Examining US Policy Makers' Conceptions of Liberty in Drafting the Affordable Care Act

186 Pages·2017·1.28 MB·English

by  Louis Altobelli

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2017
Examining U.S. Policy Makers' Conceptions of
Liberty in Drafting the Affordable Care Act
Louis Altobelli
Walden University
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Walden University

College of Social and Behavioral Sciences

This is to certify that the doctoral dissertation by

Louis Altobelli

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Mary Bruce, Committee Chairperson,
Public Policy and Administration Faculty

Dr. Lori Demeter, Committee Member,
Public Policy and Administration Faculty

Dr. George Larkin, University Reviewer,
Public Policy and Administration Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2017
Abstract
Examining U.S. Policy Makers’ Conceptions of Liberty in Drafting the Affordable Care
Act
by
Louis Phillips Altobelli

MS, Champlain College, 2011
BA, University of North Carolina at Chapel Hill, 2008

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Public Policy and Administration

Walden University
February 2017
Abstract
The U.S. legislators may have incorrectly incorporated outlooks on liberty and natural
law associated with the Patient Protection and Affordable Care Act (ACA) of 2010. The
purpose of this case study was to use Kersch’s conceptualization of declarationism and
Hayek & Kamowy’s construct of socialism to examine whether the ACA incorporates
principles associated with the natural right of liberty as promoted by the Founders of the
United States. The central research question that guided this study investigated whether
U.S. lawmakers followed the intentions of the Founders in passing the ACA, as
demonstrated in the legislation, related bureaucratic reports, and court cases. Data for this
study consisted of seminal and foundational document such as the Declaration of
Independence and United States Constitution, public law, and publicly available
government documents related to the enactment and implementation of the ACA. These
data were deductively coded and subjected to a thematic analysis. Findings indicate there
was evidence of partisanship in the bill drafting process, possible violations of
parliamentary procedure, and judicial activism. The positive social change implications
of this study include recommendations to policy makers to remain diligent and cognizant
of the risks of drifting from the principles of liberal, constitutional democracy. Doing so
may promote more equitable and efficient implementation of landmark and controversial
public policy.
Examining U.S. Policy Makers’ Conceptions of Liberty in Drafting the Affordable Care
Act
by
Louis Phillips Altobelli

MS, Champlain College, 2011
BA, University of North Carolina at Chapel Hill, 2008

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Public Policy and Administration

Walden University
February 2017
Dedication
First, and foremost, I dedicate this study to God, my rock, my shield, and my soul
provider. Psalm 28:7 says, “The LORD is my strength and my shield; my heart trusts in
him, and he helps me. My heart leaps for joy, and with my song I praise him.” A study of
this magnitude was only completed with the power of the Holy Spirit whom I have
praised from the beginning of this journey and will continue to praise. As we walk
through the sand at the end our days we will surely look back to only see one set of
footprints.
This study is dedicated to my mother and father whom were my steady and
guided influence. Select lines from the oft-cited Rudyard Kipling poem, “If”, best portray
their encouragement: “If you can keep your head when all about you, Are losing theirs
and blaming it on you, If you can trust yourself when all men doubt you, But make
allowance for their doubting too; If you can wait and not be tired by waiting … If you can
dream—and not make dreams your master; If you can think—and not make thoughts
your aim; If you can meet with Triumph and Disaster, And treat those two impostors just
the same; If you can bear to hear the truth you’ve spoken … If you can talk with crowds
and keep your virtue, Or walk with Kings—nor lose the common touch … Yours is the
Earth and everything that’s in it, And—which is more—you’ll be a Man, my son.”
And though those words are as indicative of their support, even the most beautiful
poets and their poems in the world are unable to capture the love they gave me during my
time here on this earth. I love ya’ll and thank you for raising me to be a faithful, good
ole’ Carolina (and a bit of California) boy.
Acknowledgements
There are many people I would like to thank. My family was by my side every
step of the way. It would not have been possible to complete this work without their
support, love, and understanding throughout my academic career, which at times required
patience from those around me. To my brothers and sisters in my church family, friends,
and colleagues whom I forever indebted, I would like to thank you for your patience and
care during the writing of my dissertation. I would like to also thank my committee
members for their diligence, ensuring that my dissertation was held to the highest
standard and doing so in a timely manner. These individuals provided only
encouragement during my journey, which, in many ways, took a village. Throughout the
entire process, I have prayed and hoped that this work, a product of hundreds of hours of
writing and research, is worthy of the love I have received in the duration of this
culminated effort.
Table of Contents
List of Tables .......................................................................................................................v
List of Figures .................................................................................................................... vi
Chapter 1: Introduction to the Study ....................................................................................1
Background ....................................................................................................................2
Problem Statement .........................................................................................................4
Purpose of the Study ......................................................................................................6
Research Questions ........................................................................................................7
Conceptual Framework ..................................................................................................8
Nature of the Study ........................................................................................................9
Definitions....................................................................................................................10
Assumptions .................................................................................................................10
Scope and Delimitations ..............................................................................................11
Limitations ...................................................................................................................11
Significance..................................................................................................................12
Summary ......................................................................................................................14
Chapter 2: Literature Review .............................................................................................15
Introduction ..................................................................................................................15
Literature Search Strategy............................................................................................15
Conceptual Framework ................................................................................................16
Literature Review Related to Key Variables and Concepts .........................................17
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The Founders and Liberty ..................................................................................... 17
Faith of the Founders. ..................................................................................... 19
Leadership of the Founders. ............................................................................ 20
Trends in liberty. ............................................................................................. 22
Differences from the Colonial era to the 21st century. ................................... 23
Changing of U.S. Implementation ........................................................................ 25
Total liberty. .................................................................................................... 25
Taking a stand. ................................................................................................ 26
Moral standard. ............................................................................................... 28
Dictators and Socialism ........................................................................................ 29
Ideology. ......................................................................................................... 29
Dictatorship and complete control. ................................................................. 30
Trends in socialism. ........................................................................................ 32
Difference from the Colonial era to the 21st century. .................................... 33
Achieving true socialism................................................................................. 35
Future in socialism. ......................................................................................... 38
Political Maneuvering ........................................................................................... 40
Political advantage through procedure............................................................ 41
Political advantage through bureaus. .............................................................. 44
Political advantage through the courts. ........................................................... 46
Relevant and Current Research ....................................................................................50
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