The Fight Over Obamacare

Without a doubt Americans receive the worst healthcare the Western world has to offer. To make matters worse, Americans also pay more for the shoddy treatment. For years people from all ends of the political spectrum have been demanding reform. Republicans and conservatives have advocated for market orientated reforms whilst Democrats and liberals have preferred the idea of a single-payer system. That all changed after the 2008 election.

One of Obama’s 2008 elections promises was to finally bring a universal healthcare system to America. That fight would prove too difficult and so Obama settled on the next best idea, one that would mean fewer Americans were uninsured and healthcare insurance was generally better. Despite this it is a far cry from single-payer, despite what you hear from Republicans. Over the succeeding two years massive political fights were waged over the bill, officially called “The Patient Protection and Affordable Care Bill”, nicknamed Obamacare. The final bill divided people like no other in recent years, conservatives hated it and liberals loved it.

The strange thing is, Obamacare was originally a Republican/conservative proposal! It was first dreamt up in the 1990s by the conservative Heritage Foundation and implemented in Massachusetts by Republican Mitt Romney! Yet as soon as Obama tried to pass it, the Heritage Foundation immediately denounced it and Romney twisted himself into a pretzel formation trying to defend Romneycare whilst attacking Obamacare during the 2012 election.

In response to Obamacare (and other parts of Obama’s agenda) the radically right-wing republicans formed the Tea Party. With the help of the Tea Party’ fervour, the Republicans made a net gain of six Senate seats, 63 House seats, six governorships and 680 seats in state legislatures. Fast-forward three years and attitudes have changed. The Tea Party has started a Civil War within the GOP that could plague them in the 2014 elections. Opinion surrounding Obamacare has also changed, although national polls show it is still unpopular.

So why is Obamacare so important in 203? Well firstly the arguments over its constitutionality reached the Supreme Court. As well as that some of its provisions did not take effect until late 2013 and Republicans shutdown the government for 16 days because of it.

The biggest news that Obamacare made last year was at the Supreme Court. Parts of Obamacare were being challenged as unconstitutional and many Democrats feared that the conservative-leaning court would rule against it. When the news finally came that Obamacare had been held up as constitutional, Democrats were overjoyed and Republicans were furious. Yet it wasn’t a total victory for Obamacare, the part of the law that demanded states expand their Medicaid programs was ruled unconstitutional. This meant that in states with Republican control, many people would not receive the coverage that they would have had, had the Supreme Court ruled the other way. Baring in mind that the expanded coverage is funded entirely by the federal government for the next few years, then reducing to 90% funding thereafter, there is no reason for state governments to block it.

At the moment the following states are expanding Medicaid. The party of the states governor is in brackets.

Arizona (R)	Illinois (D)	Nevada (R)	Rhode Island (D)
Arkansas (D)	Iowa (R)	New Jersey (R)	Vermont (D)
California (D)	Kentucky (D)	New Mexico (D)	Washington (D)
Colorado (D)	Maryland (D)	New York (D)	West Virginia (D)
Connecticut (D)	Massachusetts (D)	North Dakota (R)
Delaware (D)	Michigan (R)	Ohio (R)
Hawaii (D)	Minnesota (D)	Oregon (D)

The following states are currently deciding whether or not to expand Medicaid

Missouri (D)

New Hampshire (D)

Pennsylvania (R)

Utah (R)

The following states are not expanding Medicaid

Alabama (R)	Kansas (R)	North Carolina (R)	Virginia (R)
Alaska (R)	Louisiana (R)	Oklahoma (R)	Wisconsin (R)
Florida (R)	Maine (R)	South Carolina (R)	Wyoming
Georgia (R)	Mississippi (R)	South Dakota (R)
Idaho (R)	Montana (D)	Tennessee (R)
Indiana (R)	Nebraska (R)	Texas (R)

This was far from the only headlines Obamacare made last year, one of the other major flashpoints involved a government shutdown. Every so often the US Congress has to pass a ‘Continuing resolution’ which appropriates funds for certain activities carried out by the federal government. Last year Congress had to pass a CR by the 1^st of October or the federal government would ‘shutdown’ due to lack of appropriated funds.  AS the deadline approached it became increasingly clear that a shutdown was on its way. The Republican controlled House wanted to pass  a version of the CR that would defund Obamacare, the Democratic-controlled Senate refused. A deal was not reached and the federal government shutdown on the 1^st of October. AS the shutdown continued it became increasingly clear who was getting blamed: Republicans. After two weeks under the glare of public opinion, Republicans caved and a version of the CR passed with no mention of Obamacare.

This was a major victory for Democrats and a major loss for Republicans.

Yet that was not the only reason Obamacare was making the news in October 2013. On the 1^st of October the healthcare exchanges opened and were plagued with problems. As well as a poor website, the initial signup was disappointing for Democrats. Yet as the months drew on, signups increased significantly with 2.1 million people having signed up by 2014.

Obamacare will continue to make headlines in 2014 as the law finally comes into effect.