Almost no law as sprawling and consequential as the Affordable Care Act has passed without changes — significant structural changes or routine tweaks known as “technical corrections” — in subsequent months and years. The Children’s Health Insurance Program, for example, was fixed in the first months after its passage in 1997.
But as they prowl Capitol Hill, business lobbyists like Mr. DeFife, health care providers and others seeking changes are finding, to their dismay, that in a polarized Congress, accomplishing them has become all but impossible.
Republicans simply want to see the entire law go away and will not take part in adjusting it. Democrats are petrified of reopening a politically charged law that threatens to derail careers as the Republicans once again seize on it before an election year.
As a result, a landmark law that almost everyone agrees has flaws is likely to take effect unchanged.