The Language of Health Policy: How Do We Think About Health?

How do Americans think about health and access to health care? Candidates during the 2008 Presidential Election challenged the American public to consider this question. The ensuing debate has factored prominently into our political process throughout President Obama’s time in office. My paper examines President Obama’s rhetoric during the passage of the Patient Protection and Affordable Care Act (PPACA) through the lens of a “human right to health.” The President utilized two key frameworks to discuss health reform: a financial framework and an American values and responsibilities framework, through which he presented health as a “right for every American.” Ultimately, both frameworks were necessary to pass the PPACA and are applicable to policy framing strategies and issues within and beyond recent health care reform efforts.

One such issue is the Medicaid expansion. One provision of the PPACA required states to expand their Medicaid programs in order to provide more low-income people with health insurance. This provision of the PPPACA was amongst those challenged by Florida and other states in the Supreme Court Case: the National Federation of Independent Businesses v. Sebelius. In the highly anticipated June 2012 decision, the Supreme Court ruled that it was unconstitutional for the federal government to threaten to cut state’s existing Medicaid funding if states chose not to expand their Medicaid programs. As a result of this decision, states must now choose whether or not to expand their Medicaid programs. If states decide to do so, they receive federal funding to support this expansion.

In a surprising turn of events, Florida Governor Rick Scott recently chose to expand his state’s Medicaid program, stating:

“I am committed to working every day to improve access to affordable, high-quality healthcare in Florida, while also protecting taxpayers and keeping our economy growing to create more jobs – which ultimately fuels the dreams of every Florida family” (Scott 2013).

Like President Obama, Governor Scott employed both the financial and American values and responsibilities frameworks to discuss his health policy decision.

Through my research, I analyzed President Obama’s health care reform rhetoric through the lens of human rights. My research provided insight into the political debate that culminated in the passage of the PPACA. However, I am currently exploring broader ramifications of my work. One potential implication of my research is the development of the financial and American values and responsibilities rhetorical frameworks for the discussion of health policy. Moving forward, I will examine broader applications for these frameworks, such as state decisions to accept or reject the Medicaid expansion.

Scott, Rick. “Governor Rick Scott: We Must Protect the Uninsured and Florida Taxpayers with Limited Medicaid Expansion.”

Victoria (Tori) Wilmarth
Duke University ’13

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