What is at stake in the US healthcare debate?

It has been two years since Barack Obama, the US president, signed into law an overhaul of the US healthcare system.

“We only have hypocrites on this issue in presidential elections…The American people are going to look at two flip-floppers and they are going to decide which one went from wrong to right and which one went from right to wrong.“ – Phil Kerpen, vice-president for policy at Americans for Prosperity

The Affordable Care Act will extend insurance coverage to 32 million more Americans.

After months of vitriolic debates and protests by Republicans and Democrats, Obama said the passage of this law proved that the US government – a government of the people and by the people – still works for the people.

But two years on, recent polls show that the people remain divided in their support for the law.

And Republicans have launched a renewed assault on what they refer to as “ObamaCare”.

“To be competitive with the rest of the world we need to bring down healthcare costs. We have the most expensive healthcare because we leave it to the free market, we have price gouges, we get ripped off by prescription drug companies and medical manufacturers…we need to stop this.” – Richard Kirsch, author of Fighting for Our Health Care

Republican presidential candidates Rick Santorum and Mitt Romney have both made repealing the healthcare law a central theme of their campaigns. That is despite the fact that as governor, Romney passed similar legislation in his state of Massachusetts.

Next week the US Supreme Court will scrutinise the 2010 law – and look into whether it is constitutional to require Americans to purchase health insurance.

So how will the bitter healthcare debate impact the 2012 presidential campaign? And, while the Republican candidates have vowed to repeal the law, have they come up with better alternatives?

Joining the discussion on Inside Story: US 2012 with presenter Anand Naidoo are guests: Richard Kirsch, the author of Fighting for Our Health Care and a senior fellow at the Roosevelt Institute; Phil Kerpen, the vice-president for policy at Americans for Prosperity; and Manu Raju, a senior congressional reporter for Politico.

A lot of this law has not been phased in yet…people have not seen what kind of impact it will have on them so the debate is really being shaped by both sides without folks seeing what kind of tangible benefit it will have for them. — Manu Raju, senior congressional reporter for Politico

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The Affordable Care Act:

• requires all US citizens, except the poor, to buy health insurance or pay a fine
• overhauls several parts of the US healthcare system, including making companies cover their employees
• allows children to stay on their parents’ insurance until the age of 26
• forces insurance companies to justify rate increases and prohibits them from denying clients treatment on a pre-existing medical condition
• offers tax breaks to small insurance companies
• gives coverage to uninsured retirees above the age of 55