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Healthcare reform has been a significant concern for American presidents since the 1940s. President Obama emphasized the importance of establishing universal healthcare coverage during his tenure. In 2010, he signed the Patient Protection and Affordable Care Act, commonly known as the ACA or “Obamacare,” which was a significant milestone for the United States. The ACA aimed to enhance the accessibility and affordability of healthcare coverage for Americans and is considered one of Obama’s most important accomplishments. (Milstead, J. A., & Short, N. M.,2019).

This initiative has enabled almost 31 million individuals to obtain insurance. Since its launch, the ACA has undergone various modifications, influenced by new presidential administrations and significant events such as the COVID-19 pandemic. These changes have guaranteed coverage for people with pre-existing health conditions, provided tax credits and subsidies, revised insurance eligibility criteria, and eliminated discriminatory premium rates.

However, several years after the ACA was enacted, over one-third of U.S. residents could not recognize that Obamacare and the ACA were the same. President Trump promised to repeal the Affordable Care Act (ACA) during his election campaign. On his first day in office, he issued an executive order to reverse the implementation of the ACA. Since then, he has consistently made statements attacking the law, frequently claiming that it has already been destroyed or crippled.

The plan was to replace the ACA with a new healthcare plan focused on delivering more choices, lower costs, and better care. However, the Republican party could not agree on a replacement plan, and the ACA remained in place. The Trump administration believed in a free and open healthcare market, which meant raising taxes to provide affordable healthcare to marketplace consumers. Despite its ambitious goals, the Affordable Care Act faced considerable opposition from the Republican party. Following his inauguration in 2017, President Trump issued an executive order to maximize the ACA and dismantle the Medicaid plan. This was part of his broader agenda to repeal and replace the ACA, which he believed was too expensive and ineffective. Congress was also busy working on a repeal of the Affordable Care Act. The Republican Party thought that the Act was too costly and caused an undue burden on businesses and the economy.

The Affordable Care Act (ACA) was a significant healthcare reform in the United States that ensured everyone, including those with pre-existing conditions, had access to health benefits. If repealed, insurers would have been allowed to reject services due to errors, which would have resulted in millions of Americans being denied the healthcare they needed. The ACA has expanded healthcare access for millions of Americans, improved the quality and performance of the healthcare system, and reduced the uninsured rate in the United States to historic lows.

Previous research on healthcare reforms has focused chiefly on Medicaid, which has had mixed results regarding voter turnout and registration. However, these studies have considered various factors such as data, methods, magnitudes, and statistical significance. Evidence from past studies on the ACA suggests immediate positive outcomes that faded over time, while results from Medicaid variations outside the ACA were mixed. Despite a significant number of individuals gaining private coverage through the ACA, little attention has been given to its overall impact.

This study uses American National Election Study data to analyze how the Affordable Care Act affects electoral outcomes. It assesses if opinions on government involvement in healthcare impact voting behavior by controlling for demographic and political factors. The study found that views on government involvement in healthcare impact voters’ choice of presidential candidate. Surprisingly, the study also found that voters who support government involvement in healthcare are more likely to vote for a Republican candidate. This may be due to government healthcare plans that disproportionately serve seniors, who are more likely to support conservative candidates. However, the Affordable Care Act ensured that no one was limited or denied health benefits, including people with pre-existing conditions. (Derr, I., 2022).

After more than a decade since its introduction, the ACA has become a polarizing issue for Americans, with opinions often divided along political lines. According to a 2023 survey conducted by the Kaiser Family Foundation, 90% of Democrats approve of the ACA, while 70% of Republicans disapprove of it. The Affordable Care Act (ACA) is an unprecedented law transforming America’s healthcare system. Due to its complexity, a comprehensive analysis of its impact would require an entire book. Nevertheless, it cannot be denied that the ACA has significantly changed how healthcare is provided in the United States. (Aviana, C. E.2023).


Aviana Cooper, Esq.September 29, 2023.The Pros and Cons of the Affordable Care Act (Obamacare) https://www.findlaw.com/healthcare/patient-rights/the-pros-and-cons-of-the-affordable-care-act–obamacare-.html,
C. J., Marton, J., & Yelowitz, A. (2020). The Full Impact of the Affordable Care Act on Political Participation. https://doi.org/10.7758/rsf.2020.6.2.08
Derr, I. (2022). Politics in Healthcare: The Benefits of the Affordable Care Act. https://core.ac.uk/download/524161594.pd
Fingar, K., Coffey, R., Mulcahy, A., Andrews, R., & Stocks, C. (2018). Shifts in Medicaid and Uninsured Payer Mix at Safety-Net and Non-Safety-Net Hospitals During the Great Recession.
Journal of Healthcare Management, 63(3), 156-172.https://doi.org/10.1186/s12913-016-1362-1
M. (2019)Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
Sayeed, S., Liscano, R., & Ahmad, A. (2007). Performance Modelling of Priority Queuing Discipline under Self-Similar and Poisson Traffic. https://doi.org/10.1109/lcn.2007.124



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