Today will be one of the more important dates in recent U.S. history, as it will mark the official start of health care exchanges as part of the Affordable Care Act, otherwise known as Obamacare. Today also marks the deadline for a congressional federal spending bill and in an effort to pass a spending bill, the House of Representatives had included a provision to defund Obamacare. Since the spending bill did not pass, the government has officially "shut down." In the midst of this political uncertainty, what is the fate of the Affordable Care Act? Do you believe this saga will ever come to an end?

Naomi Shine '15

I think it is highly unlikely that the fate of the Affordable Care Act will be determined by a desperate, last minute attempt made by conservatives in the House of Representatives to defund the bill. With a democratic majority in the Senate united against defunding Obamacare, conservatives in the House of Representatives should be well aware that their efforts to derail the ACA will go unrealized. With many measures of the ACA already in place and health care exchanges opening as scheduled, the question is not whether the ACA will survive this conflict but whether select conservatives will continue to antagonize the ACA or channel their energy into finding ways to improve the ACA to better serve their constituents.

Naomi Shine '15 is an undergraduate departmental representative for the Health: Science, Society and Policy major.

Andrew Hart, Ph.D. '14

I think the Obamacare "escape fire" has been lit. The political posturing in Washington, D.C. likely adds to the uncertainty that states, health care providers, the business sector and individuals have been dealing with all along, which means some states-and the stakeholders within them-will do better than others in terms of getting people insured. Nothing new there. Prof. Michael Doonan (Heller) recently published his book, which explores American federalism through the development and implementation of health policy. After reading the first several chapters, the message is clear: the buck doesn't stop with the executive branch, the legislative branch, or the states themselves-there's almost always a work-around.

Andrew Hart '14 is a Ph.D. candidate at the Heller School for Social Policy and Management and an internship instructor and lecturer in the Health: Science, Society and Policy program.

Jennifer Mandelbaum '14

No matter the outcome of the federal spending bill, health care exchanges will open as planned. Due to its funding structure, the ACA is largely protected from setbacks in the annual budget process. Starting Oct. 1, 40 million Americans will be able to sign up for coverage. Attempting to stop further provisions from the ACA from being implemented is not only unprogressive, but also impracticable. In a recent New York Times op-ed, Kentucky governor Steve Beshear writes, "Lack of health coverage puts [citizens'] health and financial security at risk." It is time to stop putting politics ahead of citizens' health care needs.

Jennifer Mandelbaum '14 is an undergraduate departmental representative for the Health: Science, Society and Policy major.

Russell Leibowitz '14

Just over a year ago Speaker John Boehner was asked whether Republicans would continue to try to repeal the Affordable Care Act. His response was clear: "I think the election changes that. It's pretty clear that the president was reelected." Now, with the Republican Party even more radicalized than it was at the height of the Tea Party three years ago, he's decided to side with the radical right to hold government services and the paychecks of hundreds of thousands of Americans hostage until the conservatives' demands are met. This kind of policy is the height of irresponsibility. Instead of choosing to negotiate on a fair playing field, he's decided to play political games with people's livelihoods. The ACA will remain the law of the land regardless of these Republican tactics while the people suffer from the conservatives' reckless political demands.

Russell Leibowitz '14 is the co- president of Brandeis Democrats and a member of Brandeis Academic Debate and Speech Society.

Aaron Schluger '14

Regardless of the fate of the government in the upcoming days, the President has affirmed that the Affordable Care Act's health insurance exchanges will open for business amidst a battle of political posturing. On a microscopic level, the effects of a government shutdown will leave a confused public without resources to aid them in navigating the intricacies of participating in health care exchanges. Uncertainty among the American people may lead them to believe that they cannot buy healthcare, when in reality the ACA will indeed go into effect irrespective of the fate of the government. A macroscopic view of the current political landscape concerning the ACA highlights the growing tension regarding the delivery of healthcare in the United States, which remains the only advanced economy that has yet to provide its people with a guarantee of basic health care. The ultimate trial of the long narrative of health care laws in the United States will be whether we can provide for others who need medical attention without the financial ability to secure it for themselves.

Aaron Schluger '14 is the president of the Pre-Health society

Flora Wang '15

The Affordable Care Act (ACA) has been one of the crucial issues President Barack Obama has campaigned for from the primaries to his presidency. While the Republican Party views the shut down of the government as inevitable and has publicly stated that they are unwilling to accept anything related to Obamacare, the Act will probably pass. It is clear that the current system insufficiently serves the needs of the public health of America and change is needed. If the bill were to pass the Senate without ACA funding, President Obama has threatened to veto it. Hopefully party lines will not stop a necessary act that seeks to lower health care costs for those who need it most and the ACA will pass with sufficient funding to serve that purpose.

Flora Wang '15 is an Undergraduate Departmental Representative for Health: Science, Society and Policy.