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Health Reform and the Future of American Politics

  • Lawrence R. Jacobs


The Affordable Care Act of 2010 (ACA) is a landmark in American social policy that is disrupting America’s “liberal tradition.” It is successfully expanding access and compelling insurers to change their business models to serve more socially-useful purposes; cost control enjoyed initial success but confronts barriers rooted in America’s resilient political economy. The ACA is disrupting long-standing patterns of American politics, introducing new developmental paths that unsettle or, in certain respects, offset the familiar patterns of selectivity, deference to private markets, and “drift” that tend to produce government inaction as economic insecurity increases. New policy arrangements for financing and delivering medical care is ushering in a new politics of US health care that are resetting the terms of future debate; the ACA is also challenging familiar approaches to studying politics including analyses of framing, policy effects and political development, and American political thought.



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Achenbaum, Andrew. 1986. Social Security Visions and Revisions. New York: Cambridge University Press.
Austin, D. Andrew, and Hungerford, Thomas. 2009. “The Market Structure of the Health Insurance Industry.” Congressional Research Service. September. (accessed June 15, 2014).
Barthold, Thomas. 2012. Letter on Partial Re-estimate of Tax Provisions in ACA. June 15. (accessed June 15, 2014).
Berenson, Robert, Ginsburg, Paul, Christianson, Jon, and Yee, Tracy. 2012. “The Growing Power of Some Providers to Win Steep Payment Increases from Insurers Suggests Policy Remedies May Be Needed.” Health Affairs 31(May): 973–81.
Bureau of Economic Analysis. 2014. “Gross Domestic Product: First Quarter 2014 (Advance Estimate).” (accessed June 15, 2014).
Burns, James McGregor. 1963. The Deadlock of Democracy: Four-Party Politics in America. Englewood Cliffs, N.J: Prentice-Hall.
Callaghan, Timothy, and Jacobs, Lawrence. 2014. “Advocating for Health Reform: Enrollment in the Affordable Care Act.” Presented at the American Political Science Association Washington, D.C. August 28–31.
Campbell, Andrea. 2005. How Policies Make Citizens: Senior Political Activism and the American Welfare State. Princeton, NJ: Princeton University Press.
Christensen, Clayton, Flier, Jeffrey, and Vijayaraghavan, Vineeta. 2013. “The Coming Failure of ‘Accountable Care'.” Wall Street Journal, February 18. (accessed June 15, 2014).
Claxton, Gary, Levitt, Larry, Damico, Anthony, and Rae, Matthew. 2014. “Data Note: How Many People Have Nongroup Health Insurance?” Kaiser Family Foundation. January 3, 2014. (accessed June 15, 2014).
Cohn, Jonathan. 2014. “Maybe Those Obamacare Plan Cancellations Weren't As Bad As You've Heard.” New Republic, April 24. (accessed June 15, 2014).
Congressional Budget Office. 2014a. “Budget and Economic Outlook, 2014–2024.” February. Washington, DC. Pub. No. 4869. (accessed June 15, 2014).
Congressional Budget Office. 2014b. “Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act.” April. Washington, DC. Pub. No. 4930. (accessed June 15, 2014).
Cox, Cynthia, Claxton, Gary, and Levitt, Larry. 2013. “Beyond Rebates: How Much Are Consumers Saving from the ACA’s Medical Loss Ratio Provision?” Kaiser Family Foundation. (accessed June 15, 2014).
Department of Health and Human Services. 2014. “Health Insurance Marketplace: Summary Enrollment Report for October 1, 2013 to March 31, 2014.” May 1. (accessed June 15, 2014).
Dittmer, Philip, and McBride, William. 2012. “Obamacare's New Taxes, and How You May Be Affected.” July 5. (accessed June 15, 2014).
Disch, Lisa. 1996. “Publicity-Stunt Participation and Sound Bite Polemics: The Health Care Debate 1993–94.” Journal of Health Politics, Policy and Law 21(Spring): 333.
Eaton, Charlie, and Weir, Margaret. 2014. “How Powerful Consumer Advocates Help Obamacare Succeed in California.” Scholars Strategy Network. (accessed June 15, 2014).
Eckstein, Harry. 1960. Pressure Group Politics. Palo Alto, CA: Stanford University Press.
Elmendorf, David. 2011. “Letter to Speaker John Boehner.” February 18. (accessed June 15, 2014).
Esping-Anderson, Gosta. 1990. Three Worlds of Welfare Capitalism. Princeton, NJ: Princeton University Press.
Furman, Jason. 2014. “Third Estimate of GDP for the First Quarter of 2014.” (White House blog, Council of Economic Advisers), June 25, 2014. (accessed June 29, 2014).
