President Obama made history this week as the first U.S. president to publish an academic paper.
Published in the Journal of the American Medical Association (JAMA), Obama’s piece focused on his signature achievement in the White House: the Affordable Care Act. In his piece, the president noted that the Affordable Care Act had “made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care.”
While most articles in JAMA are peer-reviewed, the president’s submission did not go through that formal process. Instead, according to Bloomberg, the journal’s editors “reviewed and critiqued the article,” as well as fact checked its claims.
Officially dubbed a “Special Communication” with the JAMA readership, commentators took particular delight that the piece follows all the conventions for a scholarly article. For instance, the address the President wrote on the paper is “Barack Obama, JD, The White House, 1600 Pennsylvania Ave NW, Washington, DC 20500.”
As his term draws to its January 2017 conclusion, Obama has spoken out strongly in defense of the health care law. Reforming America’s health care system to cover more adults and reduce costs to consumers and the government was one of the president’s major talking points on the campaign trail in 2008.
Congressional debate on the health care law was contentious, but Democrats delivered the Affordable Care Act to the president’s desk in early 2010. In November of that year, Democrats were pummeled at the ballot box and the president’s party has not had a majority in the U.S. House of Representatives since.
That has left the president in a position of implementing the Affordable Care Act even as many in Congress seek to repeal the law or dramatically alter its most significant parts. Obama has faced considerable criticism over the law’s roll out, particularly the difficult debut for Healthcare.gov, the online health insurance exchange.
In his JAMA piece, however, the President sung the praises of the healthcare law. He noted the dramatic decline in the rate of Americans who are uninsured, which fell from 16 percent in 2010 to 9.1 percent in 2015.
“Early evidence indicates that expanded coverage is improving access to treatment, financial security, and health for the newly insured,” Obama wrote.
Countering Republican critics who claim that the Affordable Care Act resulted in higher prices for insurance, Obama also notes how the law has “greatly improved health insurance coverage for people who already had it.”
The president also highlights how Americans with pre-existing conditions can no longer be denied health insurance. Another major selling point in the piece is that all Americans — even those insured before the Affordable Care Act took effect — have access to more coverage without co-pays and out-of-pocket costs.
While the law has led to dramatic coverage gains, some critics have accused the president of doing little or nothing to rein in fast growth in health care costs. Responding to these complaints, Obama writes, “Trends in health care costs and quality under the ACA have been promising.”
Perhaps mindful that his time in the White House is drawing to a close, the president offered many suggestions on how to improve the law. Two proposals that have drawn the most buzz are a “public option” in health insurance plans, something that was rejected during the Congressional debate over the Affordable Care Act, and robust help for people who still struggle with high prescription drug costs.
The presidential candidates seem to have taken note. Hillary Clinton has endorsed a public option, while Donald Trump renewed his calls to completely repeal the Affordable Care Act.