Chapter 15 details the Affordable Care Act (ACA), often called Obamacare, put into effect in 2009. Interlandi argues that the negative backlash toward the ACA is indicative of the historical resistance to providing healthcare to Black people and other marginalized groups, as well as a fear of socialism. After the Civil War, Black people were left without homes, food, or clothes. Smallpox ran rampant. When Black citizens asked for access to quarantine shelters and vaccination, they were denied.

Interlandi notes that activists like a Black physician Rebecca Lee Crumpler sought to change things. Crumpler published a pamphlet with advice for sanitation and health while explicitly calling out the failings of Congress, who had the power to help but instead perpetuated the idea that illness in Black communities was a reflection of a genetic failing: “[T]here is a cause for every ailment, and that it may be in their power to remove it” (391). Interlandi states that, for decades, the National Medical Association (NMA), consisting of Black doctors, advocated for a universal healthcare system that would benefit every citizen in the country. Meanwhile, the American Medical Association (AMA) vehemently opposed this suggestion on the grounds that such a program would devolve the country into socialism.