US President Joe Biden at an event to celebrate the 13th anniversary of the Affordable Care Act in the East Room of the White House in Washington.
Last weekend marked the thirteenth anniversary of the administration of former US Pres. Barack Obama passing the historic Affordable Care Act (ACA) by Congress and signed into law. Since then, the The ACA, Billed as “Obamacare”, has brought nearly 30 million uninsured Americans under the health insurance umbrella. It also survived challenges in court, and notably its individual mandate, which required tax authorities to levy punitive fees on those who failed to purchase health insurance policies. Upheld by the Supreme Court in 2012, Attempts by former President Donald Trump’s administration to overturn the law by attacking its key provisions also failed in the Supreme Court, and today there is a far greater sense of inclusivity, access and justice as far as health insurance regulation is concerned.
My Encounter with ACA When I first took on the role of American correspondent for this newspaper in early 2010, it was twofold. At first, it was the most dramatic event to happen in Washington when I arrived there on a cold February morning. While the US healthcare context may not have been directly relevant to India, the sheer intensity of the struggle and conversation around the Obama administration’s drive to take it to Capitol Hill attracted a global audience and made it a daily cover for me. Made a clear story to do. , To me, and perhaps to some readers of the coverage we provided of the ACA’s torturous passage through Congress, it was surprising to see the White House finally bow to Republican demands for the last lap and across the finish line. Congressman Bart Stupak, a longtime opponent of abortion, pushed for the inclusion of the Hyde Amendment, an anti-abortion-funding provision within Medicaid, in the ACA bill.
Second, I was directly affected by the restrictive nature of previous health insurance, as the ACA had not yet passed into law when I arrived. Members of my family with any health problem, no matter how minor and transient, were denied health insurance policies because of a ludicrously broad definition of “pre-existing condition,” which bizarrely included From, even the “condition” of pregnancy was included. Furthermore, almost without exception, hospitals and doctors were recommending the routine use of expensive tests and medication, in contrast to the UK, where these are relatively under-prescribed. This made healthcare doubly expensive, making it completely out of reach for the poorer sections of the population.
The ACA was notable for the paradigm shift it brought to this deeply entrenched system of insurance companies teaming up with healthcare providers. Overnight, it broke their system of minimum patient support and maximum user out-of-pocket payments. It was a shining example of how vested interests, no matter how deep their pockets and how insidiously they were able to lobby MPs to maintain the status quo, can be outsmarted by enlightened leadership. who took the fight to his doorstep, yet settled to receive. Bill passed.
What was immediately apparent at the time of the ACA’s passage, and remains relevant today, is the fact that in line with the traditional balance of power between the federal and state governments in the US, the latter still retain a large degree of autonomy. To lay down the policy position as far as the healthcare sector is concerned. The same applies to reproductive rights, especially given the ability of US states to now deny women the right to abortion. Roe v. Wade being quashed by the Supreme Court.
Regardless of the setbacks the ACA may face in the years to come—and it has already withstood the fiercest legal assaults—it will always be a seminal law affecting the daily lives of ordinary people in America. That became the symbol of Mr. Obama’s “yes we can” campaign was a bonus for Democrats, reflecting the power of the individual voice that still shapes their political prospects.
Narayan@thehindu.co.in