In Defense of Circular Reasoning: The Affordable Care Act and the Resilience of Law and Self-Reference

Note from the Digital Editor: In order to highlight the high-level of research and scholarship from the authors who have published in the William & Mary Policy Review’s peer-reviewed print journal, we have reproduced the abstracts from Volume 5, Issue 1 along with a link to an electronic copy of the full form of the piece. 

(image by Ted Eytan)

Self-referential, circular phenomena abound in modern life. Markets plunge based on investors’ fear of a bear market. When a song is declared a hit, it is played on heavy rotation and therefore becomes well-known and popular. Broken windows beget more community disorder. In not only these but many other examples, self-reference rears its head. In each instance, the input generates the output which then itself constitutes an input. This paper looks specifically at self-referential phenomena in the health system as a means of understanding the functions self-reference may serve, and how law, itself a self-referential system, interacts with social ordering of a circular nature. This article examines two examples of circular decisions in the health system, and the two corresponding provisions of a particular legal regime, the health reform enacted by the Affordable Care Act of 2010 (ACA), that address these recursive patterns.

Find the full version of this article in PDF form here.

Christina Ho is an Associate Professor of Law at Rutgers University. 

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