The Affordable Care Act was promised to both lower health care costs and improve health care quality. In simple terms, the idea was that increasing an individual’s access to preventative care will improve health and therefore reduce expensive trips to the emergency room (that they patient can often not pay for) and decrease the incidence of chronic illnesses. The administration argued that ensuring that a far larger majority of Americans were insured made financial, moral, and practical sense.
And as presidential candidate in 2008, President Barack Obama argued that health care was a right. During the second presidential debate with Republican Senator John McCain of Arizona, his populist campaign platform evolved as he acknowledged that many Americans had seen their health care premiums increase substantially in recent years. “We’ve got to reform health care to help you and your budget,” he stated. “So one of the things that I have said from the start of this campaign is that we have a moral commitment as well as an economic imperative to do something about the health care crisis that so many families are facing.”
In that same debate, he explained that families who liked their insurance coverage could keep their current plans, and pledged his administration would work with employers to lower family premiums by as much as $2,500. “If you don’t have health insurance, you’re going to be able to buy the same kind of insurance that Senator McCain and I enjoy as federal employees. Because there’s a huge pool, we can drop the costs,” he added, flushing out further details of his plan. “And nobody will be excluded for pre-existing conditions, which is a huge problem.” During his 2009 inauguration speech, Obama further expounded on the importance of health care reform, noting that the high cost of health care “causes a bankruptcy in America every 30 seconds.”
More than six years have passed since that inaugural address; the health care reform has been hammered out, hotly debated, passed without a single Republican vote, and caused a shutdown of the federal government. Its key provision — the individual insurance marketplaces, designed to allow consumers to comparison-shop for health insurance policies in online marketplaces where their collective bargaining power will theoretically foster competition and drive down price — have launched. But the costs of the reform are still a subject of much debate.