Speaking at the School of Public Health Thursday, Lawrence Jacobs, director of the University of Minnesota’s Center for the Study of Politics and Governance, discussed the implementation of one of the most contentious pieces of U.S healthcare legislation in the last few years — the Patient Protection and Affordable Care Act.
Passed in 2009, the ACA enacted several significant changes to the U.S healthcare system. The policy mandates that everyone purchase health insurance, raises requirements for businesses to provide health insurance and removes insurance companies’ ability to deny coverage based on pre-existing conditions.
The law has faced a considerable amount of opposition, particularly from members of the Republican Party, who have sought to appeal or defund it in Congress over 50 times. Its legality has also been challenged in several Supreme Court cases.
About 25 University students and professors attended Jacob’s hour and a half lecture Thursday, which also included a question and answer session.
During his presentation, Jacobs highlighted data from the Scholars Strategy Network, which focused on several aspects of the ACA, including public opinion and awareness of the law and the effects of the new policy on institutions and interest groups.
He said while there is opposition to the idea of the ACA as a whole, data shows that many individuals, including an estimated 40 percent of Republicans, support the specific reforms it prescribes.
“When you talk about specific features of the ACA, like extension of coverage for parents who have insurance to their children under 26, so-called under 26-ers, 80 percent support overall,” he said. “And when you look at this among within the party, you find about 70 percent of Republicans supporting it.”
Jacobs also discussed several specific groups that have been opposed to the ACA, most notably businesses. Companies across the country have expressed concerns that additional costs from the law will be passed on to them.
However, Jacobs said these businesses’ opposition often isn’t entirely based on empirical evidence, citing work from several other researchers including Boston University Prof. Cathie Jo Martin. Instead, he said, factions within the business community have taken sides on the legislation.
“This is just another area where I think engrained views and fears are overriding what seem to be just a very clear dollars and cents argument,” he said.
On public opinion as a whole, Jacobs said perceptions of the ACA’s key component — requiring everyone to have health care — have shifted as more people have expanded their view of social rights to include healthcare.
“This is not the kind of America of our parents — at least my parents,” Jacobs said. “These are qualitative changes I think are happening along the way. But it’s provoked, I would say, an understandable, legitimate backlash among conservatives and Republicans who say, ‘This is really different.’ You’re redefining the social contract. You’re redefining the nature of social rights and the scope of government.”
Overall, Jacobs said it was important to allow a longer time period to elapse, potentially up to 30 or 40 years, before assessing the success of major policies like the ACA. He added that he thinks that the trajectory of the ACA thus far has momentum, despite the enormous challenges and repeal efforts it has faced.
LSA junior Mira Dalal, who attended the lecture, said she agreed with Jacobs’ point that the success of the ACA is still yet to be seen.
“I think that it’s important that he mentioned that it’s very easy to categorize policies as good or bad, success or failure,” Dalal said. “Today the public really looks for a really quick explanation or characterization of how successful a policy is, but it’s not that simple. It usually takes amendments and time to actually see it happen.”
Jacobs’ presentation concluded the Robert Wood Johnson Foundation Scholars in Health Policy Research lecture series for the fall semester. The series is funded by a grant from the RWJF, and sponsors visits from academics that employ an interdisciplinary approach to health policy research through the combination of the fields of economics, political science and sociology.
There are eight more RWJF Health Policy Research lectures tentatively scheduled for the winter semester.