With the results of the 2016 election now in the record books, Congress and the president are set to engage, for the second time in less than a decade, in a debate over the future of the health care system of the United States.  

Donald Trump will be the fourth president in a row to enter office with his political party in at least nominal control of both houses of Congress.  For the first time since Dwight Eisenhower was elected in 1952, an incoming Republican president saw his party win an absolute majority in both the U.S. Senate and the U.S. House of Representatives.   And one of the first items on President-elect Trump's agenda will be a debate regarding the future the Patient Protection and Affordable Care Act.  

The Affordable Care Act (ACA) is the result of more than a year of intense legislative debate that produced a bill that ran more than 1,000 pages and has spawned tens of thousands of regulations, rulings and releases over the seven years since it was signed into law.  It constitutes an intricate web of inter-related and interdependent laws, regulations, mandates and subsidies that have affected health care stakeholders such as employers, providers, insurers, drug manufacturers, government programs and private insurance, to name just a few.  Although President-elect Trump campaigned on a promise to "repeal and replace" the ACA, achieving consensus again on how to reform the health care system will not be an easy task.