Documents: |
|
|
|
| ||||||
Cours:
The Patient Protection & Affordable Care Act
Expanding access to health care was the problem Obama really wanted to tackle. Many former presidents had tried to pass legislation before with little success and a strong Republican opposition: Harry Truman, Lyndon Johnson, Jimmy Carter and Bill Clinton. By 2008, health care was still the missing part of the American welfare state. As Obama was being sworn in, 17% of the population (45m Americans) was not covered by any form of health insurance.
One of the major problems is that the US health care costs are much more higher than in any other country. Doctors, medication, Hospitals are very expensive. So expensive that health insurance has to sell expensive policies to cover these high costs.
Since the 1942 Stabilization Act, health insurance coverage had been linked to employment.
Expanding access to health care was the problem Obama really wanted to tackle. Many former presidents had tried to pass legislation before with little success and a strong Republican opposition: Harry Truman, Lyndon Johnson, Jimmy Carter and Bill Clinton. By 2008, health care was still the missing part of the American welfare state. As Obama was being sworn in, 17% of the population (45m Americans) was not covered by any form of health insurance.
One of the major problems is that the US health care costs are much more higher than in any other country. Doctors, medication, Hospitals are very expensive. So expensive that health insurance has to sell expensive policies to cover these high costs.
Since the 1942 Stabilization Act, health insurance coverage had been linked to employment.
|
The 1942 Stabilization passed under Franklin Roosevelt because of inflation concerns, required strict limits on wages. It exempted insurance benefits from those limits. As a result, employers competing to recruit the best employees began offering health insurance, or if they already offered it then they began offering more and more of it. After all, these employers couldn’t offer higher wages because of the law, so they offered what they legally could. It was good to be a health insurance company.
|
During the Democratic Primary Election, Clinton and Obama embraced the idea of universal coverage. While they all promised universal coverage and lower costs, there were major differences between the candidates’ plans.
Democrats were traumatized by Bill Clinton’s failed health care reform effort.
Once Obama elected, in Capitol hill, with Democrats firmly in control, they hoped to seize on the opportunity, but, again, there were different approaches. It did take a lot of deals before Obama could sign into law the Patient Protection and Affordable Care Act on March 23rd, 2010.
Democrats were traumatized by Bill Clinton’s failed health care reform effort.
Once Obama elected, in Capitol hill, with Democrats firmly in control, they hoped to seize on the opportunity, but, again, there were different approaches. It did take a lot of deals before Obama could sign into law the Patient Protection and Affordable Care Act on March 23rd, 2010.
From the very beginning, it was assumed that, in order to close the coverage gap, any reform would both extrend coverage to those who were excluded for medical reasons and those who were excluded for financial reasons.
Obamacare first expanded the Medicaid program to low-income individuals who were single and had no children. Second, it provided tax credits for the Americans who didn’t get health insurance through their jobs and were mandated to buy it. The value of the tax credits people received was tied to their income, so that people in the lower-middle class would find themselved paying close to nothing for their coverage while relatively wealthier Americans would receive no tax credits.
In the end, Obama had his reform and 40 million more Americans were expected to get health insurance coverage. It wouldn’t be truly universal coverage. More than 20 million Americans (less than 10%) were expected to continue to be without insurance.
It was undoubtedly a historic achievement or “a big f-ing deal” as Vice -President Joe Biden was overheard whispering into the president’s ear during the signing ceremony. There was NOT a single Republican member of Congress who voted for the final bills.
Obamacare was at least a partial success. The lofty ambition of universal coverage was not realized but it grew nearer. When Obama took office, 44.2 million Americans (17.1%) had not health insurance. When he left, they were 27 million (10%). During the Obama presidency, 20 million Americans got coverage who didn’t have before.
Insurance companies had been barred from discriminating based on their potential clients’ health.
However, as far as cutting health care costs, the law proved ineffective.
The success of Obamacare as a policy came at heavy political cost. President Obama can forever claim this achievement but, as we will see in the next part, the law was a clear contribution to the backlash that put the Republicans back into majority status in Congress.
Document complémentaire:
Reportage: Obamacare in Trump Country