Federalism and the Patient Protection and Affordable Care Act of 2010: The Founding Fathers Would Not Be Surprised.

The article discusses various issues related to the enactment of the Patient Protection and Affordable Care Act of 2010 (ACA). It is stated that U.S. President Barack Obama was not the first national leader to propose universal health insurance coverage. Before the final passage of the bill, Obama had to navigate difficult interest-group politics and also had to answer to respond to broad cultural concerns about the role of government. It is stated that the state governments were among the most important interest groups in the entire health reform process.