The United States healthcare system is so broken, sometimes I forget that it used to be even worse. After all, 15 short years ago, pregnant people could legally be denied health insurance, just for being pregnant. Cancer, diabetes, epilepsy, Alzheimer’s, arthritis, mental illness, AIDS — all potentially disqualifying conditions, too. Or, if your health care plan did offer coverage, it might charge you an exorbitant premium based on your preexisting conditions alone. In 2009, health care was a rogue landscape of private insurers prioritizing profit above all else while making arbitrary calls over life-or-death issues for their customers.

Okay, so maybe that last point hasn’t changed too much. But when Barack Obama signed the Affordable Care Act (ACA) into law in March 2010, it undeniably expanded crucial access to health care for millions of people. In 2024, less than 9 percent of people in the U.S. are uninsured, compared to nearly 17 percent in 2009. In addition to banning private insurers from discriminating based on preexisting conditions, the ACA expanded eligibility for Medicaid coverage, introduced new health insurance subsidies and extended dependent child coverage up to age 26. (I happen to be a 1998 baby, so the impact of that last reform was felt particularly acutely by my social circle this year.)

These are worthwhile wins, but from the moment the ACA was enacted, it has suffered a crisis of dual identity. When news headlines began calling the legislation “Obamacare,” Republican detractors saw their moment to seize the term; they’ve brandished it ever since to make the ACA out as an example of Democratic overreach and liberal government run amok. Obama will forever be the face of the health care legislation he championed, in all its wins and failures, even years after his second term ended.

This is a problem. And the re-election of Donald Trump as president proves why.

This past week, a spate of viral TikTok videos have mocked posts by people who claim to have voted for Trump, without knowing that his pledge to repeal Obamacare actually means ending the Affordable Care Act. Users cite the video of one Trump voter, who supposedly said he hadn’t realized the ACA’s protections for preexisting conditions are what allowed his mother with stage 4 cancer to obtain insurance coverage.

References to these posts have circulated extensively across social media, but I haven’t been able to track down the original posts themselves. Still, it wouldn’t be outside the realm of possibility, and it taps into a very real phenomenon. In a 2017 poll, more than a third of Americans said they didn’t know that Obamacare and the Affordable Care Act were the same thing. In a different survey released this year, more than 60........

© Truthout