The Effect of a Dynamic U.S. Political Landscape on the Access and Affordability of American Healthcare

Written By Saad Zulqurnain on February 22, 2023


The modern world has made many strides in healthcare since the beginning of time – from the natural healing of the Neolithic Age to the worldwide replication of Prussia’s 1883 mass healthcare coverage initiative. Among the more advanced nations with well-established systems of governance, the policies of lawmakers in terms of healthcare aim to increase life expectancy while their citizens conduct business. (Asakitikpi, 2016, p. 29) But in a nation as diverse as the United States, the communication and interactions of business in the industry have led to the proliferation of both radical and conservative theories of governance, which elected officials – mainly in Congress – have incorporated when legislation, especially in healthcare.


Many nations of immense presence on the global stage have come to a myriad of crossroads over competing claims from within their own borders. Politics and leading interests greatly shape each or many competing claims to deliver a compromise that best serves the people of each nation. Immense research from a diversity of sources has been undertaken to examine how political interests affect the dynamic healthcare landscape. As has become a noticeable trend in U.S. politics, each policy is initially met with rife applause, followed by the opposition and ultimately either passed into law or struck down by our representatives. The effects of three such pieces of legislation dealing with healthcare having gone through said trend will be the subject of focus in this research paper.

The Advent of Medicaid

The Second World War and its events served as a means for the world to see the United States for what it truly stands for – a nation that wishes to spread peace and serve solutions where it may find turmoil and dismay. In 1965, applying principles from their foreign policy, Congress passed Medicaid to ease the tension at home surrounding access to healthcare. Though the U.S. was one of the few nations to not suffer physical damage – unlike air-raided Nazi Germany and Italy – its citizens also packed their bags and moved around the nation in search of better jobs with adequate benefits to support their families. Because the people entrusted the federal government to lead the war effort, it also assumed the initiative in ensuring healthcare for the needy and underprivileged (Grogan et al., 2017, p. 752). Although the best healthcare was still only available to the ultra-wealthy and privileged classes, Medicaid introduced the perception of healthcare as a basic right, regardless of one’s social status.

The Political Fret of Obamacare

At the turn of the 21st-century, despite repeated appeals and political movements, healthcare was overwhelmingly controlled by those of immense wealth – in the United States, “those of immense wealth” would imply insurance companies. Using the free market as their excuse, insurance companies heightened their premiums and copays to maximize profits from private enterprises purchasing insurance plans for their employees. (Larson and Muller, 2002, p. 266) There was also the federal government that provided healthcare to the elderly and poor through Medicare and Medicaid. The middle class – not of immense wealth or qualifying for government subsidies – was left with ever-rising healthcare costs and bills that needed to be paid off for them to remain insured. According to Lenzer of the British Medical Journal, the Affordable Care Act of 2010, or simply Obamacare, served as a gateway for 33 million Americans to receive access to quality healthcare at an affordable price that they would otherwise be unable to afford from underpaying jobs. However, Obamacare as passed into law was not the original idea of American Democrats, who wished it to resemble the Europeans’ healthcare for all system. Because of competing claims from insurance companies, politicians, and underprivileged citizens, a significant number of Americans remain uninsured as healthcare could not be recognized as a charity but as a business. (Phadke, 2011, p. 16) Obamacare, as with every piece of legislation, is a compromise between the interests of those with money and those seeking service – a recurring theme of 21st-century politics.

The Trump Administration and Conservative Governance

A leading claim as to why modern Republicans do not see eye-to-eye with the Medicaid advocates in 1965 is the entanglement of corporate interests in government. According to Page, President Trump and his supporters need to see the private sector, or the pharmaceutical industry in this case, undergo prosperity as corporate interests are a cornerstone of the Republican party platform. Because the Affordable Care Act was perceived as a government “handout,” or an unearned and freely given government subsidy, the Trump administration brought forth a lawsuit in late-2020 to strike down the policy and decentralize healthcare in America, returning control of United States healthcare back to private enterprise. (Lueck, 2020, pp. 1–2) The opinion of the most current Republican platform – which has amassed the support of tens of millions of Americans – shows just how polarized and ununified Americans’ opinion over healthcare access has become.


Early attempts in establishing a centralized government throughout the world have always been a subject of intense negotiation among popular, competing claims. Although humans have overcome such a trivial task, replications of such turmoil have pitted citizens against their brethren in hopes of winning out in life-altering policy-making. This research paper has thoroughly examined this phenomenon in the shift of Americans’ unified opinion to insure as many as possible to a polarized political landscape where the well-being of citizens hangs in the balance of a hot button among corporate interests, profits, access, and affordability.


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in Nigeria. Africa Development / Afrique et  Développement, 41(4), 29–45.

GROGAN, C. M., & PARK, S. (ETHAN). (2017). The Politics of Medicaid: Most Americans Are Connected to the Program, Support Its Expansion, and Do Not View It as Stigmatizing. The Milbank Quarterly, 95(4), 749–782.

LARSON, J. S., & MULLER, A. (2002). MANAGING THE QUALITY OF HEALTH CARE. Journal of Health and Human Services Administration, 25(3), 261–280.

Lueck, S. (2020). Eliminating Federal Protections for People with Health Conditions Would Mean Return to Dysfunctional Pre-ACA Individual Market. Center on Budget and Policy Priorities. 


Lenzer, J. (2014). One year into Obamacare: where is it now? BMJ: British Medical Journal, 349. /stable/26518969

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PHADKE, A. (2011). Planning Healthcare for All? Economic and Political Weekly, 46(21), 15–18.