Health Policy Reform Innovation Essay

Posted: January 2nd, 2023

Health Policy Reform Innovation Essay

Select a state health policy reform innovation Discuss the rationale for the policy, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact. ethical outcome based on evidence. Examples of state innovations include Maryland’s hospital rate setting, Vermont’s single payer system, and Massachusetts’ health reforms Submission Requirements: The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling. The paper is to be formatted per current APA style, 5-7 pages in length, excluding the title, abstract and references page. Incorporate a minimum of 5 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to current APA style.Health Policy Reform Innovation Essay

A healthy policy includes the plan, decisions, and actions taken to realize specific health care initiatives in society. A good and explicit health policy outlines the target health goals and thus to set reference points and targets. A healthy policy summarizes the primacies, priorities, goals and the projected roles of numerous groups and informs the public. Policy plays a major role in influencing the response of the government to the health agenda (Béland et al., 2019). Similar to other political objectives, the American health policies continue to be erratic where one time the health policy is receiving significant political support, and then later, the policy is facing considerable opposition. This is evident in the Affordable Care Act (ACA), a health policy that was ratified in 2010 and is still under operation. From the time ACA was enacted, the policy has faced both strong support and strong opposition as well (McIntyre & Song, 2019). The Congress house has been faced with the option of abolishing the ACA and replacing it with another health policy, or the option of revising the contentious aspects of the ACA policy to ensure it is more acceptable to a broader political audience. This paper will discuss the ACA policy and provide a rationale for the policy, and how the policy was adopted.

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The Affordable Care Act (ACA) was abstracted as a policy that facilitated the increase of the Americans having medical insurance by ensuring that health insurance was more reasonably priced and imporved access to care. The ACA managed to expand access to care and make health insurance affordable by increasing Medicaid eligibility and forming new market places where individuals who initially did not have medical insurance were able to get direct health coverage from insurers (Courtemanche et al., 2018). The insurance coverage was expanded in different ways that included increasing the Medicaid eligibility to contain Americans who were earning equal to 138% of the federal poverty level. Secondly, the ACA presented opportunities for small insurance firms to acquire some share from the big insurance firms by targeting employers having lower than 51 staff members. Lastly, the ACA offered premium subsidies for Americans to purchase medical insurance coverage for individuals earning below 401% above the federal poverty level (Courtemanche et al., 2018). Additionally, the ACA delegated new approaches that aimed to improve the quality of care and decrease healthcare costs; consisting of decreasing costs for some Medicare services and experimental delivery models.Health Policy Reform Innovation Essay

From the time ACA was enacted and operationalized, the policy has significantly improved the health care within the US. The policy decreased the number of Americans who were uninsured. Despite the rollout problems the ACA faced, the policy has enabled a large number of Americans who were previously without health insurance to acquire health insurance coverage (Courtemanche et al., 2018). Statistics showed that about 22.8 million Americans enrolled for new health insurance between the years 2013 and 2015, whereas only 5.9 million Americans lost medical insurance coverage. The total number of Americans who did not have health insurance coverage reduced from 42.7 million to 25.8 million (McIntyre & Song, 2019). Secondly, the ACA provides an effective incentive for registration with health insurance by mandating that the majority of adults should have health insurance, and the defaulters would be fined. Thirdly, the Affordable Care Act has helped to stabilize the insurance market by providing tax credits that help people with low income to purchase health insurance covers. Moreover, the ACA has lowered the payments directed to providers using cost control strategies that reduce the amount of money that care providers get from Medicare to lower the amount the government spends on healthcare costs. In addition, the ACA has led to improved quality of care by forming government agencies and bodies with the role of managing and regulating healthcare practices (McKenna et al., 2018). The Affordable Care Act has generally increased access to care by reducing the number of Americans without health insurance, improved the quality of care, and also reduced healthcare costs.

In spite of the ACA being the most significant change in the health care policy within America after both Medicaid and Medicare were ratified in 1965, the implementation of the ACA has been characterized by unanticipated twists and turns, and disagreements that have delayed implementation of some key provisions (Glied et al., 2017). Actually, from the time the ACA was enacted, there have been numerous claims regarding the policy’s success and failure from the individuals supporting it and those opposing it. The opinions and views in the debates about the ACA policy are very sensational and characterized by political persuasion. However, the majority of these debates do not recognize that there is a key difference between the affordability of care and access to health care (Rigby et al., 2014). Medical insurance facilitates the affordability of health care whereas access to healthcare involves the process of obtaining the necessary health care. ACA has played a major role in reducing the gap between health care affordability and access. For example, the Affordable Care Act has availed health insurance for more than 20 million Americans who did not have health insurance previously. However, such an argument does not take into account the number of individuals who had health insurance before but lost the coverage during the regime of the ACA. Moreover, the increase in health insurance has been significant during the Medicaid expansion, indicating that the working and the middle-class Americans did not benefit from the ACA implementations, particularly Americans earning over 400% above the federal poverty level (McKenna et al., 2018). This has resulted in unbalanced access to health care because the individuals in Medicaid insurance are mired by narrow slots, whereas the individuals lacking the Medicaid coverage are likely to face high out of pocket costs.

