The Affordable Care Act of 2010, signed by President Obama, established near-universal health insurance coverage in the United States, mandating coverage and prohibiting exclusion based on pre-existing conditions — the most significant American health insurance reform since Medicare.

The ACA debate generated fierce political and cultural argument that produced documentary, poetic, and satirical writing; the underlying anxieties about illness, loss of coverage, and the healthcare system as site of fear and inequity have pervaded American poetry in the early twenty-first century.