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The Obama Center in Jackson Park, Chicago, is a 20 acre complex opening on June 19, 2026, built by Todd Williams Billie Tsien Architects. The Obamas chose land that was once use for the World Columbian Exposition World Fair. Using public space was controversial, made up for by a new branch of the Chicago Public Library, a basketball court and playgrounds. The most controversial part is the Obamalisk (obelisk type) tower which is as dour as one can get. One of Obama's speeches with letters on the tower top the architect says is not legible, but thats just fine he says, as if it is empty rhetoric. Or as Kennicott says just rhetoric, ornament, did all those words 17 years back really matter or were they merely oratorical good vibes. So much has happened since then that Kennicott rightly looks at the new Obama Tower with skepticism of what Obama ever accomplished. In healthcare the Obamacare plan is now not working or being replaced. Obama continued the wars Bush started, were they really that different.  At every turn from the entry there are questions like this. At the entry itself with the Declaration of Independence there is a display of unequal treatment, questioning the very experiment of Jefferson, Washington, by placing their formative ideas for a new society that had already been born in Britain with the abolition of slavery in 1772 with Somerset vs Stewart. Ben Franklin forming the Abolition of Slavery Society in Pennsylvania as early as 1775 and becoming its president in 1787. None of the founders get any credit for envisioning a different society, than they had to live in, and which even Abe Lincoln struggled with from 1850's till the Emancipation as way to win the Civil War. The entry to the Smithsonian has done the same. Yet it is this same document the Declaration which says "All men are created equal and they are endowed by their creator with some inalienable rights, life liberty and the pursuit of happiness,"  that has inspired  and given new hope to hundreds of millions of Chinese and Indians, Africans, and other Asians by 1900 and 1950, the vast majority of people on the planet. Philip Kennicott of the Washington Post asks the questions over and over in this report-  was America sleeping when it should have been alert? Lighthizer and Jamieson says this on this page that 5 million jobs were lost, economic growth was down by 1% to 2% instead of 3% of the period 1960-2000, and $20 trillion in America's wealth transferred overseas by the combination of Bush-Obama in the 2000-2020 period, manufacturing decimated, wages stagnant, America's working class communities destroyed, all the while this high minded rhetoric went on. As Kennicott says the period of rhetoric and oratory is gone, in the past, the presidency merely decades of decadence of America's elites as Marco Rubio says in a new book. ...

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Obamacare and other similar efforts were never the solution needed to a broken healthcare system in the US, and acted with a mere band aid patching up effort not getting at the root causes for the breakdown in the healthcare system in the US. Pharmaceutical companies act with impunity in the US to price medicine in ways that are inimical to the lives of the people of the US. This is true also of other companies in the healthcare system in delivery of insurance plans and delivery of medical services.

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U.S. Senator Ben Sasse suggests an alternative approach of simply repealing the Affordable Care Act called Obamacare and replacing it at a later date. This is endorsed by president Trump. This is the new Republican strategy in July 2017. Forty nine senators voted in favor of this repeal in 2015, when president Obama vetoed this legislation. Two more senators are expected to support repeal according to Ben Sasse.

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This article by Horowitz in the NYT shows some of the criticism leveled against the Clintons and how they were out of touch with the white working class voters who have drifted to Mr. Trump.  It may be overdone in that not all white working class voters have drifted to Trump, and a Gallup survey has shown Trump supporters to be some white working class but also many from other groups in society, and many older less educated voters.  Trade Unions have played a large role in this election, and workers in manufacturing have voted Democratic in midwestern states such as Wisconsin, Michigan and Illinois. Horowitz also ignores some points in this campaign such as when Bill Clinton was adept at openly stating that he agreed with people who said Obamacare had increased premiums, and that some of the Obamacare program needed to be fixed. This took some of the criticism of Republicans on Obamacare and turned this around. He also showed a better understanding at times of the plight of working class people just from his habit of listening and thinking about how this affects ordinary people, a skill he has even to this day. A 2014 NBC/WSJ poll showed Bill Clinton with a 56 percent favorability rating, which is higher than president Obama, and exceeded only by Michelle Obama at 64 percent. ...

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The Affordable Care Act or Obamacare gave families of 4 with incomes of less than 125,000 or single income less than $60,000 a chance to buy insurance with federal subsidies. When these subsidies were increased under the IRA Act of president Biden the enrolment has doubled in the last 5 years to $24 million. These subsidies expire in 2025. Under the One Big Beautiful Act the policy of subsidies for ACA is not being renewed when it expires in 2025. This shows the band aid approach of Obama to healthcare and the lack of a comprehensive approach. The policy on migrants during the Obama and Biden administration also stretched public funding resources. Insurance companies now plant to make up for the los of subsidies from the government by raising prices for this subpopulation in a broken healthcare system in the US by 15-20%. This report in WSJ shows a young woman on ACA insurance in Illinois with a payment of $590 a month to Blue Cross of Illinois facing a new payment of $678, almost the size of a mortgage. ...

