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This Symposium contribution explores differences in how congressional Republicans responded to Medicare and how they responded to the Patient Protection and Affordable Care Act (ACA). Given the narrowness of the constitutional challenges to the ACA that congressional Republicans promoted and the many federal taxes, expenditures, and regulations that they support, this Article rejects the suggestion that today's Republicans in Congress generally possess a narrow view of the constitutional scope of federal power. The Article instead argues that congressional Republicans then and now-and the two parties in Congress today-fracture less over the constitutional expanse of congressional authority and more over the political objectives that robust federal power will be used to accomplish. Accordingly, the key question going forward is not one of perceived constitutional limits on Congress, but whether the federal government will expand or even maintain its role in combating economic vulnerability, a role that President Lyndon Johnson's Great Society performed to a significant extent by transforming America from a regulatory state to a welfare state.

Library of Congress Subject Headings

Constitutional law, Patient Protection and Affordable Care Act, Health insurance--Law and legislation