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Jessica M. Mulligan’s chapter draws on the concepts of “dog whistle politics” and white resentment to make sense of repeated attempts to repeal the ACA and disrupt its implementation. This chapter examines the different meanings and impacts of the law for differently situated individuals and families, some of whom fell into the “coverage gap” created by red states’ decision not to expand Medicaid. She concludes that there is no shared sense of the social created through the law, which has impacted its success. Instead, people’s experience of health care reform, and potentially enhanced health care access, is mediated by a politics of resentment, eligibility, and actuarial categories, past experiences with insurance and illness, and attempts to care for loved ones.

Susan Sered, author of the seminal work Uninsured in America: Life and Death in the Land of Opportunity (2005), returned to the same communities to learn how the people she originally interviewed were faring after the implementation of the ACA. Not a single person she interviewed had remained in the same coverage status for more than a few years at a time. Even with insurance, health care was hardly affordable for many. Most important, geographically driven health disparities had been exacerbated by the 2012 U.S. Supreme Court ruling, leaving large numbers of people to fall into the “coverage gap.” The existence of these gaps, together with the inconsistent nature of coverage and the absence of a human rights ethos, created barriers and resentment, with many people feeling that other categories of people received greater benefits.

Emily K. Brunson’s chapter examines how the ACA has unfolded in Texas, a state with significant popular and political sentiment against the law despite being home to the highest percentage of uninsured persons in the nation. Presenting longitudinal case studies of three previously uninsured women—some of whom were able to access insurance coverage following the ACA and some of whom fell into the coverage gap—Brunson shows how each person struggled with issues of choice, responsibility, and risk in relation to their health care. The chapter also considers how social class and gender affected these women’s experiences of the ACA. Brunson concludes that while the ACA has improved health care access and health outcomes for some Texans, it has also deepened inequalities by increasing stratification based on social class.

Jordan has undergone a profound social security reform since 2010, primarily aiming to ensure the financial sustainability of the system over time. Using data from the 2010 and 2016 Jordan Labor Market Panel Survey (JLMPS), this chapter examines the dynamics of Jordanian workers’ access to social security and trends in early retirement incidence before and after the reform. The chapter also explores the time it takes to acquire social security coverage on the labor market before and after the reform. Our findings show that the overall incidence of social insurance coverage slightly increased in 2016, for private sector wage workers, irregular wage workers, and non-wage workers (employers and self-employed). Public sector employees were the most likely to acquire social insurance coverage at the start of their jobs, followed by the private sector wage workers inside establishments. Both men and women who started their first job after the 2010 reform experienced a decline in their probability of acquiring social insurance coverage upon their job start. Moreover, the average incidence of early retirement slightly declined among men while still being highly prevalent around ages 40–46.

During the H1N1 influenza pandemic, the Los Angeles County Department of Public Health utilized a scan based data collection system to collectvaccination datafrom Points of Dispensing (PODs). The system digitizes responses and handwritten text, extracts it and places it into a database, while keeping digital copies in an accompanying repository, which is indexed and search-ready by all fields for follow-up or VAERs reporting. The system made it possible to collect, analyze and accurately report time sensitive client-specific data to decision makers and guide planning efforts. It enabled the Department to respond to the data required by the Centers for Disease Control&Prevention, and to process data requests from the County Board of Supervisors, City Council Members, Department Executives, the Incident Commander, and the media. Finally, it enabled the Department to map client data to identify gaps in vaccine coverage.