Paper Example on Healthcare Insurance Policy Issues: Affordable Care Act

Introduction

Health insurance refers to the type of insurance coverage that covers the expenses of an insured person surgical and medical services provided by health facilities. With the rising cost of living and economic issues in the USA same as other parts of the world, affording quality medical services has been a challenge for American citizens. There are public and private health insurance programs which people choose depending on the personal evaluation on the ability to contribute for a premium from either of the two choices.

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In most cases, public health insurance is a federal program that targets government officials and citizens who cannot afford the services from private insurance proving companies. Health, insurance help to reduce the challenge of securing funds needed during a medical emergency or any situation seeking medical intervention through progressive contribution. The Congress over five decades ago designed mediocre and Medicare to cater for this need and over the years it has experienced improves to improve the coverage (Obama, 2016). One of the policies that have been implemented in recent years is the Affordable Care Act.

The Policy to Address the Issue

Hence, in 20101, the Affordable Care Act (ACA) was created and enacted in 2014. This was public policy that aimed at improving the accessibility of the quality healthcare services for all individuals by expanding the provisions of Medicare and Medicaid programs and other areas that will reduce the disparity in health. ACA targeted the senior citizens above 65 years and other Americans below the poverty line (100%-400%) (Obama, 2016). Also, the expansion of the Medicaid program was a pillar, and support for innovative techniques to deliver quality healthcare services at lower costs. Moreover, instead of employers seeking the expensive health insurance coverage from the private providers, ACA provides a platform for accessing the state-owned coverage. Expanding the eligibility for Medicaid services ensure that more people could access the quality health care services that the USA aims to provide to its citizens. Thus, the situation would help to reduce the endemic health disparities experienced among the Americans. The population of the old and economic disparities has been growing, and this policy was reliable in improving the health insurance coverage in the USA.

Why This Policy Supports the Issue Mentioned

The ACA policy supports the health insurance coverage issues which aim to expand the coverage by stretching the eligibility limits and increasing funding to Medicaid and Medicare programs. This policy is new, but its provisions are just an improvement of programs for insurance coverage supporting the Americans citizens (Glied & Jackson, 2017). The target is families, business organizations, government institutions, individuals, and insurers among other potential beneficiaries and service provider to make the health insurance comprehensive. Moreover, the policy has placed new responsibilities on employers and organizations in supporting the health of their employees by contributing to Medicaid and Medicare programs. Furthermore, the individual 65 years and above especially those who cannot afford healthcare are privileged to access free medical and surgical services. Thus, the policy supports the issue of health insurance adequately.

Two Policy Modification That Will Positively Impact Outcomes of the Issue

Despite the ACA policy being reliable in reducing healthcare inequalities and promoting the quality of care American population enjoy there might be few adjustments that will improve the efficiency. First, some states have not expanded the Medicaid program as entirely suggested by the ACA since it was implemented. For instance, Nebraska and Maine have been having discussions aiming to vote in the expansion (Dorn, 2014). Therefore, it is crucial for the federal government to support and encourage all states to expand such a program to improve the access of healthcare to the senior citizens across the USA. Second, enrolling for Medicaid and Medicare services is challenging as the procedures for the process are complex which makes it difficult for eligible individuals especially the old generation. Therefore, to control this situation, it would be appropriate if the system was made convenient that any user with little knowledge and convenience of the internet or a computer could access it. Moreover, employing more corps to assist in the process either manually or on a digital platform could improve the accessibility of the services.

Two Policy Modification That Will Negatively Impact Outcomes of the Issue

Additionally, some modifications to the policy could have a detrimental impact on the users of health insurance products under Medicaid and Medicare. First, the supreme court has been very instrumental in the implementation of the ACA and through its ruling that states should not be forced to implement segments of the policy such covering people up to 133% of poverty line, is very detrimental (Blumenthal & Collins, 2014). Such freedom has affected residents of many states who cannot enjoy similar health care as other Americans in states where the policy has been implemented fully. This situation is evident as more states have realized being adamant in fully implementing ACA affects their population and have decided to collect signatures to support the vote for increased coverage to address the health disparities and cut the cost of delivering healthcare which is the major goal of the policy (Clemans-Cope, Long, Coughlin, Yemane, & Resnick, 2013). Secondly, the introduction of the short-term health plan which runs for 90 days and is considered cheaper. This might be seen as effective in promoting access to health care services through affordable insurance, but such coverage duration is very short and would compromise the quality of care. Thus such changes will affect the efficiency of the ACA policy in ensuring that all Americans access quality health insurance coverage.

How the Government Through Congress Intervene on the Policy Issue as Part of Business Administration

According to writing by the 28th American president Woodrow Wilson, public administration is a business; thus effective strategies and tactics should be utilized to improve efficiency. Thus, to improve the efficiency of government business, there is a need for policies to achieve its set goals and streamline its activities (Uwizeyimana, 2013). The congress represents the needs of the people and makes laws which serve this purpose, once they have been signed by the president who is in the executive body of the government. Therefore, the policy-making function has been bestowed on the Congress to provide the effective leadership on government agendas. In the ACA policy, Congress has been effective in various ways. First, it is responsible for the repeal or amendment of the policy. For instance, it placed prohibition for states to reduce the eligibility of Medicaid before 2014 however, they were encouraged to increase. This congressional position aimed to reduce the barriers for Americans to enroll in the public insurance program (Thompson, Gusmano, & Shinohara, 2018). Secondly, Congress is responsible for determining which party in the business of providing insurance coverage should perform which role and consequences for failing to follow the law. For instance, organizations with more than 50 employees working part-time and full-time are required to provide insurance coverage for its employees or face penalties. Third, congress is responsible for starting new institutes and boards meant to improve the efficiency of the policy. For instance, in 2013 the independent payment advisory board that provides guidance on how to reduce per capita expenditure on the cover.

References

Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act-a progress report.

Clemans-Cope, L., Long, S. K., Coughlin, T. A., Yemane, A., & Resnick, D. (2013). The expansion of Medicaid coverage under the ACA: implications for health care access, use, and spending for vulnerable low-income adults. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 50(2), 135-149.

Dorn, S. (2014). What Is the Result of States Not Expanding Medicaid?.

Glied, S., & Jackson, A. (2017). The future of the Affordable Care Act and insurance coverage. American journal of public health, 107(4), 538-540.

Obama, B. (2016). United States health care reform: progress to date and next steps. Jama, 316(5), 525-532.

Thompson, F. J., Gusmano, M. K., & Shinohara, S. (2018). Trump and the Affordable Care Act: Congressional Repeal Efforts, Executive Federalism, and Program Durability. Publius: The Journal of Federalism.

Uwizeyimana, D. E. (2013). The politics-administration dichotomy: Was Woodrow Wilson misunderstood or misquoted. J. US-China Public Adm, 10(2), 165-173.