Dying for Dollars: Health Equity in the Age of Reform

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act ( ACA ) into law. Almost instantly, fourteen state attorneys general joined together to file suit to challenge ACA in federal courts in Virginia and Florida. These states took action amid widespread political rhetoric that condemned Congress for shattering its constitutional limits by invading citizens\u27 private decisions to purchase health insurance. Few political trends are as divisive as the changing role of government in private health care coverage decisions. Yet, the American debate continues to be distracted by marketplace rhetoric. This Comment argues that the American preoccupation with the business of health thwarts meaningful exploration of health equity. By challenging the process of health care financing and administration rather than focusing on more systemic forces in society, current health care reform ignores the most influential factors in health, such as preexisting socioeconomic differentials and basic social conditions. This Comment will extricate ACA’s regulatory outcomes from the politics surrounding it, offering comparisons with European health systems and urging policymakers to implement incremental, multisectoral advancements toward better health in the American body politic