By Steffie Woolhandler, MD, MPH, and David U. Himmelstein, MD
American Journal of Public Health, January 2017
President Obama inherited an economy in crisis, burgeoning inequality in wealth and health, and a legion of medically uninsured Americans whose ranks had grown by 11 million under the previous administration. He staunched the bleeding but provided no cures.
The Affordable Care Act (ACA; Pub L No. 111–148), Obama’s signature achievement, covered millions, but leaves 9% uncovered. It minimally regulated insurers and imposed a modest new tax on the wealthy but accelerated the corporate takeover of health care and endorsed high-deductible insurance plans that offer illusory protection. It provided $11 billion in new funds for community health centers and public health agencies but drained money from safety-net hospitals and failed to reverse the downward trend in funding for public health.
Aside from the ACA, Obama’s health record is mixed at best. He made some progress on environmental regulation, and the terrible threat of climate change has at least been acknowledged. But the yawning gap between rich and poor—in both wealth and health—has widened.