Document Type
White Paper
Publication Date
2026
Abstract
During each of the past three Democratic presidential administrations, health policy has been a key domestic priority. President Clinton unsuccessfully sought to pass comprehensive health reform, before settling for important incremental expansions of health insurance coverage during his second term. President Obama successfully pushed the Affordable Care Act to enactment, though perhaps at the cost of losing Congress decisively in his first midterm election. And President Biden both dealt with the health-policy consequences of the COVID emergency and enacted a major reform of the Medicare prescription drug program, including the first-ever provision for the government to negotiate prices, in the Inflation Reduction Act.
In each of these administrations, the crafters of health policy have focused on identifying tools that can ensure the broadest possible insurance coverage, while delivering high quality care at affordable cost for both consumers and the system as a whole. That focus is understandable— and, indeed, entirely salutary. The goal of health policy should be to ensure that everyone can live longer, better lives, and to do so in a sustainable way for our society. The successive reforms of the Clinton, Obama, and Biden Administrations have moved us closer to that goal— though we have a ways to go before everyone has the coverage they need.
Recommended Citation
Bagenstos, Samuel R. Entrenching Incumbent Power: Medicare Advantage, Part D, and the Politics of Health Reform. Empowering Democracy Initiative, 2026.
Comments
This is a white paper for the Empowering Democracy Initiative. © 2026 Empowering Democracy Initiative. All rights reserved.