The vast majority of ACA-related rulemakings were deemed by these agencies to be “significant,” economically or for other reasons. The Internal Revenue Service followed with 17 percent of rulemaking under the ACA, just above the Employee Benefits Security Administration, with 11 percent. Department of Health and Human Services, and particularly the Centers for Medicare and Medicaid Services, which conducted two-thirds of all rulemakings. The largest initiator of ACA-related regulatory activities was, unsurprisingly, the U.S. ![]() These regulations translated to almost 9,000 pages, or more than 9,000,000 words, that were finalized by the end of 2019.Ī more detailed look at the regulatory actions provides further insights about congressionally delegated authority and what executive branch agencies do with that authority. By our count, the final version of the ACA amounted to 961 pages, or about 475,000 words, which so far have triggered 265 unique rulemaking activities. ![]() These data allow us to illustrate the large amount of policy-making activity going on “under the hood” of the ACA, while much of the original statutory text remains on the books.Īlthough observers in the health policy and administrative law fields have long recognized the vast amount of regulatory delegation contained in the ACA, the numbers presented in our analyses are truly staggering. Our dataset contains the universe of regulatory actions from both the Obama and Trump Administrations that were triggered by the ACA. We collected data on all regulatory actions related to the ACA that have been undertaken since its enactment, providing the first exploratory analyses of both the law itself and its ensuing rulemaking activities. policymaking can be found in the ACA, which we focus on in a recent article. One of the clearest examples of the increasing importance of rulemaking to U.S. Yet each final regulation essentially holds the same force of law as a congressionally passed statute. Indeed, with Congress increasingly gridlocked, the vast majority of policymaking in the United States today may be of a regulatory more than a legislative nature. Congress routinely delegates the task of filling in important policy details to federal bureaucrats. In the modern administrative state, rulemaking fulfills a crucial role in governance because, when enacting statutes, the U.S. Instead, this dispute arose from an objection to the Trump Administration’s interpretation and implementation of the ACA’s contraceptive mandate through the rulemaking process. Pennsylvania, did not directly emanate from the ACA itself. The Court’s most recent decision, Little Sisters of the Poor Saints Peter and Paul Home v. In fact, the nation’s highest court will hear yet another challenge to the ACA later this year about the entire law’s constitutionality. Litigating the ACA-a signature achievement of the Obama Administration-in front of the Supreme Court is nothing new. ![]() The recent ruling caps off, at least temporarily, a decade of numerous lawsuits and Supreme Court showdowns. The so-called contraceptive mandate has been one of the most contentious parts of the ACA. The controversy emanated from the Patient Protection and Affordable Care Act’s (ACA) mandate to provide coverage for all preventive health care services free of cost. Supreme Court recently sided with the Trump Administration in exempting employers who have a “moral or religious objection” from the requirement to provide their employees with contraceptive health care coverage.
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