Galbraith, Alison, Soumerai, Stephen, Ross-Degnan, Dennis, Rosenthal, Meredith, Gay, Charlene, and Lieu, Tracy. 2012. “Delayed and Forgone Care for Families with Chronic Conditions in High-Deductible Health Plans.” Journal of General Internal Medicine. 27 (September):11051111.
Gallup Polling Organization. 2016. “Uninsured Rate Drops More in States Embracing Health Law.” April 16. (accessed June 15, 2014).
Gross, Wendy, Stark, Tobias, Krosnick, Jon, Pasek, Josh, Sood, Gaurav, Tompson, Trevor, and Agiesta, Jennifer. 2013 “Americans’ Attitudes toward the Affordable Care Act: Would Better Public Understanding Increase or Decrease Favorability.” Stanford University. (accessed June 15, 2014).
Hacker, Jacob. 2002. The Divided Welfare State: The Battle over Public and Private Social Benefits in the United States. New York: Cambridge University Press.
Hacker, Jacob. 2004. “Privatizing Risk without Privatizing the Welfare State.” American Political Science Review 98(2): 243–60.
Hancock, Jay. 2014. “Employer Health Costs Forecast To Accelerate In 2015.” Kaiser Health News. June 24, 2014. (accessed June 29, 2014).
Hartz, Louis. 1955. The Liberal Tradition in America. New York: Harcourt Brace Jovanovich.
Horney, James, and Water, Paul Van de. 2009. “House-Passed and Senate-Passed Bills Reduce Deficit, Slow Health Care Costs, and Include Realistic Medicare Savings.” Center on Budget and Policy Priorities, Washington D.C. December 4. (accessed June 15, 2014).
Hurley, Robert, Strunk, Bradley, and White, Justin. 2004. “The Puzzling Popularity of the PPO.” Health Affairs 23(2): 5668.
Jacobs, Lawrence. 1993. The Health of Nations: Public Opinion and the Making of Health Policy in the U.S. and Britain. Ithaca, NY: Cornell University Press.
Jacobs, Lawrence. 1995. “The Politics of America's Supply State: Health Reform and Medical Technology.” Health Affairs 14(2): 143–57.
Jacobs, Lawrence. 2012. “Community Clinics: The Hidden Revolution.” Scholar Strategy Network Policy Brief. (June 15, 2014).
Jacobs, Lawrence, and Ario, Joel. “The Affordable Care Act Leaves the Intensive Care Unit for Good.” Health Affairs 31(December): 2603–08.
Jacobs, Lawrence, and Callaghan, Timothy. 2013. “Why States Expand Medicaid: Party, Resources, and History.” Journal of Health Politics, Policy and Law 38(October): 1023–50.
Jacobs, Lawrence, and King, Desmond (eds). 2010. “Varieties of Obamaism: Structure, Agency and the Obama Presidency.” Perspectives on Politics 8(3): 793802.
Jacobs, Lawrence, and King, Desmond 2012. Obama at the Crossroads: Politics, Markets, and the Battle for America’s Future. New York: Oxford University Press.
Jacobs, Lawrence, and Mettler, Suzanne. 2011. “Why Public Opinion Changes: The Implications for Health and Health Policy.” Journal of Health Policy, Politics and Law 36 (December): 917933.
Jacobs, Lawrence, and Mettler, Suzanne. 2014. “Taming Conservatism: The Policy Effects of the Affordable Care Act on Attitudes Toward Taxation.” Presented at the Annual Meeting of the Midwest Political Science Association, Chicago, IL, April 5.
Jacobs, Lawrence, and Shapiro, Robert Y.. 2000. Politicians Don't Pander: Political Manipulation and the Loss of Democratic Responsiveness. Chicago: Chicago University Press.
Jacobs, Lawrence, and Skocpol, Theda. 2012. Health Care Reform and American Politics. 2d ed. New York: Oxford University Press.
Jacobs, Lawrence, and Skocpol, Theda. 2014. “Progressive Federalism and the Contested Implementation of Obama’s Health Reform.” In The Politics of Major Policy Reform, ed. Jenkins, Jeffrey and Milkis, Sidney. Cambridge, UK: Cambridge University Press.
James, Julie. 2012. “Health Policy Brief: Pay for Performance.” Health Affairs October: 16. (accessed June 15, 2014).
Kaiser Family Foundation. 2011. Kaiser Family Foundation. “Kaiser Health Tracking Poll.” December. (accessed June 15, 2014).
Kaiser Family Foundation. 2014a. “Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors.” January 22.
Kaiser Family Foundation. 2014b. “Kaiser Health Tracking Poll.” March. (accessed June 15, 2014).
