ABSTRACT
This chapter focuses on healthcare reform that was enacted in 2010 and discusses the years preceding passage of the Affordable Care Act (ACA), 2006–2008. It describes the process of passing the legislation and the controversies surrounding that passage. The chapter examines threats to the Act, such as court challenges, elections, repeal attempts, White House opposition beginning in 2017, and implementation of the Act. There is no dearth of policy alternatives or solutions for the healthcare system’s problems. The chapter explores republican alternatives to health reform and judgments about the legislation and its implementation and the future of healthcare reform. The liberal think tank Institute for America’s Future advocated a public option as part of healthcare reform. Democratic/liberal proposals tended to focus more on access issues and public-sector solutions. Attempts at healthcare reform in the 1993–1994 period at the national level prompted some states, such as Massachusetts, to attempt its own reforms.
