In the decade-plus since it became law, the Affordable Care Act has helped slow the explosive growth in health spending. But the United States still spends about twice as much per capita as other wealthy nations.
That leaves President Joe Biden with an enormous health care challenge, beyond leading the country out of the pandemic: curbing health care cost increases that, economists warn, are unsustainable.
The political obstacles will be enormous. Biden faces a Republican Party that has spent the past decade trying to destroy the ACA. There also is a remote possibility that the U.S. Supreme Court will scrap Obamacare when it rules on a challenge to the law mounted by GOP state attorneys general, many legal experts say. And Biden will have to overcome the resistance of powerful medical and pharmaceutical interests that oppose price constraints.
“It’s like we’re running up the down escalator,” said Michael Miller, policy director of Community Catalyst, a Boston-based organization that advocates for universal health care.
Biden already has laid out some of the ways he hopes to stem health care costs, but most would require congressional approval.
He argues that a law creating a health insurance “public option,” a government-run plan available to all working-age adults, would inject more competition into the health care marketplace, leading to lower prices. He has promised to rein in drug prices, in part by getting Congress to remove the prohibition that prevents…