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ARTICLES Affordable Care Act Entrenchment ABBE R. GLUCK* & THOMAS SCOTT-RAILTON** The Affordable Care Act (ACA) is the most challenged—and the most resilient—statute in modern American history. Through and despite hun-dreds of court challenges, scores of congressional repeal efforts, unex-pected state resistance, gutting by the Supreme Court, unprecedented administrative strangulation, and criticism from the beginning that the statute did not go far enough to embrace the principle of universal healthcare, the ACA has changed the way many Americans and the polit-ical arena think about healthcare and the entitlement to it. Over its ten-year lifespan, the ACA went from being the rallying cry of the GOP in 2010, to the center of the Democratic platform in 2018, cata-pulting universal healthcare to the top of the 2020 Democratic presiden-tial primary agenda. It began as a statute criticized for its practical compromises and its incrementalism—including leaving most insurance in the private ...