Home Institution

Whitman College

Publication Date

Spring 2012

Program Name

Switzerland: Global Health and Development Policy


Background: Low-income populations live shorter and less healthy lives in the United States due to a complexity of social, environmental and behavioral factors. These populations also face significant barriers in accessing health services. In 2010, the Patient Protection and Affordable Care Act (PPACA) passed, marking the first major reform of the American healthcare system since the 1960s. This paper evaluates its potential to address health disparities through changes to medical care delivery. Methodology: Results were compiled from government documents, reports from research institutes, journal articles, and an expert interview. A section-analysis was also performed, evaluating the strengths and weaknesses of the Affordable Care Act in addressing the needs of low income populations. Findings: The PPACA includes extensive provisions to amend income-related barriers to care. These include expanded access to federal insurance coverage, subsidized cost-sharing for low-income brackets, elimination of payments for specific preventive services, and investment in infrastructure. Weaknesses not addressed include the high cost of medical care, disparities in quality and availability of care between the federally and privately insured, and access to care for immigrants. Conclusion: The PPACA will expand access to and reduce the cost of preventive care. However, these improvements do not address structural deficiencies of the US healthcare system that are root causes of income-related health disparities. True reform requires integration of the multiple-payer model to ensure equitable availability and quality of basic care, tougher measures to control costs, and coverage that includes migrants.


Community Health and Preventive Medicine | Family, Life Course, and Society | Health Services Research | Inequality and Stratification | Medicine and Health | Politics and Social Change | Public Health