As I write this note on October 1, 2013, the nation is witness to the simultaneous opening of the Affordable Care Act (ACA) marketplaces across the fifty states and a government shutdown. What more poignant moment to recognize the importance of health politics and policy in the US context? Clearly, we cannot understand the shaping of US health policy in the current era without taking account of partisan polarization. Although House Republicans voted forty-two times to repeal Obamacare and failed, they are still willing to shut down the government in an attempt to deny funding the ACA. What does this mean for governing in America? For the development of the ACA across the fifty states? Amazingly, it may mean relatively little. Obviously, and for good reason, those who oppose Obamacare fear that as the ACA is implemented and millions of Americans receive...

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