Will Obamacare Have an Impact on Urban Spaces?

Now that the dozens of repeal votes, budget battles, and court cases have failed to prevent the launch of the Affordable Care Act, we can turn our attention to its potential impacts. For cities and urban space, the Act's effects could be significant.

1 minute read

October 2, 2013, 7:00 AM PDT

By Jonathan Nettler @nettsj


Drew Reed speculates on some of the ways in which the Affordable Care Act could influence the design and operation of America's cities. 

"In terms of its direct effect on urban space, the most concrete effect it may have is changes to hospital construction. Since the 2008 economic crash, hospital construction has dropped significantly. As Planetzien [sic] notes, hospitals had been fleeing poor neighbourhoods even before the crisis, since poor people are less likely to have insurance."

"Obamacare would also have important effects on city budgeting," he continues. "Currently, several large US cities, most notably Detroit, are bankrupt. As Business Insider notes, the Obamacare plan provides them with a way to cover their public employee pension costs, freeing them up to get out of bankruptcy, and hopefully be able to make local investments to change the cityscape for the better."


Monday, September 30, 2013 in thisbigcity.net

portrait of professional woman

I love the variety of courses, many practical, and all richly illustrated. They have inspired many ideas that I've applied in practice, and in my own teaching. Mary G., Urban Planner

I love the variety of courses, many practical, and all richly illustrated. They have inspired many ideas that I've applied in practice, and in my own teaching.

Mary G., Urban Planner

Cover CM Credits, Earn Certificates, Push Your Career Forward

Logo for Planetizen Federal Action Tracker with black and white image of U.S. Capitol with water ripple overlay.

Planetizen Federal Action Tracker

A weekly monitor of how Trump’s orders and actions are impacting planners and planning in America.

June 11, 2025 - Diana Ionescu

Metrorail train pulling into newly opened subterranean station in Washington, D.C. with crowd on platform taking photos.

Congressman Proposes Bill to Rename DC Metro “Trump Train”

The Make Autorail Great Again Act would withhold federal funding to the system until the Washington Metropolitan Area Transit Authority (WMATA), rebrands as the Washington Metropolitan Authority for Greater Access (WMAGA).

June 2, 2025 - The Hill

Large crowd on street in San Francisco, California during Oktoberfest festival.

The Simple Legislative Tool Transforming Vacant Downtowns

In California, Michigan and Georgia, an easy win is bringing dollars — and delight — back to city centers.

June 2, 2025 - Robbie Silver

Color-coded map of labor & delivery departments and losses in United States.

The States Losing Rural Delivery Rooms at an Alarming Pace

In some states, as few as 9% of rural hospitals still deliver babies. As a result, rising pre-term births, no adequate pre-term care and harrowing close calls are a growing reality.

3 hours ago - Maine Morning Star

Street scene in Kathmandu, Nepal with yellow minibuses and other traffic.

The Small South Asian Republic Going all in on EVs

Thanks to one simple policy change less than five years ago, 65% of new cars in this Himalayan country are now electric.

5 hours ago - Fast Company

Bike lane in Washington D.C. protected by low concrete barriers.

DC Backpedals on Bike Lane Protection, Swaps Barriers for Paint

Citing aesthetic concerns, the city is removing the concrete barriers and flexposts that once separated Arizona Avenue cyclists from motor vehicles.

7 hours ago - The Washington Post