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The state of American health coverage: the 2022 elections and the Affordable Care Act

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  • Gusmano, Mickael K.
  • Thompson, Frank J.

Abstract

The Affordable Care Act of 2010 (ACA) was the most significant policy breakthrough to expand health insurance coverage in the USA in 45 years. Culminating a decade-long effort by Republicans to repeal and undermine the ACA, the Trump administration launched a panoply of executive initiatives to sabotage the law. Benefitting from Democratic control of both the House and Senate during its first 2 years, the Biden administration through legislative and executive initiatives made substantial headway in reversing Trump's sabotage and further reinvigorating the ACA. The 2022 elections witnessed a shift in the partisan milieu. Republicans gained control of the House of Representatives; Democrats scored modest gains in state elections. Emphasising two pivotal features of American governance – federalism and the outsized role of the courts – this essay examines the implications of this new partisan context for Biden's efforts to bolster ACA durability prior to the 2024 presidential election.

Suggested Citation

  • Gusmano, Mickael K. & Thompson, Frank J., 2024. "The state of American health coverage: the 2022 elections and the Affordable Care Act," Health Economics, Policy and Law, Cambridge University Press, vol. 19(3), pages 292-306, July.
    • Handle: RePEc:cup:hecopl:v:19:y:2024:i:3:p:292-306_2
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