Messaging, medicine, and obamacare

Abstract

By sheer size and scope, the Affordable Care Act is the most sweeping piece of social policy legislation enacted since the creation of Medicare and Medicaid in the 1960s. It aimed to refashion nearly one-fifth of the US economy and touches every man, woman, and child. In short, it is complicated and personal. The fate of such fundamental reform often rests in the hands of a fickle electorate. And the ACA is no exception. For the law to succeed, tens of millions of Americans must join new insurance marketplaces known as exchanges, the health sector must shift to new delivery and payment models, businesses must offer workers insurance or pay a penalty, and state officials must help facilitate many of the changes envisioned in the law. During nearly 2 years of debate, public attitudes on the ACA have risen and fallen-and that will surely continue for many years to come.