Abstract
Jill Quadagno and Daniel Lanford review the history and implementation of the Patient Protection and Affordable Care Act of 2010 (ACA), often called Obamacare. This historical breakthrough in public policy came in the first two years of President Obama’s term. Although the Republican Party opposed the Act and no Republican Congressperson voted for it, the law dramatically changed the United States health care system as well as the national narrative about whether health care is an appropriate entitlement. The chapter explains the origins of the ACA, reviews its implementation, and examines why the Republican attempt to repeal Obamacare met with very strong resistance.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Notes
- 1.
David Himmelstein, and Steffie Woolhandler, “The current and projected taxpayer shares of US health costs,” American Journal of Public Health 106, No. 3 (2016): 450.
- 2.
Daniel Lanford, and Jill Quadagno, “Healthcare: Universal” in The Blackwell Encyclopedia of Sociology, 2nd Edition, ed. George Ritzer, (New York: Wiley-Blackwell, 2016): Entry 844.
- 3.
Steve Contorno, and Angie Holan, “Five years later, Medicaid opt-outs create holes in universal bill.” Politifact, March 25, 2015. http://www.politifact.com/truth-o-meter/promises/obameter/promise/433/sign-a-universal-health-care-bill/
- 4.
Jill Quadagno, “Right Wing Conspiracy? Socialist Plot?: The Origins of the Affordable Care Act,” Journal of Health Politics, Policy and Law 39, No. 1 (2014): 35.
- 5.
Quadagno, “Right Wing Conspiracy?,” 38.
- 6.
Jill Quadagno, One Nation, Uninsured: Why the US Has No National Health Insurance (Oxford University Press, 2005), 115.
- 7.
Quadagno, One Nation, Uninsured, 125.
- 8.
Quadagno, “Right Wing Conspiracy,” 36.
- 9.
Avit Roy, “The Tortuous History of Conservatives and the Individual Mandate.” Forbes, February 7, 2012. http://www.forbes.com/sites/aroy/2012/02/07/the-tortuous-conservative-history-of-the-individual-mandate/
- 10.
Mark Pauly, Patricia Damon, Paul Feldstein, and John Hoff, “A Plan for Responsible National Health Insurance,” Health Affairs 10, No. 1(1991): 9–11.
- 11.
Seymour M Lipset, American Exceptionalism: A Double-Edged Sword (New York: Norton, 1997), 3.
- 12.
Jill Quadagno, “Interest Group Influence on the Patient Protection and Affordability Act of 2010: Winners and Losers in the Health Care Reform Debate,” Journal of Health Politics, Policy and Law 36, No. 3 (2011): 444.
- 13.
Quadagno, “Interest Group Influence, 450.
- 14.
Lawrence Jacobs, and Theda Skocpol, Health Care Reform and American Politics: What Everyone Needs to Know (New York: Oxford University Press, 2010), 160–163.
- 15.
Congressional Record, Introduction of the Health Equity and Access Reform Today. Hon. William M. Thomas, November 24, 1993, p. E 3078. 103rd Congress. (Washington, D.C.: Library of Congress, 1993).
- 16.
Haynes Johnson, and David Broder, The System: The American Way of Politics to the Breaking Point (Boston: Little Brown, 1996), 364.
- 17.
Theda Skocpol, Boomerang: Health Care Reform and the Turn Against Government. (New York: W.W. Norton, 1997), 176.
- 18.
Ben Kail, Jill Quadagno, and Marc Dixon, “Can States Lead the Way to Universal Coverage? The Effect of Health Care Reform on the Uninsured,” Social Science Quarterly 90, No. 5 (2009): 16.
- 19.
Colleen Medill, “HIPAA and Its Related Legislation: A New Role for ERISA in the Regulation of Private Health Plans?,” Tennessee Law Review 65, No. 2 (1998): 492.
- 20.
M.A Hall, “The Impact of Health Insurance Market Reforms on Market Competition,” American Journal of Managed Care 6 (2000): 59–61.
- 21.
S.K Schneider, “Medicaid Section 1115 Waivers: Shifting Health Care Reform to the States,” Publius 27, No. 2 (1997): 104.
- 22.
Lynn Blewett, Michale Davern and Holly Rodin, “Covering Kids: Variation in Health Insurance Coverage Trends by State, 1996–2002,” Health Affairs 23, No. 6 (2004): 176.
- 23.
P.J Cunningham, “SCHIP Making Progress: Increased Take-Up Contributes to Coverage Gains,” Health Affairs 22, No. 4 (2003): 168.
- 24.
David Hyman, “Massachusetts Health Plan: The Good, the Bad and the Ugly,” University of Kansas Law Review 55 (2006): 1106.
- 25.
Huma Kahn, “Has Mitt Romney’s Massachusetts Health Care Law Worked?” The Note (May 12, 2011). http://abcnews.go.com/blogs/politics/2011/05/has-mitt-romneys-massachusetts-health-care-law-worked
- 26.
U.S. Congress, Healthy Americans Act. Bill Summary and Status, 110th Congress. S. 334. (Washington, D.C.: Library of Congress, 2007).
- 27.
