- In March of 2010, President Barack Obama
enacted the Affordable Care Act, also known as Obamacare,
in an effort to make health insurance
more affordable and more accessible to all Americans.
By the time Obama came into office,
using legislation to improve access to health care
wasn't a new idea.
The earliest form of private health insurance
emerged in the late 1800s as industrial sickness funds,
giving payments to dues paying members were forced out of work
due to illness or injury.
By the beginning of the 20th century,
many European nations had enacted health care programs.
Progressives in the United States
sought a similar program with their candidate, Theodore
Roosevelt, in 1912, but he lost the presidential election
that year.
In the 1930s, FDR passed the Social Security Act,
which gave government payments to people
who had to stop working due to illness or injury.
In 1944, Congress passed the veteran's readjustment act,
which expanded public health care
to many millions of ex-service members after World War II.
In the 1960s, Lyndon B Johnson signed Medicare and Medicaid
into law, and the government began
providing subsidized health care to elderly and low
income Americans, respectively.
Other presidents, including Harry Truman in the 1940s,
Richard Nixon in the early 70s, and Bill Clinton in the 1990s
tried to pass health care reform,
but private insurers fear that government
subsidized insurance would impinge on their business.
When Barack Obama became president in 2009,
'45 million Americans were uninsured.
A growing number of American employers
had cut health insurance from their benefits.
The growing costs of medical care
became a lead cause for personal bankruptcies, foreclosures,
and family crises.
So the new president made health care reform his chief mission.
In February 2009, just one month after his inauguration,
Obama delivered a speech to Congress
announcing his administration's push for reform.
Even though Obama and his fellow Democrats
controlled Congress and the White House,
the reform efforts were delayed, as members
of Congress debated how much of a role
the government should have in health care.
After many compromises, the ACA finally
made it through Congress, and Obama signed the law in 2010.
The immediate goals of the ACA were to make health insurance
available to more people, while also making health care cheaper
and expanding the Medicaid program,
though only some states opted into that expansion.
To put the ACA to work, the federal government
created a health care marketplace,
which is a service that allows Americans
to shop for and enroll in an affordable health insurance.
The ACA also created government standards for minimum services
that must be covered by private insurance plans
and stopped private insurance from denying
or charging people more based on preexisting health conditions.
In 2014, an individual mandate went into effect which required
Americans to pay a penalty if they decided not
to buy a health insurance plan.
Through these provisions, the ACA managed to achieve
many of Obama's goals.
By 2016, nearly 20 million previously uninsured
people had acquired health care.
Despite that accomplishment, some
have criticized Obamacare for the individual mandate penalty,
and the government regulation of what
they see as a private industry.
By 2014, Republicans in the House of Representatives
had already voted more than 50 times
to repeal the measure, only to be blocked by the Senate
each time.
Obama's successor, President Donald Trump,
campaigned on repealing Obamacare,
and signed an executive order to allow
the sale of cheaper health insurance policies
with fewer benefits.
He also signed a tax bill that repealed
the individual mandate clause.
While the debate continues over the best methods of increasing
American access to health care, the ACA remains a pivotal piece
of legislation in our history.