As of today, no one quite knows what will happen to ACA. Republicans control the required levers to massively repeal or replace ACA. They also have the power to massively over-reach and do themselves profound political damage through over-reach that damages millions of people’s lives or that damages the overall health care delivery system. Trump’s unexpected victory provides a remarkable natural experiment that illuminates bedrock issues: The power and accuracy of media messages in public policy, path dependence as a barrier to radical policy change, tensions between interest-group and partisan politics, fiscal federalism and the relationship between states and the federal government, the politics of race and class in redistributive programs. It’s all there in the politics of health reform.
Post-November 8 is a great time to explore these questions and to look back on what some of the best health policy scholars, political scientists, and sociologists have had to say about the enactment, implementation, and political reception facing health reform. The Journal of Health Politics, Policy, and Law has therefore opened some of its best pieces on ACA for public access. I recommend this to anyone serious about understanding the rise and potential fall of the Affordable Care Act, on which rides the health and well-being of many millions of people. (FYI: I am JHPPL’s social media editor.)
We are watching history in action. It isn’t pretty to watch. We can at least witness the process with analytic rigor informed by a sound understanding of what has come before.