A guide to the Affordable Care Act, our new national health care law. An account of the process from the 2008 presidential campaign to the moment in 2010 when the bill was signed into law before anyone had a chance to digest the document. At a time when the nation is taking a second look at the ACA, "Inside National Health Reform" provides essential information for Americans to review the governmental processes and politics in enacting this legislation.
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.
This provocative work explores the invention and reinvention of a fundamental goal of American social policy—universal health care. In Health Security for All, Alan Derickson examines the emergence of diverse proposals for all-encompassing health reform since the early twentieth century. This study discovers not only a number of imaginative arguments for extending health services but also an unexpectedly wide array of passionate advocates for universalism. An innovative approach to one of the great unresolved social and political problems of our time, Health Security for All will be of interest to social scientists, health policy scholars, historians, and idealists across the political spectrum.
The 2010 Affordable Care Act is a sweeping reform to the US health care system. Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. Unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world.
Jonathan Cohn's The Ten Year War is the definitive account of the battle over Obamacare, based on interviews with sources who were in the room, from one of the nation's foremost healthcare journalists. The Affordable Care Act, better known as “Obamacare,” was the most sweeping and consequential piece of legislation of the last half century. It has touched nearly every American in one way or another, for better or worse, and become the defining political fight of our time. In The Ten Year War, veteran journalist Jonathan Cohn offers the compelling, authoritative history of how the law came to be, why it looks like it does, and what it’s meant for average Americans. Drawn from hundreds of hours of interviews, plus private diaries, emails and memos, The Ten Year War takes readers to Capitol Hill and to town hall meetings, inside the West Wing and, eventually, into Trump Tower, as the nation's most powerful leaders try to reconcile pragmatism and idealism, self-interest and the public good, and ultimately two very different visions for what the country should look like. At the heart of the book is the decades-old argument over what’s wrong with American health care and how to fix it. But the battle over healthcare was always about more than policy. The Ten Year War offers a deeper examination of how our governing institutions, the media and the two parties have evolved, and the dysfunction those changes have left in their wake.
In no other country has health care served as such a volatile flashpoint of ideological conflict. America has endured a century of rancorous debate on health insurance, and despite the passage of legislation in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues. Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change. He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990sùand of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt RomneyÆs reforms in Massachusetts became a model for Democrats and then follows both the passage of those reforms under Obama and the explosive reaction they elicited from conservatives. Writing concisely and with an even hand, the author offers exactly what is needed as the debate continuesùa penetrating account of how health care became such treacherous terrain in American politics.
During his winning presidential campaign, Barack Obama promised to counter rising economic inequality and revitalize America's middle-class through a series of wide-ranging reforms. His transformational agenda sought to ensure affordable healthcare; reform the nation's schools and make college more affordable; promote clean and renewable energy; reform labor laws and immigration; and redistribute the tax burden from the middle class to wealthier citizens. The Wall Street crisis and economic downturn that erupted as Obama took office also put U.S. financial regulation on the agenda. By the middle of President Obama's first term in office, he had succeeded in advancing major reforms by legislative and administrative means. But a sluggish economic recovery from the deep recession of 2009, accompanied by polarized politics and governmental deadlock in Washington, DC, have raised questions about how far Obama's promised transformations can go. Reaching for a New Deal analyzes both the ambitious domestic policy of Obama's first two years and the consequent political backlash—up to and including the 2010 midterm elections. Reaching for a New Deal opens by assessing how the Obama administration overcame intense partisan struggles to achieve legislative victories in three areas—health care reform, federal higher education loans and grants, and financial regulation. Lawrence Jacobs and Theda Skocpol examine the landmark health care bill, signed into law in spring 2010, which extended affordable health benefits to millions of uninsured Americans after nearly 100 years of failed legislative attempts to do so. Suzanne Mettler explains how Obama succeeded in reorienting higher education policy by shifting loan administration from lenders to the federal government and extending generous tax tuition credits. Reaching for a New Deal also examines the domains in which Obama has used administrative action to further reforms in schools and labor law. The book concludes with examinations of three areas—energy, immigration, and taxes—where Obama's efforts at legislative compromises made little headway. Reaching for a New Deal combines probing analyses of Obama's domestic policy achievements with a big picture look at his change-oriented presidency. The book uses struggles over policy changes as a window into the larger dynamics of American politics and situates the current political era in relation to earlier pivotal junctures in U.S. government and public policy. It offers invaluable lessons about unfolding political transformations in the United States.
When the Supreme Court's majority ruling in NFIB v. Sebelius upheld the Patient Protection and Affordable Care Act (the PPACA, or Obamacare), it was clear that this major shift in American health care provision was here to stay. For better or worse, the PPACA is now both a target for, and a constraint on, the next wave of reformist ideas. Driven by curiosity about how the American health care regime will continue to evolve in the near and medium term, Dean Michael Schill and Professor Anup Malani of the University of Chicago Law School commissioned fourteen essays from leading scholars of law, economics, medicine, and public health that offer predictions for the most important issues and debates in health-care reform over the next five to seven years. Essays are arranged in five sections. Part I, ACA and the Law, sets the stage with three essays on legal challenges and justifications for the Act. Part II, ACA and the Federal Budget, explores the variety of potential fiscal consequences resulting from Obamacare. Part III, ACA and Health Care Delivery, offers competing viewpoints on what the Act will ultimately mean for consumers of health care. Part IV, Health Care Costs, Innovation, and the ACA speculates about what the altered financial structure of health care will mean for the pace of development of new medical technologies. Part V, ACA and Health Insurance Markets, concludes the volume with a pair of contrasting assessments of the prospects for the new insurance "exchange" markets.