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WSJ Analysis of $1 trillion Medicaid Cuts in the One Big Beautiful Act-who it impacts most. It means less money for insurers, hospitals, and 9 million able bodied Medicaid recipients being moved to being covered by new employers. Under extension of Obamacare able bodied Americans were added to Medicaid in some of the states. Some states such as Texas and Florida and other southern states decided not to do this. The One Big Beautiful Act removes this extension of Obama care and the funding to states and adds the able bodied requirement to cut funding by about $1 trillion. Insurance companies who covered the insured and got payments from the federal government will lose these payments. Hospitals will also lose these payments from the federal government that sent money to the states for funding Medicaid. Overall Medicaid funding is proportionally cut more in Republican states. In Arizona, Kentucky and Virginia Medicaid cuts will be 18%, compared to 9% in New York and 13% in California. 93% of the cuts are in states that have expanded Medicaid to include able bodied adults. The Big Beautiful Act also cuts down on provider taxes which hospitals used to get more funding. Rural hospitals are given access to a $50 billion fund in the Act  so they can be kept open. ...

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Elizabeth Rosenthal looks at Obamacare's contribution to cost containment in 2013-2014. Rosenthal says its is a kind of delicate maneuvring at the edges, because serious work needs to be done. The fee-for-service and many of the drivers for increases in medical costs, the old system of pricing, are still in place. In 20 years at the current rate and after Obamacare health care will still take 25% of the U.S. budget if nothing is done. Healthcare costs are about half that of the U.S. in some of the advanced European countries. She calls Obamacare a trickle down theory of cost containment becaue it leaves most of the drivers for cost increase in place and works at the margins. Princeton economist Uwe Reinhardt calls it an ugly patch on a somewhat ugly system. Rosenthal cites the armies of consultants anticipating every move to reduce prices, and working on "strategic billing'' to increase revenues for hospitals and doctors. For those who say the prices are now up more slowly than in the past, Michael Chernew of the Harvard Medical School, has this to say- its like a diet, reminding us that that we haven't even lost weight, just gaining weight slower than before. ...

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This Economist magazine editorial says the Republican plan for health care with its roll back of Medicaid expansion by limiting funding to states after 2020, and by scaling back subsidies especially for older Americans and not basing them on income levels, is likely to have its own problems just as the Affordable Care Act. One concern is that keeping healthy people in the market with a mandate that everyone have insurance is present but in a milder form with premiums going up by 30% in one year if they change their mind. There is concern that this may not work among insurers leading to an increase in premiums, pricing people out of the market in "a death spiral." This could lead to more people being priced out of the market as premiums rise. About 12 million people were added to Medicaid by increasing eligibility level to $16400, or 138% of poverty line- this reduced the uninsured from 16% in 2010 to 8.8% today. The Economist concludes that the Republican health care bill has its own problems, and that this bill does not clear up the problems in Obamacare by substituting Ryancare as the Republican bill is called. Peggy Noonan writing in the WSJ says this may have negative consequences for the new Republican base shift to populist support. Critics on the right like Rand Paul see even the reduced subsidies as an entitlement program, yet the Republicans can only change parts of the Affordable Care Act as they need 60 votes in the Senate where they only have a small majority.   ...

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Obama ACA subsidies to go directly to the people through Health Savings Accounts proposed by Republican Senators Graham, Scott and Cassidy in 2017, and again in 2025, and not to Insurance companies. In a post on his social media site DJT tells Congress that the ACA subsidies given directly to people rather than money sucking insurance companies would lead to a better result of people getting their own and better coverage for less money than under Obama type subsidies sent to insurance companies.  Much of Obamacare was done under a campaign from insurance companies and other health vested interests that undermined the original objectives so that however good the original objectives the watered down, disincentivising of reducing unproductive costs, led to a hotch potch band aid result. A common sense approach with the courage to get the right result that works for the people of the Nation to get good health care similar to Japan and other nations in Europe at reasonable cost is not a goal that an advanced nation like the US should see as unreachable or beyond our efforts, skills and wisdom. Obama and Bush failed, Bush in a major error to remove the negotiating power of government Medicare agency with pharmaceutical companies that Democrats failed to push back. ...

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Former Senator Jim DeMint lays out his reasoning for the Republican fight to defund ObamaCare, as the healthcare legislation is now called by Republicans. He points to problems with the legislation with issues about how much the added entitlements will cost in the future( more than the $250 billion by 2023 estimate of CBO insists DeMint based on the general lowballing of projections), and higher premiums for the young and elderly on exchanges. He says the 2012 elections were fought on economic issues not ObamaCare, and that the public he has met in visits to different states as president of the Heritage Foundation continues to be skeptical about ObamaCare. He sees the correct role of the Opposition party to point out the deficiencies in the law and call for corrections in the path for healthcare.