Saba Hamedy, “Obama on Senate bill: It’s not a health care bill,” (July 26, 2017). http://www.cnn.com/2017/06/22/politics/barack-obama-health-care-bill-reaction/index.html
- 28.
“Obama Calls Wyden Plan Radical.” The Oregonion, (July 2, 2009). http://oregoncatalyst.com/2484-Obama-calls-Wyden-health-plan-radical.html
- 29.
Ezra Klein, “Unpopular Mandate: Why Do Politicians Reverse their Positions,” New Yorker (June 25, 2012). http://www.newyorker.com/reporting/2012/06/25/120625fa_fact_klein#ixzz2KK6q96lt
- 30.
Benjamin Sommers, Genevieve Kenney and Arnold Epstein, “New Evidence on the Affordable Care Act: Coverage Impacts of Early Medicaid Expansions,” Health Affairs 33, No. 1 (2014): 83–84.
- 31.
Sommers, Kenney and Epstein, “New Evidence on the Affordable Care Act,” 84.
- 32.
Daniel Beland, Philip Rocco, and Alex Waddan, Obamacare Wars: Federalism, State Politics and the Affordable Care Act. (Lawrence KS: University of Kansas Press, 2016), 61–63.
- 33.
Tom Cohen, “House Republicans Vote, Again, to Repeal Health Care Law,” (July 11, 2012). www.cnn.com/2012/07/11/politics
- 34.
Klein, “Unpopular Mandate.”
- 35.
Beland, Rocco and Waddan, Obamacare Wars, 65.
- 36.
Simon Haeder, and David Weimer, “You can’t make me do it: state implementation of insurance exchanges under the Affordable Care Act,” Public Administration Review 73, No. S1 (2013): 37.
- 37.
Beland, Rocco and Waddan, Obamacare Wars, 66.
- 38.
Kaiser Family Foundation, “Summary of a 1993 Republican Health Reform Plan.” Kaiser Health News (Feb. 23, 2010). http://kaiserhealthnews.org/Storeis/February/23/GOP-1993-health-reform-bill
- 39.
Jonathan Oberlander, “Under Siege: The Individual Mandate for Health Insurance and Its Alternatives,” New England Journal of Medicine 364, No. 12 (2011): 1085–87.
- 40.
Kaiser Family Foundation, A Guide to the Supreme Court’s Affordable Care Act Decision, (July 2, 2012). http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8332.pdf
- 41.
Sommers, Kenney and Epstein. “New Evidence on the Affordable Care Act,” 83.
- 42.
Carter Price and Christine Eibner, “For States that Opt Out of Medicaid Expansion: 3.6 Million Fewer Insured and 8.4 Billion Less in Federal Payments,” Health Affairs 32, No. 6 (2013): 1033–1036.
- 43.
Lawrence R Jacobs and Timothy Callaghan, “Why States Expand Medicaid: Party, Resources, and History,” Journal of Health Politics, Policy and Law 38, No. 5 (2013): 1031.
- 44.
Jacobs and Callaghan, “Why States Expand Medicaid,” 1031.
- 45.
Michael Cannon, 50 Vetoes: How States Can Stop the Obama Health Care Law. (Washington, D.C.: Cato Institute, 2013).
- 46.
Lanford, Daniel and Jill Quadagno, “Implementing Obamacare: The Politics of Medicaid Expansion under the Patient Protection and Affordable Care Act of 2010,” Sociological Perspectives 59, No. 3(2016): 628.
- 47.
David Sears, Jim Sidanius, and Lawrence Bobo, eds. Racialized Politics: The Debate About Racism in America, (Chicago: University of Chicago Press, 2000).
- 48.
Nicholas Winter, “Beyond Welfare: Framing and the Racialization of White Opinion on Social Security,” American Journal of Political Science 50, No. 2 (2006): 415.
- 49.
Nicholas Valentino, and David Sears, “Old Times There Are Not Forgotten: Race and Partisan Realignment in the Contemporary South,” American Journal of Political Science 49, No. 3 (2005): 678.
- 50.
Eric Knowles, Brian Lowery, and Rebecca Schaumberg, “Racial prejudice predicts opposition to Obama and his health care reform,” Journal of Experimental Social Psychology, 46 (2010): 420–423.
- 51.
Michael Tesler, “The Spillover of Racialization into Health Care: How President Obama Polarized Public Opinion by Racial Attitudes and Race,” American Journal of Political Science 56, No. 3 (2012): 697–698.
- 52.
Lanford and Quadagno, “The Politics of Medicaid Expansion,” 630.
- 53.
Kaiser Family Foundation, State Health Insurance Marketplace Types, (December 3, 2018). https://www.kff.org/health-reform/state-indicator/state-health-insurance-marketplacetypes/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
- 54.
Beland, Rocco and Waddan, Obamacare Wars, 124–125.
- 55.
Kail, Quadagno and Dixon, “Can States Lead the Way,” 17.
- 56.
Jacob Hacker, “Why Reform Happened,” Journal of Health Politics, Policy and Law 36, No. 3 (2011): 439.
- 57.
Donald Light, “The practice and ethics of risk-related health insurance,” Journal of the American Medical Association 267, p. 18 (1992): 2503–04.
