The recent federal government shutdown had a great deal to do with ongoing conservative opposition to the 2010 passage of the Patient Protection and Affordable Care Act (ACA), also known as “Obamacare.”

Even though the legislation was signed into law by President Barack Obama more than three years ago and upheld by the U.S. Supreme Court in 2012, the ACA, in reality, is far from settled law, according to Todd Stein, a lecturer in the Sam Nunn School of International Affairs and leader of the government affairs/public policy practice at Kitchens New Cleghorn LLC.

Stein discussed the history and possible future of Obamacare last Wednesday as part of the Policy@Tech Speaker Series.

“Only 39 of the 58 Senate Democrats who initially voted for Obamacare in December 2009 are still in office, and those senators are getting nervous because they can clearly see things beginning to fray,” said Stein, who served as legislative director and general counsel for now-retired Sen. Joseph Lieberman of Connecticut during the debate and passage of the ACA.

Stein said that lingering uncertainty about the long-term costs of the ACA, coupled with highly publicized difficulties with online sign-up for the program, have raised substantial doubts about its long-term viability. Stein said that provisions in the initial version of the ACA that would have purportedly saved $124 billion over 10 years have either been eliminated or are in imminent danger of being eliminated. Consequently, the ACA is now cited by the Congressional Budget Office as the fifth leading driver of the nation’s long-term debt.

Other factors are also raising doubts about the ACA’s future. The ACA employer mandate — requiring all employers with 50 or more full-time employees to provide health coverage — was delayed for a year by executive order. This, in turn, delays the entrance of a substantial number of people into the insurance pool. In addition, healthy young people who have difficulty enrolling in ACA because of ongoing technical problems — or who simply choose not to enroll and opt to pay a tax penalty — could also reduce revenues to the insurance pool.

“As recently as September, 51 percent of Americans still did not know what to make of Obamacare,” Stein said. “Depending on what happens these next weeks and months, that 51 percent will either get behind the program or apply sufficient political pressure to drive substantial changes to it. That’s why I say it is not a matter of settled law.”