“We have to pass the bill so that you find out what is in it, away from the fog of the controversy.”

Nancy Pelosi was the House Speaker when she made those remarks about Obamacare at the 2010 Legislative Conference for the National Association of Counties. At the time, Pelosi was mocked for not understanding what was in the legislation she was supporting. But the reality is that with all legislation that is considered by Congress, we almost never really know what is in it until it has been passed.

obamacare-redtapeIf you took civics class in high school (or just watched Schoolhouse Rock), you likely know how a bill becomes a law. But what most people don’t understand is the process by which a law becomes policy.

We often think that the judiciary is the branch of government responsible for interpreting the law. But in reality most interpretation is done by the executive branch, through the various regulatory agencies. Regulatory agencies handle administrative law, primarily by codifying and enforcing rules and regulations. When Congress passes a new law it usually goes to a regulatory agency to determine how the law will be put in place.

A prime example occurred yesterday when the department of Health and Human Services issued a regulation for Obamacare that details the package of benefits that each insurance company must cover. As Sarah Kliff points outs, Obamacare requires colonoscopies to be covered by insurers without copayment. But what happens if the gastroenterologist finds a pre-cancerous or cancerous polyp? Many insurers require the patient to pay for part of the cost of having the polyp removed. But the Obama administration has decided to interpret Obamacare in a way that requires insurance companies to pay for the full cost of the removal of a polyp during a recommended colonoscopy.

Just like that, with one simple interpretation of the law, the Obama administration raised the cost of your insurance premiums. This is but one example of the thousands of rules that will be determined by the Obama administration—and on one piece of legislation. The same process occurs every time a new law is passed.

When Americans go to the ballot box every four years, they aren’t merely choosing who will sit in the White House; they’re choosing a group of technocrats who are authorized to make decisions that affect their lives in the most minute ways. Americans need to become more aware that they don’t just elect a president, they elect an entire regulatory regime.