The Affordable Care Act: Placing Healthcare Reform in a Historical and Comparative Context

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Healthcare has been an important issue for Utah voters throughout the past decade, but the 2012 Utah Priorities Survey revealed they are now more concerned with it.  In the 2012 survey, 69% of respondents indicated that they were concerned or very concerned with healthcare, making it the fourth most important issue to voters in this election year.

Healthcare is not only an important issue to voters, but a divisive one as well.  The Utah Priorities Survey of Party Delegates and Voters, which was conducted two months after the Utah Priorities Survey, showed that Democratic delegates and voters were more likely to prioritize healthcare issues than Republicans.  The starkest difference between the parties concerned the Affordable Care Act (ACA), now more commonly known as Obamacare. When asked if it should be repealed, 75% of Republican voters agreed, compared to only 12% of Democratic voters.

Healthcare reform has been debated in the United States for much of the last century.  There have been many attempts to implement universal healthcare coverage, with reform efforts often coming as advocates argue that costs for medical care have grown too high. In 2008, healthcare was a major issue in the presidential election, and Barack Obama was elected on a platform that included an overhaul of the nation’s healthcare system. The year following his inauguration was noted for intense debate over healthcare reform, but eventually the ACA was passed in March 2010.

Soon after the ACA was passed, attempts were made to repeal it, and a number of parties sued the federal government.  These cases eventually were merged into National Federation of Independent Business v. Sebelius.  On June 28, 2012, the U.S. Supreme Court upheld the individual mandate, a provision in the ACA requiring individuals to purchase healthcare or face a penalty, declaring the penalty implemented as a tax was constitutional.

The Supreme Court ruling also allowed states to opt out of an expansion of Medicaid for low-income individuals.  Utah’s Governor Gary Herbert has said he is not completely against this expansion, but believes the federal government should allow states more flexibility to provide healthcare. He has also indicated that he wants to wait until after the presidential election, saying “If Pres. Obama is re-elected that will tell us one thing about the direction of healthcare in this country. If Gov. Romney is elected… it will change the direction of healthcare and hence, Medicaid as we go forward for the next four years.”

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