Cairo Review of Global Affairs   |  December 6, 2012

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Universal health coverage is increasingly recognized as a global social norm and moral imperative. With the passage of the Patient Protection and Affordable Care Act (ACA), the United States looks to join an ever-growing number of countries with universal health coverage and embraces the potential for improved access to adequate and affordable health care. Yet, because the ACA adopts America’s existing federalist framework, states and the federal government have much to do to prepare for 2014, when the ACA’s most significant reforms take effect. In this article, we identify the changes that states and the federal government must make to comply with the ACA and their progress to date in doing so. We also discuss the law’s significance in the global movement for universal health coverage and conclude that the law brings the United States one step closer to the global ethic of universal health coverage, despite uncertainty at the domestic level.

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