On March 23, 2010 President Barrack Obama signed into law the Patient Protection and Affordable Care Act, otherwise known as Health Care Reform (HCR). The signing of this legislation into law has been at the forefront of many vigorous debates on whether the process that was used to pass the bill or even the bill itself is ethical. 
     The United States has been able to boast about the quality of our health care for many decades now. People come from all over the world to be treated in the United States by some of the finest physicians, surgeons and specialist on the planet. The issue many Americans have with the current health care system is the enormous cost that is associated with needed services. Many Americans suffer financially for years due to the high cost of care. During the 2008 Presidential election season, leading democratic candidates pledged repeatedly to their constituents and potential voters that if elected, they would certainly reform the health care system and make it accessible and affordable for all. Republican candidates acknowledged the need for reform as well, but had a much different approach. Fearing anything that remotely resembled socialized health care, republicans touted items such as Tort reform, as well as lifting the commerce restriction that prevented insurance companies from competing across state lines. But, most of the republican ideas for fiscal reform fell on deaf ears, as President George W. Bush had recently passed a prescription drug bill that was unpaid for, and responsible for adding tremendously to the National deficit. 
     Immediately after President Barrack Obama was elected he set out to form legislature that would fulfill a promise that he made to constituents on the campaign trail and reform the Nation’s health care system. At the forefront this looked as if it was going to be a relatively easy task, as the President enjoyed the advantage of having a majority in the House of Representatives and a super-majority in the Senate. But, soon many ethical issues arose, such as federal funding for abortion and the individual mandate that required all citizens to purchase health care or pay an excise tax, as a result of their unwillingness to comply with the mandate.
     The federal funding for abortion issue was the center of many debates between republicans and democrats, as well as some pro-life democrats. The proposed reform bill presented by Speaker Nancy Pelosi and the President did not restrict the use of funds for abortion. This became an obstacle for the Speaker and the President as many pro-life Americans believe the act of abortion is unethical. Many Christians point to the Holy Bible and the scriptures recorded in the book of Exodus. In Exodus 21:22, 23 Moses wrote in 1512 b.c.e. that: “When men strive together and hit a pregnant woman, so that her children come out, but there is no harm, the one who hit her shall surely be fined, as the woman’s husband shall impose on him, and he shall pay as the judges determine. But if there is harm, then you shall pay life for life” (Moses). This Bible text supports the idea presented by many Christians that God views the unborn child as a life, thus making the willing termination of such a life a sin, an unethical act that is punishable by death. Although, this belief is not shared by all Americans, the lack of restriction pertaining to the use of individual tax dollars to fund community health centers where “many of these community health centers will be run by Planned Parenthood and other groups that see abortion as an essential service” (Mosher), was met with harsh opposition by pro-lifers. Many of the President’s supporters argued that no funds went directly to pay for abortion procedures. But, organizations such as Planned Parenthood do not separate funds for individual programs, therefore individual tax revenues would go to substantiating the financial viability of such entities that perform abortion. 
