healthcare
The U.S. healthcare system comprises a combination of public programs, private insurance, and out-of-pocket payments.
key legislation
what is Medicare?
federal health insurance program for people 65+
also includes younger people with disabilities
started in 1965 under Social Security and now administered by Centers for Medicare and Medicaid Services enacted under President Lyndon B. Johnson
eligible regardless of income or medical history
Democratic president who served from 1963 to 1969
what is Medicaid?
provides health insurance for adults and children with limited income
managed by state governments
established in 1865, part of Lyndon B Johnson’s administration
expanded in 2010 by the Affordable Care Act
what is the Affordable Care Act (ACA)?
signed into law in 2010 by President Barack Obama
an expansion of Medicaid eligibility + changes to insurance markets
insurers now have to accept all applicants without charging based on preexisting conditions
an additional 20 to 24 million people covered
reduced income inequality by taxing top 1% to fund benefits in bottom 40%
before ACA, some states did not allow able-bodied adults to participate in Medicaid and many set income eligibility far below federal poverty level
ACA required states to expand or they would lose all federal Medicaid funding
National Federation of Independent Business v. Sebelius (2012) deemed this to be unconstitutional, so states can now choose whether or not to expand Medicaid
Medicaid coverage varies widely by state
Democratic president who served from 2009 to 2017
party views
democrats, in general....
support government-led expansion of healthcare access
want to strengthen ACA, expand Medicare/Medicaid
view healthcare as a right
republicans, in general....
favour a market-based approach
want to repeal/reduce ACA, private insurance over government programs
block grants or work requirements for Medicaid
view healthcare as a personal responsibility, with government playing a limited role
current administration
what's going on with healthcare in 2025?
John Thune and Mike Johnson want to cut Medicaid
One Big Beautiful Bill Act: new requirements for Medicaid, pay more fees for coverage, no more gender-affirming care, no more funding nonprofits with abortion care, harder for illegal immigrants to use Medicaid
Republicans divided on the subject, with Ron Johnson believing not enough cuts, Josh Hawley believing cuts are too far
Republican senator from South Dakota, Senate majority leader
Republican U.S. Rep from Louisiana, Speaker of the House
Republican senator from Wisconsin
Republican senator from Missouri