The Evolution of America -- Obama Care as seen by future history

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Following is an excerpt taken from the college textbook "American History: The Past Fifty Years--Evolution of a Country," copyright 2030.
 
Chapter 13: The Patient Protection and Affordable Health Care Act
 
It is extraordinary that a single law has merited so much as a paragraph mention in an American history text, nonetheless the 2013 implementation of the Affordable Care Act (a.k.a. Obama Care) justifiably warrants its own chapter. Having been the catalyst that drove the next step in America's socio-political evolution its impact cannot be over stated.
 
In 2013 the core elements of the act (which had become law years earlier in 2010 via a masterful exercise of obscure alternative procedures employed by the Democrat controlled congress) was implemented. In that year it became a crime for US citizens to not purchase health insurance coverage. Enforcement power was commended to the growing institution of the Internal Revenue Service (IRS).

Behind the sweeping impact of this law was its daunting financial numbers. The average annual household income was $45,000 in 2013 and the average family healthcare policy cost $20,000 (in 2013 dollars). Through the IRS the government directed and controlled 50% of the average American household's yearly disposable income. This put the US on a social par with the United Kingdom in terms of taxing 50% of the income of its citizens for the purpose of funding social welfare programs.
 
However, the act went much further. One of its less discussed and poorly understood rules was that no insurance company was permitted to sell policy coverage to both privately insured citizens while also selling policies to those seeking coverage through the government healthcare exchanges (euphemistically known as the HealthCare Marketplace). Insurance companies were forbidden to compete with the government in its own exclusive market and so either left the industry or became a branch of the government program so as to survive.
 
Wisconsin was the first state to be dispossessed of all private health insurance carriers by the close of 2013. In 2016 all states except Texas had seen all private health insurance companies close with the final result that all US citizens were ushered into the national healthcare single payer system. In that year American healthcare made the historic transition to being entirely nationalized and socialized.
 
Although Texas mustered a legislative attempt to take the state back to private insurance, the IRS successfully sued and subsequently won receivership over the state's budget. Following that court decision the Texas militia instigated a short ill-fated secession attempt at the toll of tens of thousands of civilian lives. It is generally held that the Texan uprising was the root cause behind the Great American Bankruptcy of 2016 which precipitated the nation's first across-the-board default on paying interest on its national debts.
 
It was through the social and political chaos of the Great American Bankruptcy that order was restored by using the model provided by the Affordable Care Act. With higher education having become impossibly expensive for the personal budgets of the average citizen the government used alternative congressional procedures to implement the Affordable College and Education Act, which required every citizen to pay taxes to fund college for all high school graduates.

Over time it became apparent that such activities as smoking were driving up the nationalized health care costs and the Supreme Court found the government ban on tobacco products was within the proper boundaries of the Affordable Care Act. Similarly the ban on privately owned firearms due to their detrimental effect on health care costs was upheld by the Supreme Court in 2018.

As the role of government changed it became increasingly evident that the US constitution was ever more in tension with the welfare of its citizens. Consequently it was necessary to reform the constitution and the so-called Bill of Rights to accommodate the reality of the evolved and advanced form of the socialized political and economic systems of the modern state. Virtually all of this progress can be directly traced to the implementation of Obama Care in 2013 and its nationalizing of the one-time private health care industry.