It IS law. That’s the problem. The Act devolves on the Secretary the right to decide. That’s why the bishops were stupid not to oppose the enactment of Obamacare. I fear that even now there will be some bishops who will support Obama in 2012, or at least not oppose him. I am reminded of those German bishops who stubbornly clung to the idea that because Hitler had been baptised a Catholic and because he was polite to the bishops that he —personally—was not responsible for the anti-Catholic propoganda and actions of the Nazi Party.
That is the problem. Congress routinely abdicates the power to legislate by commanding some executive department or agency to 'promulgate regulations' or set up guidelines, etc., which carry the weight of, or create the stipulations in, the law.
The effect is that the executive agency can make law by decree and the Congress can blame others for fleshing out the frameworks they created.
Congress has no legitimate, Constitutional power to do that. We gave Congress and Congress only the power to make law.
I think the following example applies as well.
Congress can no more constitutionally assign its law making duties than the President can assign his Commander-in-Chief responsibilities.