1138 ★ CHAPTER 28 A New Century and New Crises
The Health Care Debate
For most of Obama’s first year in office, congressional debate revolved around
a plan to restructure the nation’s health- care system so as to provide insur-
ance coverage to the millions of Americans who lacked it, and to end abusive
practices by insurance companies, such as their refusal to cover patients with
existing illnesses. After months of increasingly bitter debate, in March 2010,
Congress passed a sweeping health- care bill that required all Americans to
purchase health insurance and most businesses to provide it to their employ-
ees. It also offered subsidies to persons of modest incomes so they could afford
insurance, and required insurance companies to accept all applicants. The
measure aroused strong partisan opposition. Claiming that it amounted to a
“government takeover” of the health- care industry (even though plans for a
government- run insurance program had been dropped from the bill), every
Republican in Congress voted against the bill.
Throughout Obama’s presidency, Republicans remained bitterly opposed
to the new law, and vowed to repeal it when they could. Indeed, in Octo-
ber 2013, in an effort to get the president to abandon the health- care law,
the Republican- dominated Congress shut down the federal government— a
tactic that, as during the Clinton administration, backfired. By 2015, what
came to be known as Obamacare proved to be a remarkably successful pol-
icy. Sixteen million uninsured Americans had obtained medical coverage
under its provisions, most of them less affluent Americans who received
some sort of government subsidy. The number of uninsured would have been
even lower except that twenty- three Republican- controlled states refused to
expand Medicaid coverage for their poorest residents, as the new law made
possible, even though nearly all the cost would have been covered by the fed-
eral government. Moreover, despite a general conservative majority on the
Supreme Court, the justices twice rejected challenges to the constitutionality
of Obamacare.
Financial Reform
Another significant measure, enacted in July 2010, was a financial regulatory
reform law that sought to place under increased federal oversight many of the
transactions that had helped create the economic crisis. Although the details
remained to be worked out through specific regulations, the law represented a
reversal of the policies of the past fifty years that had given banks a free hand
in their operations. But it did not require a breakup of banks deemed “too big
to fail,” and left open the possibility of future taxpayer bailouts of these institu-
tions. Moreover, officials responsible for issuing new regulations watered them
down when banks complained.