After the passage of the New Deal and the Great Society programs, the opposition engaged in debates about aspects of implementation but did not continue to fight about the passage of the legislation itself. This has not been the case with the Patient Protection and Affordable Care Act (ACA) of 2010. The essays in this section help us make sense of the ACA's impact on future politics. By focusing on the first six months after the bill's adoption, Rogan Kersh investigates the politics surrounding the ACA's implementation, addressing three aspects: first, the balance of those working toward gridlock versus a federal agency intent on efficient and swift implementation; second, an ardent move by some to repeal all or part of the ACA; and third, dwindling public support for the ACA in addition to a lack of ability or interest by supporters to continue working for reform. While these three factors suggest a volatile political climate immediately following passage, Lawrence R. Jacobs's essay encourages us to think about the longer-term implications of how the ACA will foster a new politics. Jacobs reminds us of the old adage, “policy effects politics,” and gives us a glimpse into the ACA's possible effects.