日本では国民皆保険制度が導入されているので皆保険制度を当たり前のものと思うかもしれません。しかし、2010年3月にオバマ大統領が署名した医療保険制度改革法のPatient Protection and Affordable Care Act（通称オバマケア）は、米国の社会立法において画期的なものでした。最高裁による支持判決を経て、同法が米国の法律として存続することが確実となったことで、他の先進国と同じように健康保険をほぼすべての米国人に拡大し、急増する医療費を抑制し、これによって何百万人という貧しい人々が新たな恩恵を受けることになりました。
党派の対立や激しいロビー活動が行われる中で、どのようにしてこのような大胆な改革が可決されたのでしょうか。政治と医療政策に関する米国有数の専門家であるローレンス・Ｒ・ジェイコブズとシーダ・スコチポルが執筆する本書は、2009年と2010年の政治闘争について、ホワイトハウスの戦略、民主党が利益団体と結んだ取引、ティー・パーティーや進歩的な人々の扇動が及ぼした影響などに焦点を当てながら、米国の医療保険制度改革と政治について簡潔でわかりやすい概要を提供します。改訂第3版には新しい章を追加し、この法律を支持した最高裁判決の影響も分析しています。改革の実施をめぐっては、舞台裏でしばしば戦いが繰り広げられています。最高裁の判決にもかかわらず、オバマケアは州レベルでは依然として難題に直面しています。そうした中での今後についても展望します。
   

• Explains how health care reform will affect all groups of Americans, from rich to poor
• Concise, authoritative and dramatic account of how health care reform came to pass and the politics behind the bill
• Details how it will improve America's health care system and improve health care for ordinary Americans
• Authored by two of the nation's leading scholars of American politics
• Includes a powerful final chapter on whether the new law will be repealed or watered down in coming years

New to this Edition:

• Updated to cover the 2015 King v. Burwell Decision
• Checks in five years after passage of the ACA to see how health care reform's performance is matching up to its aims
• Shows that Medicare Advantage plans have remained affordable for seniors despite doomsday predictions of rising premiums
• Provides new analysis of the ACA's funding, which represents the most progressive tax reform in decades

 
The Patient Protection and Affordable Care Act signed by President Obama in March 2010 is a landmark in U.S. social legislation, and the Supreme Court's recent decision upholding the Act has ensured that it will remain the law of the land. The new law extends health insurance to nearly all Americans, fulfilling a century-long quest and bringing the United States to parity with other industrial nations. Affordable Care aims to control rapidly rising health care costs and promises to make the United States more equal, reversing four decades of rising disparities between the very rich and everyone else. Millions of people of modest means will gain new benefits and protections from insurance company abuses - and the tab will be paid by privileged corporations and the very rich. 
　　　
How did such a bold reform effort pass in a polity wracked by partisan divisions and intense lobbying by special interests? What does Affordable Care mean - and what comes next? In this updated edition of Health Care Reform and American Politics: What Everyone Needs to Know®, Lawrence R. Jacobs and Theda Skocpol - two of the nation's leading experts on politics and health care policy - provide a concise and accessible overview. They explain the political battles of 2009 and 2010, highlighting White House strategies, the deals Democrats cut with interest groups, and the impact of agitation by Tea Partiers and progressives. Jacobs and Skocpol spell out what the new law can do for everyday Americans, what it will cost, and who will pay. In a new section, they also analyze the impact the Supreme Court ruling that upheld the law. Above all, they explain what comes next, as critical yet often behind-the-scenes battles rage over implementing reform nationally and in the fifty states. Affordable Care still faces challenges at the state level despite the Court ruling. But, like Social Security and Medicare, it could also gain strength and popularity as the majority of Americans learn what it can do for them.