Once the ACA became law, basically everything bad that happened in health care was attributed to it. For example, rising prices for prescription drugs has been a problem for years. But the ACA did not seek to address that, except for one provision that sought to facilitate generic copies of some of the most expensive biologic medications.
Also, before the ACA, some insurers stopped offering plans in the individual market, while others raised premiums dramatically and often would not cover care at high-cost providers like teaching hospitals. The ACA did create some losers. Among those hardest hit are people who earn just slightly too much to qualify for federal premium subsidies, particularly early retirees and people in their 50s and early 60s who are self-employed. Both were rejected by more conservative Democrats in the Senate.
That meant people with incomes under the poverty line but still too high to qualify for Medicaid in their states have no affordable program available.
However, even some of those consumers have seen benefits from the law, although they might not realize it, like required rebates from insurers who charge too much for administrative costs. But it is human nature for people who feel wronged to complain loudly, while people who are satisfied merely go on with their lives. Texas , a case that challenges the legality of the ACA in light of the zeroing out of the individual mandate penalty in the Tax Cuts and Job Acts.
The death of Supreme Court Justice Ruth Bader Ginsburg on September 18 and the possibility of the Senate confirming a new Justice appointed by President Trump before the presidential election has brought heightened attention to the potential outcome of this case and the future of the ACA.
While partisans divide over the importance of keeping many provisions of the ACA in place, majorities of Democrats, Republicans, and independence say it is very important to continue each of these protections for people with pre-existing conditions. Henderson, M. The dynamics of health care opinion, — Partisanship, self-interest, and racial resentment. Journal of Health Politics, Policy and Law, 36 6 , — Henry, P. The symbolic racism scale. Political Psychology, 23 2 , — Hoffman, B. Health care reform and social movements in the United States.
American Journal of Public Health. American Public Health Association Inc. Holl, K. Does question wording predict support for the affordable care act? An analysis of polling during the implementation period, — Health Communication, 33 7 , — Hughes, C. Gender, Work and Organization, 24 4 , — Jacobs, L.
Why public opinion on ObamaCare should worry us all. Kaiser Family Foundation. Kaiser Health Tracking Poll: November Kaiser Health Tracking Poll: March Kessler, G. The Washington Post. Khatana, S. Association of Medicaid Expansion with Cardiovascular Mortality. JAMA Cardiology , 4 7 , — Kinder, D. Divided by color: Racial politics and democratic ideals. Kino, S. The impact of ACA Medicaid expansion on socioeconomic inequality in health care services utilization.
Lanford, D. Implementing ObamaCare: The politics of medicaid expansion under the affordable care act of Sociological Perspectives, 59 3 , — Lee, L. Women and Healthcare affordability after the ACA. Journal of General Internal Medicine, 35 3 , — Maxwell, A. The fate of Obamacare: racial resentment, ethnocentrism and attitudes about healthcare reform. Race and Social Problems, 6 4 , — Metzl, J. Let us explain. Reagan and his Republican Senate majority, led by Bob Dole, agreed with their Democratic colleagues in the House that, as a society, we simply cannot turn away fellow Americans to die on the streets.
But it provides no funding mechanism to do it. Hospitals can try to shift those costs to other payers, or try to go after the patients themselves, who often have no alternative but bankruptcy. Conservatives viewed having insurance as a matter of personal responsibility, to avoid passing health care costs on to others.
Conservatives also turned to the Gingrich model, because they long feared the alternative of a single-payer system. What we now call Medicare for All would leave out insurance companies and instead rely on the federal government as the single insurer.
Indeed, Reagan got his start in national politics during the s campaigning against the enactment of Medicare. Today, our society has made another moral commitment that insurers cannot turn away the sick. But the market cannot let people wait until they are sick to buy insurance. That would be like buying homeowners insurance when your house is already on fire. If insurers insured only sick people, premiums would have to be exorbitantly high.
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