     On March 21, 2010 pro-life democrat Bart Stupak and 10 other House members (Stupak 11) held up the vote on HCR by demanding that an amendment be added to the bill that specifically restricted the use of tax dollars to fund abortion. Speaker of the House Nancy Pelosi refused to add such an amendment knowing the only way to pass HCR was to do so under the provision of reconciliation, which does not allow the bill to be modified or amended in any way. If such an amendment would have been granted, the bill would have to go back to the Senate for an additional vote. Being that Scott Brown a Senator from the state of Massachusetts had just won a landmark election and occupied the Senate seat that was held by the Kennedy family for over 30 years, democrats had lost their super-majority, and a filibuster by Senate republicans was almost a certainty. This would have left the bill in eternal debate, ultimately defeating the legislature. In the 11th hour of the House session Speaker Nancy Pelosi conferred with President Obama, convincing him to sign an executive order which restricted the use of federal funding for abortion. Bart Stupak and the other 10 House members needed the provision of an executive order, to appease their constituents that were vigorously against such funding. A day after Representative Bart Stupak, and the other 10 House members compromised on their pro-life position to deliver the necessary yes-votes to pass health care reform, the “Stupak 11” released their fiscal year 2011 earmark requests, which totaled more than $4.7 billion, an average of $429 million worth of earmark requests for each lawmaker (Riggs). Millions of dollars in tax payer money can be quite of an effective tool when it comes to changing ones ethical position.       One has to question how ethical it was to sell the idea to the concerned public that the executive order signed by President Obama had any effect at all on the legislature. The constitution does not explicitly grant the President the power to govern by decree or to promulgate executive orders that are like legislation (Rotunda and Nowack). In other words, President Obama executive order is not worth the paper it is written on. It has absolutely no effect at all on the law that was passed. It was done simply as a formality to help Representative Stupak and the others justify their change of position on the bill. President Obama, a graduate from Harvard University, would almost certainly of known about the lack of power an executive order has over a law passed by Congress. 
     Another ethical issue that is currently being challenged by several of the state’s Attorney General’s, is the individual mandate where all citizens are required to purchase health insurance, or face a series of fines that are enforced by the Internal Revenue Service. The Attorney General’s that oppose this legislation have taken the position that it is unconstitutional to force Americans to purchase anything from a private entity or government agency. Many who support the HCR bill argue that all drivers are required to purchase automotive insurance, or be subjected to fines, and that the requirement to purchase health insurance is no different. Except for one minor detail, those in favor of the bill would be correct. Everyone has the option not to drive. So the comparison of the two is not a legitimate argument. 
     As the court case that was filed in opposition to the HCR bill makes its way through the Federal Court system, President Obama has changed his position on one of his most popular campaign promises from the 2008 Presidential Campaign. President Obama promised “no new taxes,” for families making less than $250,000 per year. The individual mandate in the HCR bill requires individuals to purchase health insurance or be hit with an excise tax. That means that any family that cannot afford to purchase health insurance for all the members of the household will be required to pay an additional tax that will be enforced and monitored by the IRS. 
     When ABC’s George Stephanopoulos pressed Obama to admit that the individual mandate was a tax increase, Obama said, “I absolutely reject that notion.” 
     That was six months before the passage of the health care reform bill. Less than two months after the bill became law, the Obama administration filed a motion in federal court in defense of the law, arguing that the individual mandate is a tax (DeMersseman). 
     I believe the HCR bill was fraught with several unethical policies and procedures other than those in which I have mentioned. The deceptive numbers given to the Congressional Budget Office in order to bring the overall cost below one trillion dollars, in which $500 billion was double counted, as recently admitted to by Kathleen Sebelius. The tremendous financial burden that is transferred to the states as their Medicare and Medicaid costs will raise uncontrollably, the ration of care that will be necessary to keep the HCR bill viable financially in the future; these are a few examples among many. But, I also strongly believe that Americans cannot be upset with their Representatives in Washington when most have such a lack of education on the process. It is up to individual Americans to understand, even if vaguely, the process in which bills become law. A more attentive public would go a long way in promoting ethics in our Nation’s Capital. 
Works Cited
DeMersseman, William. Dissed Trust: America's Crisis of Truth, Faith, and Freedom. WestBow Press, 2010.
Moses. Holy Bible "English Standard Version". Wheaton: Good News Publishers, 2001.
Mosher, Steven. "Does Obamacare Fund Abortion? Let Us Count the Ways." Catholic Exchange 27 Oct. 2010: 1.
Riggs, Mike. After Voting Yes on Health Care, "Stupak 11" Request 4.7 Billion in Earmarks. 26 3 2010. 14 April 2011 <http://dailycaller.com/2010/03/26/after-voting-yes-on-health-care-stupak-11-requested-4-7-billion-in-earmarks/>.
Rotunda, Ronald and John Nowack. Treatise on Constitutional Law V. 2. Thomson/West, 2007.