1 City University of New York at Hunter College, New York, NY, USA.
2 Harvard Medical School, Cambridge, MA, USA.
Int J Health Serv. 2017 Oct;47(4):612-620. doi: 10.1177/0020731417729661. Epub 2017 Sep 14.
President Obama's signature health care reform, the Affordable Care Act (ACA), was passed in 2010 and fully implemented in 2014. Two years later, Republicans' attacks on the ACA as a failed reform helped fuel their recent electoral victory. The legislation significantly expanded insurance coverage. But it was built on, and fortified, private health insurance firms, and it accelerated the corporate takeover of hospitals and physicians' practices. This obeisance to corporate interests precluded making coverage universal or care affordable. As a result, the reform failed to address the grave health care problems faced by most working- and middle-class Americans and left many of them feeling betrayed by Democrats who oversold the ACA's benefits.
奥巴马总统签署的标志性医疗改革法案，平价医疗法案（ACA），于 2010 年通过，并于 2014 年全面实施。两年后，共和党人攻击 ACA 是一项失败的改革，这有助于推动他们最近的选举胜利。该立法显著扩大了保险范围。但它是建立在私营医疗保险公司的基础上，并得到了它们的强化，同时加速了医院和医生诊所的企业接管。这种对企业利益的屈从，排除了实现普遍覆盖和负担得起的医疗保健的可能性。因此，该改革未能解决大多数工薪阶层和中产阶级美国人所面临的严重医疗保健问题，使许多人感到被民主党人出卖，因为他们夸大了 ACA 的好处。
