A thorough overview of the 2010 Patient Protection and Affordable Care Act, aka Obamacare, in its later years.
Williams (Compromised, 2015), a former three-term Washington state representative and a former deputy insurance commissioner, follows up on his debut effort, which charted the initial passage of Obamacare. Here, he offers an intelligent and thought-provoking examination of the health care legislation’s strategic implementation as well as its obstacles, including repeal efforts. The book focuses on the period from 2009 to 2017, winding through the act’s serpentine specifics. Along the way, Williams looks at the collective history of four presidential administrations and their advocacy for health care reform. He also stresses that the dismantling of the act has already begun, as opposing Republican legislators, as well as the Trump administration, continue to search for misinterpretations, workarounds, and loopholes; the 2017 GOP tax bill repealed the act’s individual insurance mandate starting in 2019. Readers who remain baffled by its complexities will appreciate the author’s plainspoken, thoughtful analysis, replete with descriptions of the varied tiers of coverage and benefits packages, and walk-throughs to help readers understand how things could radically change. Some chapters solely address dizzying political challenges or such vexing issues as prescription pricing, while others focus on the specific pitfalls of state-based exchanges, Medicaid expansion, and abortion coverage. Some of these sections could prove to be too dryly academic and technical for readers hoping for lay interpretations. Even so, Williams’ report is astute and relevant throughout, as he highlights the debate between those eager to preserve Obama’s legacy and those who support President Donald Trump, who has insisted that a reformed health care program will more efficiently serve the American people. Finally, the author opines on the future of the act amid a labyrinth of bureaucracy, insurer dominance, and political dissension.
Another volume of adroit, unclouded analysis.