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

Young Professional

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 and Environmental 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 and Environmental Planner

Get top-rated, practical training for planners

"Planetizen federal action tracker" logo superimposed over black and white image of US Capitol dome.

Planetizen Federal Action Tracker

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

September 16, 2026 - Zachary Whalen

Geese flock to a frozen pond in Aurora, Colorado. There are houses in the background.

Colorado’s Largest Data Center Could Rise Next to Homes — Without a Public Hearing

The proposed campus would consume 11 times the power of Denver International Airport; as it has across the country, opposition mounts.

September 17, 2026 - Capital & Main

The Hoover Dam blocking the Colorado River. The river's water level is noticeably low. The cliffs surrounding the blue water are brown and jagged.

US to reduce Colorado River water deliveries to Mexico

A new Colorado Treaty amendment reduces Mexico’s Colorado River water allocation by 250,000 acre feet.

September 11, 2026 - The Arizona Republic

A busy highway in Richmond, with construction and the city visible in the background.

'This is going to be painful:’ Virginia stares down $1.7 billion funding gap for highway maintenance

The state may address the deficit by shifting $290 million from its construction budget to maintenance projects.

1 hour ago - The Virginia Mercury

The Gross Reservoir, a large body of water surrounded by trees and mountains.

Judges permit Denver to divert 77,000 acre feet from the Colorado River for reservoir expansion

Overuse and climate change have caused the Colorado River’s water levels to plummet.

September 18 - Inside Climate News

Passengers board an Amtrak train under a cloudy sky.

Amtrak, CN end decades-long dispute with eight-year agreement

The new operating agreement establishes an updated framework for the companies to work together, including processes to resolve disputes.

September 18 - Mass Transit