Health Care Reform: Congressional Politics and the Obamacare Policy Implementation in the United States

  • Alhaji Mustapha Javombo Institute of Public Administration and Management (IPAM), University of Sierra Leone (USL), A. J. Momoh Street, Tower Hill, Freetown, Sierra Leone
Keywords: United States, Congress, Affordable Care Act, Obamacare, HealthCare Policy, Reform.


The changing political climate of Congress and the dilemmas of the Affordable Care Act (Obamacare) in reforming the U.S. health care system is the focus of this work. The author is with the view that most barriers that led to the denial of previous health care reform bills were as a result of the role played by Congressional caucuses and the continuous health care malpractices perpetrated by health care industries in the United States. Healthcare policy making in the United States therefore, owns its hegemonic past from a long standing institutional and ideological politics beginning with Theodore Roosevelt’s failed proposal for a national health care system in 1912. The work further examines Congressional path dependency on health care reform and its role in health care policy adoption and implementation. The obstacles faced by Americans in having a relatively rational type of health care coverage system in the United States will also be discussed. The paper argues that the invisible hands of Congressional caucuses and health care industries continue to play integral parts in health care policy making in the U.S. thereby, frustrating government’s efforts in order to uphold the privileges and profits enjoyed at the expense of tax payers. The puzzle the work seeks to unravel is to showcase whether the fight to repeal the Affordable Care Act by Congress, States and individual plaintiffs will hold in the light of the unprecedented health care burden on Americans. The work explores John Kingdon’s Multiple Streams Framework in public policy making with particular reference to the health care policy reforms in the United States. The author concludes that in order to achieve an efficient market outcome in the case of the prevailing health care externalities in the U.S., the implementation of a policy where mostly everyone is expected to be better off is deemed necessary. 


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