What Is the Affordable Care Act a Case of? Understanding the ACA through the Comparative Method

2020 ◽  
Vol 45 (4) ◽  
pp. 677-691
Author(s):  
Holly Jarman ◽  
Scott L. Greer
Keyword(s):  
United States ◽  
Health Care ◽  
Welfare State ◽  
Affordable Care Act ◽  
Strong Support ◽  
The United States ◽  
The Us ◽  
The Affordable Care Act ◽  
Shed Light ◽  
The Welfare State

Abstract International comparisons of US health care are common but mostly focus on comparing its performance to peers or asking why the United States remains so far from universal coverage. Here the authors ask how other comparative research could shed light on the unusual politics and structure of US health care and how the US experience could bring more to international conversations about health care and the welfare state. After introducing the concept of casing—asking what the Affordable Care Act (ACA) might be a case of—the authors discuss different “casings” of the ACA: complex legislation, path dependency, demos-constraining institutions, deep social cleavages, segmentalism, or the persistence of the welfare state. Each of these pictures of the ACA has strong support in the US-focused literature. Each also cases the ACA as part of a different experience shared with other countries, with different implications for how to analyze it and what we can learn from it. The final section discusses the implications for selecting cases that might shed light on the US experience and that make the United States look less exceptional and more tractable as an object of research.

A Cross-National Perspective on the American Welfare State

2014 ◽  
Author(s):  
Julia Lynch
Keyword(s):  
United States ◽  
Health Care ◽  
Welfare State ◽  
The United States ◽  
State Regulation ◽  
Eligibility Criterion ◽  
Social Risks ◽  
Social Goods ◽  
The U.S ◽  
The Welfare State

The welfare system in the United States is not simply “small,”“residualist,” or “laggard.” It is true that protection against standard social risks is generally less comprehensive and less generous in the United States than in other rich democracies, but there are other important differences as well: The U. S. welfare state is unusual in its extensive reliance on private markets to produce public social goods; its geographic variability; its insistence on deservingness as an eligibility criterion; and its orientation toward benefits for the elderly rather than children and working-age adults. Nevertheless, the U.S. welfare state is not sui generis. The actors involved in the construction of the U.S. welfare state, the institutions created in response to social problems, and the contemporary pressures confronting the welfare state all have parallels in other countries. The markets that provide so many social goods in the United States are the products of state action and state regulation, and hence should really be thought of as part of the welfare “state.” Even recent expansions to the welfare state in the United States have, with the partial exception of health-care reform, reinforced old patterns of elderly oriented spending and benefits for worthy (working) adults. In order for the U.S. welfare state to adjust successfully to ensure against new social risks, it must focus more on underdeveloped program areas like health care, child care, early childhood education, and vocational training.

scholarly journals The Implementation and Evaluation of the United States Affordable Care Act

2019 ◽  
Vol 12 (1) ◽  
pp. 17-38
Author(s):  
David Schultz
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Health Care Outcomes ◽  
The Us ◽  
American Health Care

In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.

Bridging the Gulf on Health Care Policy Beyond the Affordable Care Act

2022 ◽  
Vol 7 (1) ◽  
pp. 0-0
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Affordable Care Act ◽  
Health Care Policy ◽  
The United States ◽  
Care Policy ◽  
Democratic System ◽  
The Affordable Care Act ◽  
Sustainable Health

This article presents a brief overview of the Affordable Care Act (ACA) and changes ushered into the health care system by the Act. The overview is followed by arguments for and against the ACA, integrating and situating the divergent arguments within the context of both democratic and conservative standpoints on health care policy. Furthermore, the article explores the possibility of identifying factors responsible for the seeming difficulty in transiting policy from agenda status to adoption in a democratic system of governance. The article concludes with suggestions on ways and strategies that can help in bridging the ostensible gap between divergent positions, with the hope of charting the course to the desired destination of an equitable and sustainable health care policy for the United States.

Private Health Insurance

2014 ◽  
Author(s):  
James A. Morone
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Affordable Care Act ◽  
Private Health Insurance ◽  
The United States ◽  
Present Condition ◽  
American Health Care ◽  
The Affordable Care Act ◽  
Multiple Risk

This article explores the development, the present condition, and the likely future of private health insurance in the United States. It emphasizes the three kinds of fragmentation that mark American health care: scattered oversight, multiple risk pools, and inchoate government. I pay special attention to the health-care challenges we face, the persisting patterns of inequality, and the important but limited reforms introduced by the Affordable Care Act.

scholarly journals Re-examining the benefits of becoming a grandparent: No evidence of positive associations in the United States and England.