- 58.
Dan Merica, Jim Acosta, Lauren Fox and Phil Mattingly, “Trump calls House health care bill ‘mean,’” (June 14, 2017). http://www.cnn.com/2017/06/13/politics/trump-senators-health-care-white-house-meeting/index.html
- 59.
Jonathan Martin, and Alexander Burns, “Governors shun new health bill from both sides,” New York Times, July 15, 2017: A1, 13. http://www.nytimes.com/images/2017/07/15/nytfrontpage/scannat.pdf?mcubz=1
- 60.
Jill Quadagno, “Institutions, Interests and Ideology: An Agenda for the Sociology of Health Care Reform,” Journal of Health and Social Behavior 51 (June 2010): 129.
- 61.
American Hospital Association, “Letter to the U.S. House of Representatives regarding the American Health Care Act.” (March 9, 2017). http://www.aha.org/advocacy-issues/letter/2017/170307-let-aha-house-ahca.pdf
- 62.
American Medical Association, “AMA Vision on Health Reform.” (Sept. 19, 2017). https://www.ama-assn.org/ama-health-reform-vision/
- 63.
“AARP calls on lawmakers to reject harmful Senate healthcare bill.” (June 22, 2017). http://thehill.com/homenews/senate/339098-aarp-calls-on-senate-lawmakers-to-reject-harmful-senate-healthcare-bill
- 64.
Tami Luhby, “Insurers blast Senate health care provision as unworkable.” (July 15, 2017). http://money.cnn.com/2017/07/15/news/economy/health-care-insurers-cruz-amendment/index.html
- 65.
Lipset, American Exceptionalism, 3–6.
- 66.
Quadagno, One Nation, Uninsured, 12.
- 67.
Bill Adair, and Angie Holan, PolitiFact’s Lie of the Year: ‘A government takeover of health care.’ (Dec. 16, 2010). http://www.politifact.com/truth-o-meter/article/2010/dec/16/lie-year-government-takeover-health-care/
- 68.
Dan Mangan, “Obamacare tops 50 percent popularity among Americans for first time in new poll, after Senate unveils bill to gut health-care law.” (June 23, 2017). http://www.cnbc.com/2017/06/23/obamacare-tops-50-percent-support-for-first-time-new-poll-shows.html
- 69.
Pramuk, Jacob, “Rough series of polls show Americans broadly disapprove of GOP health-care plan.” (June 28, 2017). http://www.cnbc.com/2017/06/28/senate-gop-health-care-bill-has-dismal-approval-rating-poll.html
- 70.
Grogan, Colleen and Eric Patashnik. 2003. “Universalism within targeting: nursing home care, the middle class and the politics of the Medicaid program.” Social Service Review 7 (1):58.
- 71.
Pat Roberts,“Senator Roberts supports improved health care bill,” (July 13, 2017). https://www.murphy.senate.gov/newsroom/press-releases/murphy-trumpcare-40-is-a-disaster-for-connecticut-just-like-every-previous-version
- 72.
Michael Tesler, “The Spillover of Racialization into Health Care: How President Obama Polarized Public Opinion by Racial Attitudes and Race,” American Journal of Political Science 56, No. 3 (2012): 698–99.
- 73.
James Morone, The Democratic Wish, (New Haven, CT: Yale University Press, 1998), 8.
- 74.
Joe Kennedy Jr. Rep. Joe Kennedy Calls Out Paul Ryan for Calling ACA Repeal ‘Act of Mercy, (March 9, 2017). https://sojo.net/articles/rep-joe-kennedy-calls-out-paul-ryan-calling-aca-repeal-act-mercy
- 75.
Hamedy, “Obama on Senate bill.”
- 76.
Chavez, “ObamaCare repeal without replacement.”
- 77.
Hamedy, “Obama on Senate Bill.”
- 78.
Steve Contorno and Angie Holan, “Five years later, Medicaid opt-outs create holes in universal bill.” Politifact, March 25, 2015. http://www.politifact.com/truth-o-meter/promises/obameter/promise/433/sign-a-universal-health-care-bill/
- 79.
Kaiser Family Foundation, Key Facts about the Uninsured Population, (Sept. 19, 2017). https://www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/
- 80.
Bureau of Labor Statistics, Fact Sheet USDL-16-2302. Consumer Price Index. (December 15, 2016). https://www.bls.gov/news.release/archives/cpi_12152016.pdf
- 81.
Theda Skocpol, Protecting Soldiers and Mothers, (Belknap Press 1992), 59.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 The Author(s)
About this chapter
Cite this chapter
Quadagno, J., Lanford, D. (2019). The Obama Health Care Legacy: The Origins, Implementation, and Effort to Repeal the Affordable Care Act of 2010. In: Rich, W. (eds) Looking Back on President Barack Obama’s Legacy. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-01545-9_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-01545-9_4
Published:
Publisher Name: Palgrave Macmillan, Cham
Print ISBN: 978-3-030-01544-2
Online ISBN: 978-3-030-01545-9
eBook Packages: Political Science and International StudiesPolitical Science and International Studies (R0)