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YALE LAW & POLICY REVIEW
Unilateralism, Defunding,
and the Shrapnel of Health Reform
Michael Lee*
INTRODUCTION
In the shadow of a Presidential veto, it will be impossible to repeal health
care reform completely-despite the overwhelming number of additional seats
Republicans won in the 2010 election. Congress could, however, strip imple-
mentation funding from the Patient Protection and Affordable Care Act
(PPACA)1 and its companion bill, the Health Care and Education Reconcilia-
tion Act (HCERA), known jointly among detractors as Obamacare,3
and more properly as the Affordable Care Act (ACA). Defunding the health
care bill has been advocated by Republican leaders such as Rep. John Boehner
(R-OH) and Sen. John McCain (R-AZ),4 who view the ACA as simultaneously
unpopular' and counterproductive.6 The economics of the bill do appear
M.D. Candidate, Washington University School of Medicine; J.D. Candidate, Yale
Law School. This Essay is an elaboration of a speech delivered to the Yale Political
Union.
1. Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119
(2010) [hereinafter PPACA].
2. Health Care and Education Reconciliation Act of 2010, Pub. L. 111-152, 124 Stat.
1029 [hereinafter HCERA].
3. See, e.g., The Truth About Obamacare: What the Liberal Media Aren't Telling
You About Obama's Healthcare Plans, MEDIA RESEARCH CENTER,
http://www.obamacaretruth.org/ (last visited May 22, 2010).
4. Simmi Aujla, Price: We'll Defund Health Reform, POLITICO (Sept. 11, 2010, 3:13
PM), http://www.politico.com/news/stories/o910/42o15.html.
5. The bill had only lukewarm support prior to passage, despite the fact that cer-
tain propositions were actually supported by most Americans. Frank Newport,
Jeffrey M. Jones & Lydia Saad, Americans on Healthcare Reform: Five Key
Realities, GALLUP (Oct. 30, 2009), http://www.gallup.com/poll/23989/americans-
healthcare-reform-five-key-realities.aspx. Recent polling has been more favorable.
See Robert Pear, Among Some, High Marks for Health Care Overhaul's Beginnings,
41](ViewImageLocal?handle=hein.journals/interal29&div=1&collection=&method=preview&ext=.png&size=3)