2019 ◽  
Author(s):  
Paula Sheppard ◽  
Christiaan Willem Simon Monden
Keyword(s):  
United States ◽  
Young Child ◽  
Life Expectancy ◽  
Welfare State ◽  
Longitudinal Data ◽  
Well Being ◽  
The United States ◽  
Mortality Rates ◽  
The Us ◽  
The Welfare State

Despite positive associations between active grandparenting and well-being, little evidence so far suggests that the transition to grandparenthood increases well-being. We extend previous work from Europe, where weak effects were found, in two ways. First, kin effects are likely to be context-dependent and differ by the type and generosity of the welfare state, and by mortality rates. Second, it may be that the grandparent derives more benefits from the grandchild as young child than a new-born or infant. We retest this hypothesis with longitudinal data from the US and England. Both these studies follow people for a longer time so we further test whether effects of grandparenting emerge later after the birth of the grandchild. We found no evidence for these hypotheses in either setting, with the exception of English women who reported higher subjective life expectancy after becoming a grandmother. These largely null findings have implications for theories of grandparenting.

scholarly journals 8.I. Workshop: Populist radical right and health: National policies and global trends

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
United States ◽  
Welfare State ◽  
The United States ◽  
Radical Right ◽  
Health Policies ◽  
National Policies ◽  
Global Trends ◽  
Populist Radical Right ◽  
The Welfare State

Abstract Populist radical right (PRR) parties have been steadily expanding, not only in the number of supporters they gain and the seats they win in governments, but more importantly they have been increasingly elected into governmental coalitions as well as presidential offices. With the prominence of these authoritarian, nationalistic and populist parties, it is often difficult to discern what kind of policies they actually stand for. Particularly with regards to the welfare state and public health, it is not always clear what these parties stand for. At times they call for a reduction of health-related welfare provision, despite the fact that this goes against the will of the “ordinary people”, their core supporters; they often promote radical reductions of welfare benefits among socially excluded groups - usually immigrants, whom are most in need of such services; and finally they often mobilize against evidence-based policies. The purpose of this workshop is to present the PRRs actual involvement in health care and health policies across various countries. As PRR parties increase and develop within but also outside of the European continent it is necessary to keep track of their impact, particularly with regards to health and social policies. Although research surrounding PRR parties has significantly expanded over the last years, their impact on the welfare state and more specifically health policies still remains sparse. This workshop will present findings from the first comprehensive book connecting populist radical right parties with actual health and social policy effects in Europe (Eastern and Western) as well as in the United States. This workshop presents five country cases (Austria, Poland, the Netherlands, the United States) from the book Populist Radical Right and Health: National Policies and Global Trends. All five presentations will address PRR parties or leaders and their influence on health, asking the questions “How influential are PRR parties or leaders when it comes to health policy?” “Do the PRR actually have an impact on policy outcomes?” and “What is the actual impact of the health policies implemented by PRR parties or leaders?” After these five presentations, the participants of the workshop will be engaged in an interactive discussion. Key messages As the number of PRR parties increase worldwide and their involvement in national governments become inevitable, new light must be shed on the impact these political parties have on public health. Politics needs to become better integrated into public health research. The rise of PRR parties in Europe might have serious consequences for public health and needs to be further explored.

The Impact of the Affordable Care Act Medicaid Expansions on the Sources of Health Insurance Coverage of Undergraduate Students in the United States

2021 ◽  
pp. 107755872110158
Author(s):  
Priyanka Anand ◽  
Dora Gicheva
Keyword(s):  
United States ◽  
Health Insurance ◽  
Undergraduate Students ◽  
Affordable Care Act ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Medicaid Expansions

This article examines how the Affordable Care Act Medicaid expansions affected the sources of health insurance coverage of undergraduate students in the United States. We show that the Affordable Care Act expansions increased the Medicaid coverage of undergraduate students by 5 to 7 percentage points more in expansion states than in nonexpansion states, resulting in 17% of undergraduate students in expansion states being covered by Medicaid postexpansion (up from 9% prior to the expansion). In contrast, the growth in employer and private direct coverage was 1 to 2 percentage points lower postexpansion for students in expansion states compared with nonexpansion states. Our findings demonstrate that policy efforts to expand Medicaid eligibility have been successful in increasing the Medicaid coverage rates for undergraduate students in the United States, but there is evidence of some crowd out after the expansions—that is, some students substituted their private and employer-sponsored coverage for Medicaid.

Transformation of the US Veterans Health Administration

2006 ◽  
Vol 1 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jonathan B. Perlin
Keyword(s):  
United States ◽  
Health Care ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Affairs ◽  
United States Department ◽  
Veterans Health ◽  
Department Of Veterans Affairs ◽  
Health Administration ◽  
The Us

Ten years ago, it would have been hard to imagine the publication of an issue of a scholarly journal dedicated to applying lessons from the transformation of the United States Department of Veterans Affairs Health System to the renewal of other countries' national health systems. Yet, with the recent publication of a dedicated edition of the Canadian journal Healthcare Papers (2005), this actually happened. Veterans Affairs health care also has been similarly lauded this past year in the lay press, being described as ‘the best care anywhere’ in the Washington Monthly, and described as ‘top-notch healthcare’ in US News and World Report's annual health care issue enumerating the ‘Top 100 Hospitals’ in the United States (Longman, 2005; Gearon, 2005).

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