Clearly, the ACA has led to an increase in the number of Americans with medical insurance coverage, largely through the expansion of Medicaid. The reductions in the healthcare costs allied to the ACA are evidence and also the quality of care has improved (McKenna et al., 2018). However, whether the ACA has led to improved quality of care, is arguable. With Donald Trump, the ACA has undergone critical analysis where some Congress lawmakers are endorsing the revision of the ACA to ensure its shortcomings are addressed, while other legislators are demanding that the repeal and replacement of the ACA policy (McIntyre & Song, 2019). This has led to the presentation of numerous proposals and recommendations aimed to improve, repeal, or replace the ACA. Health Policy Reform Innovation Essay

Despite the progress or the outcome of the political debates about the ACA and the decisions that legislators in Congress make, the outcomes will have far-reaching effects. Replacement of the ACA will mean that over 251, 000, 000 Americans having medical insurance may face uncertainty regarding health coverage. If the ACA is repealed, the number of Americans with health insurance would drop to 231, 900, 000 while the usual out of pocket healthcare costs are likely to rise by $4,200 (McKenna et al., 2018). Moreover, the decision to repeal the ACA can lead to the increment of the federal deficit with $33.1 billion annually and abolish the revenue plans under ACA. Replacement of the ACA with an alternative like a single-payer plan is likely to lead to increased federal spending by trillions to ensure that all Americans have health insurance. The repeal of ACA, without replacing it would lead to millions of Americans not having medical insurance coverage and the enrollment of many Americans in health coverage is likely to decline.

As the politicians continue debating about the ACA and as the policymakers continue to deliberate regarding the available options on the ACA, it is clear that there are political tensions regarding the health policy (Glied et al., 2017). For example, there are many questions and possibilities that the leaders face about health policy, such as reduction of the healthcare costs; expanding the coverage to make sure that all Americans can access quality care; protecting Americans with chronic diseases and requiring costly health care; and reducing costs by changing it to states and restricting the liability costs for the federal government. Making decisions or balancing the numerous options requires astute political judgment on what the American health care system should be regarding the key health care goals.

Conclusion

Health policies are significantly influenced by the political climate and political debates where in some instances the politicians are supporting the policy, while others are opposing it. An example is the Affordable Care Act (ACA), which was enacted in 2010. The health policy was intended to improve care access, reduce healthcare costs, and improve the quality of care. However, just like any policy, the ACA has faced both strong support and strong opposition as well. As the debate about the ACA continues, various available options will significantly impact health care within the US. For example, repealing or replacing ACA policy may reduce the number of Americans with medical insurance coverage.Health Policy Reform Innovation Essay

References

Béland, D., Rocco, P., & Waddan, A. (2019). Policy feedback and the politics of the Affordable Care Act. Policy Studies Journal, 47(2), 395-422.

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Early effects of the Affordable Care Act on health care access, risky health behaviors, and self‐assessed health. Southern Economic Journal, 84(3), 660-691.

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2018). Effects of the Affordable Care Act on Health Care Access and Self-Assessed Health After 3 Years. Inquiry: a journal of medical care organization, provision, and financing, 55, 46958018796361. https://doi.org/10.1177/0046958018796361.

Glied, S., Ma, S., & Borja, A. A. (2017). Effect of the Affordable Care Act on Health Care Access. Issue Brief (Commonwealth Fund), 13(1).

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s Impacts on Access to Insurance and Health Care for Low-Income Populations. Annual review of public health, 38, 489–505. https://doi.org/10.1146/annurev-publhealth-031816-044555.

McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2).

McKenna, R. M., Langellier, B. A., Alcalá, H. E., Roby, D. H., Grande, D. T., & Ortega, A. N. (2018). The Affordable Care Act attenuates financial strain according to the poverty level. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55, 0046958018790164. Health Policy Reform Innovation Essay