In 2006, the Massachusetts legislature passed and Governor Mitt Romney signed into law a health care reform with subsidized health insurance coverage for low-income people, a health insurance exchange to help people not otherwise covered choose among available plans, an individual mandate requiring residents to obtain coverage if affordable, and an expansion of Medicaid to include children and long-term unemployed adults. The reform in Massachusetts turned out to be a blueprint for the Affordable Care reforms passed by Congress and signed by President Barack Obama in 2010. ObamaCare, as the federal reform law is sometimes called, is only now going into full effect, as debate continues to swirl about its provisions and its likely effects. No one can tell what the national reform’s impact on Americans’ health will turn out to be, but we can get an idea of possible benefits by looking at what is known so far about the aftermath of the earlier Massachusetts reforms. more...
Affordable Care Act
The Affordable Care Act aims to extend health insurance to tens of millions more Americans through two major routes: by giving people information and in many cases tax credits to help them purchase private insurance plans offered on state or national “exchanges,” or online marketplaces; and by giving the fifty U.S. states plus the District of Columbia additional federal funds to expand their Medicaid programs to insure all low-income people just above as well as below the federal poverty line. States have a key role in implementing health reform. Each state can choose to run its own exchange marketplace and help its residents learn about their options for purchasing affordable plans. Each state also decides whether or not to accept new federal subsidies to expand Medicaid (covering 93% of the costs from 2014 through 2022). What states do—or refuse to do—makes a big difference, as a comparison of the nation’s two largest states, California and Texas, makes clear. California is leading the way in showing that Affordable Care can work, while authorities in Texas are obstructing implementation with gusto. more...
New England is a compact and relatively liberal region, and its six states—Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut—all had relatively high levels of health insurance coverage before the Affordable Care Act. Yet rates of prior coverage still varied, and these states have made different choices about implementing reform.
Leading into 2014, each U.S. state had two key decisions to make: whether to use federal funds appropriated by the Affordable Care Act to expand its Medicaid program to include people just above the poverty line; and whether to set up and run its own exchange, an online market place where residents can comparison shop for private health insurance plans and find out about their eligibility for federal subsidies to help pay the premiums. more...
The state of Texas leads the nation in the percentage of residents lacking health insurance. In 2012, nearly a quarter of the state’s population went without health coverage, some 6.4 million people. Texas alone is home to 13% of all uninsured Americans, with poor and low-income people the most affected. More than ninety percent of well-off Texans have health insurance. But the ranks of the uninsured include more than two out of five impoverished Texans—as well as more than a quarter of individuals earning modest incomes in 2014 between $11,670 and $46,680 (or between $19,970 and $79,880 for a family of three). more...
When the Congressional Budget Office issued its latest report about the Affordable Care Act in early February, public reaction was sharp—and mostly focused on a drop of worrisome news in a sea of encouraging findings. On the good news side, the report found that insurance premiums are considerably lower than previously anticipated by the Budget Office, and that health reform is now projected to cost $9 billion less than previously estimated. And it debunked worries about a legal provision designed to buffer insurance companies from risk; it is not at all a “bailout,” as some have claimed, and indeed the federal government is projected to take in billions more than it spends. These and other encouraging findings were overshadowed by attention to another projection—that reform may reduce employment and worker hours by the equivalent of about two million full time positions in 2017. more...
Health reform has many popular parts—rules against insurance company abuses; subsidies and tax credits to make health coverage affordable for millions; improvements in Medicare. But controversy persists about the “individual mandate” rule—which says that everyone must either have health insurance coverage or pay a fine.
Attacks have intensified since the Supreme Court decision to uphold the Affordable Care Act, because the mandate fine was declared a valid exercise of the taxing power assigned by the Constitution to the federal government. Opponents of health reform denounce the mandate as “tyranny” and say that it amounts to a big “middle class tax increase.”
The Affordable Care Act aims to extend health insurance to tens of millions more Americans through two major routes: by giving people information and in many cases tax credits to help them purchase private insurance plans offered on state or national “exchanges,” or online marketplaces; and by giving the fifty U.S. states plus the District of Columbia additional federal funds to expand their Medicaid programs to insure all low-income people just above as well as below the federal poverty line. States have a key role in implementing health reform. Each state can choose to run its own exchange marketplace and help its residents learn about their options for purchasing affordable plans. Each state also decides whether or not to accept new federal subsidies to expand Medicaid (covering 93% of the costs from 2014 through 2022). What states do—or refuse to do—makes a big difference, as a comparison of the nation’s two largest states, California and Texas, makes clear. California is leading the way in showing that Affordable Care can work, while authorities in Texas are obstructing implementation with gusto. more...
New England is a compact and relatively liberal region, and its six states—Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut—all had relatively high levels of health insurance coverage before the Affordable Care Act. Yet rates of prior coverage still varied, and these states have made different choices about implementing reform.
Leading into 2014, each U.S. state had two key decisions to make: whether to use federal funds appropriated by the Affordable Care Act to expand its Medicaid program to include people just above the poverty line; and whether to set up and run its own exchange, an online market place where residents can comparison shop for private health insurance plans and find out about their eligibility for federal subsidies to help pay the premiums. more...
The state of Texas leads the nation in the percentage of residents lacking health insurance. In 2012, nearly a quarter of the state’s population went without health coverage, some 6.4 million people. Texas alone is home to 13% of all uninsured Americans, with poor and low-income people the most affected. More than ninety percent of well-off Texans have health insurance. But the ranks of the uninsured include more than two out of five impoverished Texans—as well as more than a quarter of individuals earning modest incomes in 2014 between $11,670 and $46,680 (or between $19,970 and $79,880 for a family of three). more...
When the Congressional Budget Office issued its latest report about the Affordable Care Act in early February, public reaction was sharp—and mostly focused on a drop of worrisome news in a sea of encouraging findings. On the good news side, the report found that insurance premiums are considerably lower than previously anticipated by the Budget Office, and that health reform is now projected to cost $9 billion less than previously estimated. And it debunked worries about a legal provision designed to buffer insurance companies from risk; it is not at all a “bailout,” as some have claimed, and indeed the federal government is projected to take in billions more than it spends. These and other encouraging findings were overshadowed by attention to another projection—that reform may reduce employment and worker hours by the equivalent of about two million full time positions in 2017. more...
Health reform has many popular parts—rules against insurance company abuses; subsidies and tax credits to make health coverage affordable for millions; improvements in Medicare. But controversy persists about the “individual mandate” rule—which says that everyone must either have health insurance coverage or pay a fine.
Attacks have intensified since the Supreme Court decision to uphold the Affordable Care Act, because the mandate fine was declared a valid exercise of the taxing power assigned by the Constitution to the federal government. Opponents of health reform denounce the mandate as “tyranny” and say that it amounts to a big “middle class tax increase.”
Research to Improve Policy: The Scholars Strategy Network seeks to improve public policy and strengthen democracy by organizing scholars working in America's colleges and universities. SSN's founding director is Theda Skocpol, Victor S. Thomas Professor of Government and Sociology at Harvard University.