Abstract
The United States House of Representatives' 219–212 passage of a watershed federal health-care bill on 21 March was a long-awaited breakthrough for President Barack Obama's administration. Obama had made enacting the law – officially known as the Patient Protection and Affordable Care Act – the signature goal of his first year in office. Securing what had been the most important aim of liberals in the Democratic Party for more than 50 years was a remarkable achievement. With his political capital thus substantially enhanced, it remains to be seen whether Obama can build on the momentum of this success to drive both domestic and foreign policy forward.
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