A concise and detailed account of the current state of healthcare reform in America. Recommended for anyone interested in this hot-botton issue in American politics, and healthcare reform ( )

The Tough Luck Constitution and the Assault on Health Care Reform provides a very good foundation on constitutional law and health care reform. Since it is difficult to grasp all of the important information in order to discuss these topics intelligently – in a truly informed manner – this book is a welcome and helpful outline.

If one is interested in the Affordable Care Act, as well as constitutional law and health care reform, this is a fine book to read – very “readable.” Nevertheless, I felt I had to review the chapters several times in order to make sense of the issues. And that was after I had followed as much as I could during the Supreme Court’s deliberations on the Affordable Care Act.

To a lawyer or law student, all the issues covered may make sense and may be readily understandable. But to a lay person, even a reasonably well-read individual, these topics take a bit of thinking and review to understand. What does the author mean, what he is saying as he outlines The Road to the Mandate in chapter 1 – the history of health care reform? Constitutional limitations on congressional power, constitutional objections, the Supreme Court’s decision, and the “aftermath” of the Court’s decision – topics presented informatively in the following chapters. What do we need to know in order to make informed decisions about health care reform? This book helps answer many questions. ( )

I expected this book to cover the whole range of opposition to The Affordable Care Act (Obamacare): right-wing media rants, Tea Party opposition, opposition from Governors, Attorneys-General, Washington politicians, etc. Instead, the book concerns itself with the legal challenge to the ACA in the lower Federal courts, and, especially, in the Supreme Court. Particular focus is given to the ACA's mandate, a mechanism Obama had once criticized, but resorted to in hopes that it would achieve something reasonbly close to universal health care coverage.

Everything is presented clearly enough, but I struggled a bit with the constant references to earlier Supreme Court decisions and the precedents they set, and also with some of the legal language. Still, none of it was too off-putting for, in my case, a reader who knew little of the law in general and Constitutional Law in particular.

It turns out that a book with a narrow focus on the legal arguments is a welcome one. After all, experts, reporters, and the general public alike were confused and quite suprised by Justice Roberts' decision to uphold the main argument against Obamacare's mandate, and yet find that mandate, and most of the rest of Obamacare, constitutional on a different basis. What was his judicial reasoning, and what were his personal reasons? This book gives useful background and compelling insight into both questions.

Koppelman is pretty fair in presenting the legal arguments made against the Affordable Care Act and its mandate; however, his personal attitude about those challenges is clearly seen in this paragraph near the end of Chapter 4:

"Isn't it odd that the mandate, which a few years earlier was the Republican alternative to Clinton's health plan, suddenly became, once Obama supported it, an intolerable intrusion on a new, unenumerated liberty? May we not suspect that, if Obama had rejected the mandate and chosen a different mechanism, those wonderfully creative Republicans would have invented a different constitutional rule, which that mechanism would have violated?" ( )