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Following the Money

The ACA’s Fiscal-Political Economy and Lessons for Future Health Care Reform

Published online by Cambridge University Press:  01 January 2021

William M. Sage  and
Timothy M. Westmoreland
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Abstract

It is no exaggeration to say that American health policy is frequently subordinated to budgetary policies and procedures. The Affordable Care Act (ACA) was undeniably ambitious, reaching health care services and underlying health as well as health insurance. Yet fiscal politics determined the ACA’s design and guided its implementation, as well as sometimes assisting and sometimes constraining efforts to repeal or replace it. In particular, the ACA’s vulnerability to litigation has been the price its drafters paid in exchange for fiscal-political acceptability. Future health care reformers should consider whether the nation is well served by perpetuating such an artificial relationship between financial commitments and health returns.

Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 48 , Issue 3: A Bold Agenda for the Next Steps in Health Reform , Fall 2020 , pp. 434 - 442
Copyright
Copyright © American Society of Law, Medicine and Ethics 2020

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