Perspectives on Work essay on Neoconfederate politics and health care reform (original) (raw)
Related papers
Right-Wing Conspiracy? Socialist Plot? The Origins of the Patient Protection and Affordable Care Act
Journal of Health Politics, Policy and Law, 2014
On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Did the ACA signify a government takeover of the health care system, a first step on the road to socialism, as conservative critics charged? Or was it, rather, a sellout to the right wing, as liberal single-payer advocates proclaimed? The ACA's key provisions, the employer mandate and the individual mandate, were Republican policy ideas, and its fundamental principles were nearly identical to the Health Equity and Access Reform Today Act of 1993 (HEART), a bill promoted by Republican senators to deflect support for President Bill Clinton's Health Security plan. Yet the ACA was also a policy legacy of the Clinton administration in important ways that rarely are acknowledged, notably Medicaid expansion and insurance company regulation. Although the ACA departed from the liberal vision of a single-payer plan and adhered closely to the objectives of those who believed that the health care system should encourage the free market, it included provisions that will make coverage more affordable, reliable, and accessible. On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). For the first time in more than a century, the federal government made a commitment to provide universal coverage through a complex mix of private incentives and public support. Its main features include state insurance exchanges, stringent regulations on insurance companies, fines on employers who do not offer coverage, a mandate that individuals purchase health insurance, subsidies to help lowincome people with the costs, and a substantial expansion of Medicaid. To liberal supporters of a single-payer plan, the ACA represented a disappointing concession to private insurance companies, a scheme that would
What Health Reform Tells Us about American Politics
Journal of Health Politics, Policy and Law, 2020
The passage and initial implementation of the Affordable Care Act (ACA) were imperiled by partisan divisions, court challenges, and the quagmire of federalism. In the aftermath of Republican efforts to repeal the ACA, however, the law not only carries on but also is changing the nature of political debate as its benefits are facilitating increased support for it, creating new constituents who rely on its benefits and share intense attachments to them, and lifting the confidence of Americans in both their individual competence to participate effectively in politics and that government will respond. Critics from the Left and the Right differ on their favored remedy, but both have failed to appreciate the qualitative shifts brought on by the ACA; this myopia results from viewing reform as a fixed endpoint instead of a process of evolution over time. The result is that conservatives have been blind to the widening network of support for the ACA, while those on the left have underestimat...
The Sustainability of the ACA: Legal Challenge and Legislative Opposition
Universal health care coverage has long been seen as an unattainable goal for Americans. With the Affordable Care Act, the Obama administration addressed the issue with a complex system of mandates, subsidies, and state marketplaces. The implementation of the reform encountered many obstacles including legal challenges, a congressional shut down, system failure, and, recently, a growing number of state legislatures (23 to date) enacting measures to nullify or opt out of the reform. This paper examines the resistance to the Act in two interrelated dimensions: legal challenges and state legislative opposition. These two dimensions of resistance are explored in order to speculate on the legal and political sustainability of the reform. Ultimately, the discussion on the sustainability of health care reform sheds considerable light on the broader sustainability of federal intervention in social policies (gun control, abortion, immigration, death penalty, drug control).
“Salvage” over “demolition”: Saving the ACA Post Ruth Bader Ginsburg
2020
The death of Ruth Bader Ginsburg brings up uncertainty over many issues that depend on Supreme Court decisions. This paper explores the impact of the Court on the ACA and the ability of millions of Americans to access quality healthcare. Specifically, the issues before the Court concern the survival of the mandate in the absence of the tax penalty that was repealed in 2017, the ability of the ACA to survive without the mandate, and in the worst case scenario, the limitation of the remedy to the states opposed to the ACA's survival. This paper argues that judicial restraint and consistency, both conservative ideals, should save the ACA. Regardless of the toothless mandate, the ACA is operational and many aspects of it, including the Medicaid expansions, have little or nothing to do with the mandate.
Publius, 2022
Partisan, fractious federalism has strongly shaped the Biden administration's efforts to reverseTrump's undermining of the Affordable Care Act (ACA). In June 2021, the U.S. Supreme Court sided with Democratic, rather than Republican, state attorneys general to uphold the ACA. This enabled Biden to proceed with legislative and executive initiatives to reinvigorate the program. Biden secured passage of the American Rescue Plan (ARP), which temporarily boosted ACA enrollments. He also successfully pursued several executive initiatives to bolster the program. The victories of Democratic state attorneys general and private litigants in the courts during theTrump presidency often provided the platform for Biden's success. On balance, the ACA's vital signs have improved under Biden. But the durability of these gains depends heavily on whether Congress approves Build Back Better legislation that extends ARP benefits, and whether Biden can overcome resistance by Republican states in the courts and otherwise (especially concerning waivers).
International Journal of Sciences: Basic and Applied Research (IJSBAR), 2019
The changing political climate of Congress and the dilemmas of the Affordable Care Act (Obamacare) in reforming the U.S. health care system is the focus of this work. The author is with the view that most barriers that led to the denial of previous health care reform bills were as a result of the role played by Congressional caucuses and the continuous health care malpractices perpetrated by health care industries in the United States. Healthcare policy making in the United States therefore, owns its hegemonic past from a long standing institutional and ideological politics beginning with Theodore Roosevelt's failed proposal for a national health care system in 1912. The work further examines Congressional path dependency on health care reform and its role in health care policy adoption and implementation. The obstacles faced by Americans in having a relatively rational type of health care coverage system in the United States will also be discussed. The paper argues that the invisible hands of Congressional caucuses and health care industries continue to play integral parts in health care policy making in the U.S. thereby, frustrating government's efforts in order to uphold the privileges and profits enjoyed at the expense of tax payers. The puzzle the work seeks to unravel is to showcase whether the fight to repeal the Affordable Care Act by Congress, States and individual plaintiffs will hold in the light of the unprecedented health care burden on Americans. The work explores John Kingdon's Multiple Streams Framework in public policy making with particular reference to the health care policy reforms in the United States. The author concludes that in order to achieve an efficient market outcome in the case of the prevailing health care externalities in the U.S., the implementation of a policy where mostly everyone is expected to be better off is deemed necessary.