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65 Tax L. Rev. 627 (2011-2012)
The Ideological and Partisan Polarization of Healthcare Reform and Tax Policy

handle is hein.journals/taxlr65 and id is 647 raw text is: The Ideological and Partisan Polarization of Healthcare Reform and Tax Policy MARK A. PETERSON* I. INTRODUCTION In the United States it would be difficult to identify policy arenas more infused with political drama and contention than either reform of the healthcare system or tax policy. Joining the two together has produced an invitation for particularly robust forms of political con- flict. The century of multiple failed healthcare reform efforts; the whisker-thin single-party-based legislative victory in March 2010 that gave statutory life to the Patient Protection and Affordable Care Act (known generally as the Affordable Care Act or ACA);1 and the ongoing rhetorical, congressional, and judicial battles over the ACA's implementation and its very future offer testament to the particularly discordant nature of the associated politics. The resulting context for future healthcare reform and tax policy making is not a pretty one. Nor does it readily yield predictions about the trajectory of substan- tive policy decisionmaking on these issues, other than to expect each side in the debate to adopt the John Paul Jonesian pose of we have just begun to fight! To comprehend why the United States has reached this point in its joint national healthcare and tax policymak- ing, and to understand the rather extraordinary politics that will shape the policy debates for years to come, requires a systematic and histori- cally rooted assessment of larger trends in U.S. politics, the underlying factors that agitate even further the politics at the intersection of health care and tax policy as they have played out since the New Deal, and the political and policy significance of how the ACA was enacted. To simplify this analytical task and to bring to the fore the institu- tional and political features of greatest moment, I narrow my focus in a number of respects. First, although comprehensive healthcare re- form embodies many policy objectives, including enhancing the qual- * Professor, Department of Public Policy, Luskin School of Public Affairs. Department of Political Science and School of Law, UCLA. 1 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010); Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029. 627 Imaged with the permission of Tax Law Review of New York University School of Law

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