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The Washington Post survey of 1200 readers on how the Republican healthcare plan of Speaker Ryan and the House of Representatives looks to them, how it affects them in their lives. Here Somasekhar of the Post gives the stories of 5 Americans. Some see the prospect of losing their insurance under the Republican plan even as they reach an older age, others a smaller segment says the Post, whose premiums jumped under the Affordable Care Act say they faced high premiums and high deductibles. The Post says the large majority of opinions have expressed anxiety over the proposed Republican Ryan House plan for healthcare. One of them is an uninsured poor farmer, Mr. Woosley,  income about $18000 who gained benefit from expanded Medicaid under the Affordable Care Act,  one Mr. Smith, 32 years, a personal injury attorney who faces paying $10,000 if he did not take insurance and $10,000 if he took insurance because of high premiums so a wash either way deciding to do without it, one a tech worker Mrs. Powers, 62 years, income $22,000 on year and $4000 the next, from middle class during the tech boom but facing fewer opportunities and uncertain income from part time work, hit by the deep recession facing fewer opportunities as she gets older and now the prospect of losing insurance without government subsidies, one who is from the middle class who sees little benefit from the Affordable Care Act and is forgoing insurance because of the high premiums yet faces a penalty for not being insured under the ACA, another Mr. Blanchard, 52 years, is from the middle class, a computer programmer who lost his job in downsizing, earns $100,000 as a consultant self-employed, pays $767 in premium a month and relies on the Affordable Care Act which helps him gain freedom from working at a company that could downsize,  another is a middle class programmer Mr Riffle,age 44, and his wife, who does not qualify for a subsidy with a $71,000 family salary from working 4 jobs between himself and his wife- this person finds it too expensive for his salary to buy insurance $900 a month and $14,000 deductible under the Affordable Care Act. His views are worth listening to as they go to the crux of the problem- he says he may not be any better with the Republican plan. He sees the real problem as the high cost of health care in the U.S. and the only way this can be fixed is for members of Congress to be asked to use the insurance exchanges they create. If this sample is representative it shows that there are real problems with both the Affordable Care Act and the Republican plan, that the high cost of health care the problem lurking behind every plan that does not squarely address this, and till that happens and members of Congress experience what ordinary people face, this problem can never by fully solved.   Woosley, Smith, Powers, Blanchard, Riffle, and their personal experience is at the crux of what is right and wrong  with the Affordable Care Act, and also with the new Republican plan of Speaker Ryan and the House of Representatives. For every Woosley, Powers and Blanchard who benefit, there is a Smith and a Riffle who are indifferent or are affected by the high cost under Affordable Care Act and the current system of medical care with its high cost. The Affordable Care Act does not  tackle high cost, for that to happen the culture in America that makes it possible and acceptable to charge high prices must change. Another problem apart from bringing health care costs is that any solution needs to have the whole country behind it. If the notion that all people are entitled to basic health care is to stand, the whole country needs to believe it as they do in countries like France, Britain, Germany and Japan. If this has to be made a workable proposition health care has to be offered at a price that makes this possible to achieve, and that idea also needs the deep and broad sense of support from the culture in America similar to that in these other countries. Until that happens politicians in America will get elected and turned out of office in turns on issues such as health care, based on which side they take and which problems they choose not to face squarely and responsibly. ...

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Health insurance premiums for family plans increased by 9% in 2011 according to a survey by Kaiser Family Foundation. A similiar survey by Mercer showed premium increases around 6%. Another change is that health insurance plans are becoming less comprehensive and deductibles are higher, with higher copays and employees contributing more to premiums.

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The distrust in negotiations between Republicans Boehner, Ryan, Cantor and Democrats Reid, Obama, and Pelosi, during the weeks in October 2013 preceding the reopening of U.S. government after the shutdown. Republicans call attention to the rising deficit from $4.9 trillion in 1993 compared to $16.7 trillion in 2013, triple the increase in the deficit in just one decade compared to the five decades prior to this period. Democrats say sharp spending cuts would hurt economic growth and the unemployed.

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Serious problem of rapid premium increases for middle class people not eligible for subsidies under the Affordable Care Act. Insurance companies have increased premiums rapidly to pay for the cost of treating people with previous conditions and the uninsured, as well as population with poor health conditions.

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A advisor to U.S. president Obama lists the gains in U.S. healthcare made by March 2014, after the passing of the Affordable Care Act or Obama healthcare law. He cites on access to care the reduction of the percentage of uninsured Americans from 18% in the middle of 2013 to 15.9% in the first quarter of 2014, according to a Gallup poll.

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This article in the NYT provides a look at the features of the Republican House Health Care Plan- Both the Affordable Health Care Act and the House Plan provide incentives for buying insurance- the ACA bases these incentives on income levels whereas the House Plan does not provide additional help for low incomes or elderly. Incomes at $20,000 would see a loss greater than  $2000 under the House Plan and as many of the elderly poor living in high cost areas may not have the resources to make up for this loss of subisidies they may forgo buying insurance or have insurance coverage that protects only in a limited way. President Trump has given assurances that all will be covered. For people with incomes of $50,000 or $75000 the loss of $2000 subisidies would also have some impact. At larger incomes or the well to do the subsidies are not handed out under either plan. Under the ACA the emphasis was on income levels and high cost insurance areas the subsidies were greater, under the House Plan the subisidies would be higher for the elderly compared to the young but very low income levels are not given additional help.     ...