Even though the ACA and healthcare is not a “hot button” issue this week, it is still a crucial issue that we must continue to think about for the ones that will come after us. This is an issue that will literally impact our lives and longevity of life. Let’s not let time, space, and the game of polices allow us to forget what will impact youth for decades to come.  To understand why the Affordable Care Act became a crucial issue in the last few years, we must go back to the 2008 elections and explore the state of healthcare at the time.

The American Public Health Association wrote a report on critical state of healthcare. The report highlighted some of the reasons why health care reform was “critically needed” in the United States. The report listed things like, the lack of healthcare coverage for millions of people, the unsustainable spending on healthcare, poor health outcomes, an over emphasis on treatment instead of prevention, and health disparities among multiple populations. The report states that In July 2012, “the Congressional Budget Office estimated that 55 million Americans under the age of 65 are currently uninsured; representing 1 out of 5 in that population. Most of the uninsured go without health coverage because they cannot afford it, and they would purchase it if they could. I think that the fact that we must deal with private insurance companies to access one of the most precious qualities (access to life and health) reveals a inadequacy entrenched in our democracy,  as millions of people—even under Obamacare— are still without any form of health insurance coverage and 102 million have insufficient coverage.

The dire landscape of healthcare and increasingly high cost is what re-catapulted this issue into national debate, nearly two decades after President Clinton failed to pass any comprehensive policies around the same issue. So after President Obama was elected into office, one of his first major tests would be to see if he could push a substantive healthcare act through the congressional maze. The bill passed in the Senate with a 60-39 vote on December 24, 2009. On March 21, 2010 the bill was passed by the house will a seven-vote difference (219-212). The process of passing the bill and the close numbers of those who supported and did not support the bill offers several curiosities. Why did all 178 republican and all 40 senators either not vote or vote nay on the passage of the bill? What made 34 democrats vote against it? Why did republicans introduce legislation to repeal the bill the very next day? And why did this bill go to the Supreme Court? And possibly most important in the lens of a class-based approach, why did Obama never even try to get universal healthcare on the agenda?

When looking at various policies throughout history that have been brought about by grassroots organizing and mobilization, it is far too common to see the government offer some form concession which leads to social benefits for the larger society. This idea remains true when looking at the ACA. However to fully understand how a class-based approach to policy operates we need not look much further than the ACA.  President Obama never even attempted to pass Universal Health Care and even in the scope of all the controversy with the ACA, the entire bill still upholds a capitalistic structure of our society. The core concern is the neo-liberal paradigm that leads to privatization of the funding and organization of medical care. Specifically referring to most of the funds for healthcare access being collected and administered by private insurance companies.  Even though the Obama healthcare reform did move us forward we must take a critical look at the shape of the reform that got passed. The ACA did not alter the privatized nature of reform and profit making is still the priority. It seems as though even when social welfare reforms are successful, the private companies still benefit the most.

Eventually, we have to challenge this system, if not for us, for the ones that will be left with a broken system, The ones that will come after us.