Difficulties in the United States healthcare system are evident, but it’s important to remember how far it has come. A mere decade and a half ago, pregnant individuals could be legally refused health insurance solely on the basis of their pregnancy. Conditions like cancer, diabetes, epilepsy, Alzheimer’s, arthritis and mental illness, could also lead to insurance denial. Alternatively, even if your medical plan provided coverage, it often resulted in prohibitively high premiums in accordance with preexisting conditions.
Just over 10 years ago, the health care sector operated more like an unruly battlefield filled with private insurers prioritizing wealth over welfare, and regularly making capricious decisions about their clients’ lives. That changed with the induction of the Affordable Care Act (ACA) by Barack Obama in March 2010, which unquestionably increased the reach of essential health care for numerous citizens.
Fast-forward to 2024, fewer than 9 percent of U.S citizens lack insurance coverage, compared to the nearly 17 percent in 2009. The ACA did more than just prohibit private insurers from discriminating against preexisting conditions. It expanded the scope for Medicaid coverage, created new health insurance subsidies and extended dependent child coverage up till 26 years of age. These advance steps are noteworthy, despite the multifaceted identity issues the ACA has faced since its implementation.
The ACA became associated with the term ‘Obamacare’ through widespread news coverage, leading to its appropriation by Republican critics as they aimed to paint the ACA as a symbol of Democratic over-stepping and unrestrained government. Years beyond his presidential terms, Barack Obama remains the figurehead of the healthcare legislation he advocated for, with all its triumphs and shortcomings.
Recently, an assortment of viral TikTok posts poked fun at individuals who reportedly weren’t aware that Trump’s promise to repeal Obamacare equated to ending the ACA. Numerous users pointed out one Trump voter who allegedly wasn’t cognizant that the ACA’s protection for preexisting conditions enabled his mother, suffering from stage 4 cancer, to secure insurance coverage.
While these accomplishments are notable, it must be acknowledged that they don’t measure up to the free universal healthcare offered by other developed nations such as Canada, Australia, Germany, and Norway to name a few. When Senator Bernie Sanders (I-Vermont) contended for presidency in 2016 and 2020, he pushed universal healthcare to the center of the American discourse, making it a core promise of the Democratic Party’s crusade.
However, this year saw the Democratic Party avoid allusions to universal healthcare in its platform, preferring to spotlight ‘cutting costs’ without explicitly endorsing a public option. It poses a substantial failure that many voters this election season may have cast their votes oblivious of the benefits the ACA could afford them.
Republicans have steadily opposed the ACA for over a decade, with Trump even backtracking on his own promise to revoke it during this election season. Despite his campaign rhetoric, health policy pundits anticipate that his administration may endeavor to undermine the ACA in his upcoming term.
In Trump’s initial term, before the drastic onset of the COVID-19 pandemic, the number of uninsured U.S. residents rose by over 2 million. Private alternatives to Medicare have demonstrated patterns of denying health claims and burdening patients with the need for ‘prior authorization’ for even ordinary procedures.
These hurdles have proven to be such a strain for elderly patients that the Biden administration put forth a suite of new Medicare Advantage reforms this week. These included restrictions aimed at curbing insurers’ dependence on the prior authorization procedure. However, with shifting nominees, these fresh regulations could be as transient as their introduction.
In retrospect, it can be hard to fathom that the ACA was just a vision on the brink of reality not too long ago. Despite its brief existence, support for free universal health care among Americans has escalated since its establishment.
Viewing the ACA as a stepping stone, the public’s opinion now leans towards favoring a single payer, national health plan and an expanded Medicare accessibility. The crucial challenge in the coming times will lie in upholding the basic provisions of the ACA.
Simultaneously, efforts must be made to enlighten, assemble, and advocate for the concept of comprehensive universal health care, a fundamental right all citizens should be entitled to receive.