacare A Very Different Law Than Congress Passed

One reason why the anger over Obamacare has subsided somewhat could be that more than 70 significant changes have been made to the law since it was enacted in 2010—delaying, weakening, and eliminating some of its more onerous and burdensome provisions. The law that is being implemented is not the one Congress passed.

By our updated count at the Galen Institute, at least 43 of the changes to the Affordable Care Act have been made unilaterally by the Obama administration, 24 have passed Congress and been signed into law by President Obama, and three were made by the Supreme Court, which had to rewrite the law to uphold it.

We chronicle the many changes the administration has made without legal authority which have softened or delayed the law’s impact on businesses, made it easier for people to escape penalties and enroll in coverage, and boosted subsidies. While we may agree with some of these changes, the administration does not have the authority to change the law without congressional action. Inexplicably, even when the House passed changes that would have made the president’s actions legal—such as delaying the employer and individual mandates—the president said he would veto the legislation if it reached his desk. Former Senate Majority Leader Harry Reid made sure that it did not.

Under the new Senate Majority Leader Mitch McConnell, the Senate did pass legislation, which also cleared the House, repealing major provisions of the ACA by using the complex reconciliation process. The reconciliation/repeal bill was sent to the president early this year, and he vetoed it.

So with his veto standing between Congress and repeal of the law, the most Congress has been able to do so far is to try to protect the American people from as much damage as possible.

Most of the 24 changes that have made it through Congress and been signed by the president were passed under Republican leadership in the House with bipartisan support.

The record shows that seemingly small changes to the law can have a big impact. For example, Congress passed legislation that made the “risk corridor” program budget neutral. The Consolidated and Further Continuing Appropriations Act of 2015provided that the Obama administration may not transfer funds from other accounts to make payments to health insurers to compensate them for losses in 2014 in the ACA exchanges. The budget-neutrality provision for the risk corridor program was extended to payments for 2015 in the Consolidated Appropriations Act for 2016, signed Dec. 18, 2015.

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