Kaiser Family Foundation. 2014c. “The Coverage Gap: Uninsured Poor Adults in States That Do Not Expand Medicaid.” Policy Brief. April 2014. (accessed June 15, 2014).
Katznelson, Ira. 1986. “Rethinking the Silences of Social and Economic Policy.” Political Science Quarterly 101(2): 307–25.
Koechlin, F., Lorenzoni, L., and Schreyer, P.. 2010. Comparing Price Levels of Hospital Services across Countries: Results of a Pilot Study. OECD Health Working Paper, No. 53. Paris: OECD Publishing.
LaMontagne, Christina. 2014. “Medical Bankruptcy Accounts for Majority of Personal Bankruptcies.” Nerdwallet. March 26. (accessed June 15, 2014).
Long, Sharon, Kenney, Genevieve M., Zuckerman, Stephen, Wissoker, Douglas, Goin, Dana, Karpman, Michael, and Anderson, Nathaniel. 2014. “QuickTake: Number of Uninsured Adults Falls by 5.4 Million since 2013.” Urban Institute. April 3. (accessed June 15, 2014).
Marmor, Theodore. 1983. Political Analysis and American Medical Care. New York: Cambridge University Press.
McCord, Colin, and Freeman, Harold P.. 1990. “Excess Mortality in Harlem.” New England Journal of Medicine 322(January 18): 173–77.
Medicare Payment Advisory Commission. 2009. “Report to Congress: Medicare Payment Policy.” (accessed June 15, 2014).
Medicare Payment Advisory Commission. 2011. Report to the Congress: Medicare Payment Policy. (accessed June 15, 2014).
Mettler, Suzanne. 2005. Soldiers to Citizens: The G.I. Bill and the Making of the Greatest Generation. New York: Oxford University Press.
Mettler, Suzanne. 2011. The Submerged State: The Paradox of American Politics and How We Can Overcome It. Chicago, IL: University of Chicago Press.
Mettler, Suzanne, and Soss, Joe. 2004. “The Consequences of Public Policy for Democratic Citizenship: Bridging Policy Studies and Mass Politics.” Perspectives on Politics 2(1): 5573.
Millman, Jason, 2014. “Medicare Reversed Payment Cuts, and Not Many Are Happy about It.” Washington Post Wonkblog. April 14. (accessed May 11, 2014).
Mink, Gwendolyn. 1995. The Wages of Motherhood. Ithaca, NY: Cornell University Press.
Morone, James. 1991. The Democratic Wish: Popular Participation and the Limits of American Government. New York: Basic Books.
Morone, James. 2014. The Devils We Know: Us and Them in America’s Raucous Political Culture. Lawrence, KS: University Press of Kansas.
National Conference of State Legislatures. 2013. “Medical Loss Ratios for Health Insurance.” (accessed May 10, 2014).
Nolte, Ellen, and Martin McKee, C.. 2012. “In Amenable Mortality—Deaths Avoidable through Health Care—Progress in the US Lags That of Three European Countries.” Health Affairs 31( September): 2114–22.
Orloff, Ann Shola. 1993. “Gender and the Social Rights of Citizenship: The Comparative Analysis of Gender Relations and Welfare States.” American Sociological Review 58(June): 303–28.
Pierson, Paul. 1993. “When Effect Becomes Cause: Policy Feedback and Political Change.” World Politics 45(July): 595628.
Pierson, Paul. 2000. “Increasing Returns, Path Dependence, and the Study of Politics.” American Political Science Review 94(2): 251–67.
PricewaterhouseCoopers. 2014. “Medical cost trend: Behind the numbers 2015.” June 2014. (accessed June 29, 2014).
Skocpol, Theda. 1996. Boomerang: Clinton's Health Security Effort and the Turn against Government in U. S. Politics. New York: W. W. Norton.
Sommers, Benjamin. 2014. “Insurance Cancellations in Context: Stability of Coverage in the Nongroup Market Prior to Health Reform.” Health Affairs 33 (April): 700706.
Tax Policy Center. 2010. “Senate Health Bill and Reconciliation Act of 2010: Medicare Tax; Baseline: Current Law; Distribution by Cash Income Level, 2013.” March 19. (accessed March 27, 2014).
Tax Policy Center. 2012. “The Numbers: Tax Units Above and Below the $250,000/$200,000 Threshold.” November 26. (accessed May 2, 2014).
White, Joseph. 2013. “Cost Control after the ACA.” Public Administration Review 73(September/October): 2433.
World Bank. 2013a. “Health Expenditure.” (accessed May 13, 2014).
Bank, World. 2013b. “Mortality Rate: Infants.” (accessed May 10, 2014).
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Perspectives on Politics
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