Affordable Care Act 2010
Question
To prepare:
Select a health care policy and a policy analysis framework to utilize for this Assignment. You may use the policy and framework you identified in this week’s Discussion or change your selection.
To complete:
Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following:
Part 1: Define the policy issue.
How is the issue affecting the policy arena?
What are the current politics of the issue?
At what level in the policy making process is the issue?
Part 2: Apply a policy analysis framework to explore the issue using the following contexts:
Social
Ethical
Legal
Historical
Financial/economic
Theoretical underpinnings of the policy
Include in this section:
Who are the stakeholders of interest?
Is there a nursing policy/position statement on this health care issue? If so, who developed it?
Part 3: Policy options/solutions
What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change.
What are the theoretical underpinnings of the policy options/solutions?
What are the health advocacy aspects and leadership requirements of each option?
How does each option/solution provide an opportunity or need for inter-professional collaboration?
What are the pros and cons of each suggested change? Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option.
Part 4: Building Consensus
Outline a plan for building consensus around your recommended option/solution for solving the policy issue.
Part 5: References
Limit your references so this section is no more than 2 pages.


Solution
Affordable Care Act 2010
Policy Definition
According to Chavez et al. (2018), the Affordable Care Act
(ACA), or simply Obamacare, is a recent policy initiative by the Obama
administration to reform the healthcare industry. The Affordable Care Act
(ACA), also called the health reform bill, H.R. 3590 or PPACA (Patient
Protection and Affordable Care Act), was enacted on March 23, 2010. Passed by
Congress in late 2009, the Act contains both provisions designed to expand
health insurance coverage and improve existing coverage of many groups in the
United States. The ACA 2010 is a piece of federal legislation that overhauled
many aspects of the healthcare system in the United States. It was meant to
increase healthcare affordability and reduce the extent of medical expenses
while increasing access to affordable health insurance by reducing or
eliminating limits on pre-existing conditions and annual deductibles and
introducing new insurance rules and regulations. The Affordable Care Act (ACA)
is an excellent political topic for speeches and pro-con debate, particularly
in the 2010 Congressional Midterms (Daw and Sommers, 2019). The ACA has many political implications
for election years and beyond. Since implementing the 2010 Affordable Care Act,
there has been vigorous debate about this landmark piece of legislation. While
more Americans are covered now than before it was adopted, many feel that the
benefits don't go far enough or that this type of health care is an intrusion
into personal freedoms. For example, some people have criticized the ACA for
not including a public option as an insurance provider on exchanges and for
subsidies not available to those with over 400% of federal poverty levels. The
issue over the Affordable Care Act is about health care reform. It's been
addressed by congress since 2009. It has been amended several times since its
first introduction. This paper seeks to discuss the policy framework’s
theoretical underpinnings and build a consensus regarding the progress and
solutions to the Affordable Care Act 2010, specifically in providing equal and
cheap health care services to the citizens.
Policy Framework
In this case, it is also significant
to apply a policy analysis framework to explore the Affordable Care Act (ACA)
2010 issue using the following contexts: ethical, legal, economic, and
political. The ethical context is used to model how justice, fairness, equality
and responsibility are relevant to this problem.
Social
Social justice requires that every
person access healthcare services regardless of race, gender, or creed. Social
factors are variables in one's life that affect their health status. These factors
include income, education level, and employment status. The ACA was passed with
a clear mandate from a socially liberal citizenry. The policy promotes
universal access to health care via a framework of personal responsibility and
state involvement. Personal responsibility rests in the citizens’ hands; they
must purchase insurance or pay a fine. The state will be responsible for
regulating this system by implementing federal standards for healthcare plans,
including what types of coverage they must include and how much they can
charge. Moreover, the social context of the ACA has two sides: how it affects
society as a whole and how it affects individuals. In terms of population
health, the ACA seeks to increase access to preventative care for all Americans,
reduce costs for those with common health problems, improve quality of care,
and increase healthcare delivery efficiency.
Ethical
One could argue that the ACA raises
several concerns from an ethical perspective. Some contend that it is unethical
because it requires Americans to participate in commerce as part of their civic
duty. This may compel some citizens to purchase insurance that does not fit
their needs simply to avoid paying a fine. The ACA is a very controversial
policy issue because of its ethical dimensions. By insisting upon universal
coverage for all Americans, regardless of any preexisting conditions or lack of
employment, it is violating the tenets of many major religions as well as
strict interpretations of the U.S. Constitution. One question that arises is
whether or not it is legal for the government to force citizens to purchase
products or services they do not want? Another ethical issue that arises is
whether or not it is fair for the government to force citizens who have done
nothing wrong and are not at fault for their situation to purchase health
insurance (MacCallum-Bridges,
and Margerison, 2020). Those opposed may argue that it is their
constitutional right not to buy health insurance if they choose not to, and
therefore forcing them violates their civil liberties.
Legal
The legal context explains how the
ACA was created and why it was created. The Act was introduced as an attempt by
President Obama and his administration to ensure that all Americans had
affordable healthcare. They wanted to ensure that all Americans received health
coverage, and they also wanted to ensure that all Americans received healthcare
of a high standard. Because of how America works, the ACA needed to be
introduced in a bill that would allow the President to pass the legislation
through congress. The United States Congress enacted the ACA on March 23rd,
2010, with an overwhelming majority vote: 219-212 ( Nipp et al., 2018). The
main legal issues surrounding the ACA are its Constitutionality, whether it can
be applied to states that did not adopt it themselves and whether it is an
unfunded mandate on state governments. In June 2012, the Supreme Court struck
down the individual mandate that would require all Americans to purchase health
insurance coverage or pay a tax penalty for not doing so; however, they upheld
all other provisions of the ACA.
Historical
The Historical Context explores how
healthcare policy has changed within the U.S throughout history. The ACA is a
very controversial piece of legislation because it is changing healthcare
policy from its previously based system into one where every American can
access health care at a higher level than before; this is incredibly
progressive as it works against the previous models of healthcare policy which
have been used for many years in the U.S (Olfson et al., 2018). This model of healthcare
policy is known as socialized medicine and is often opposed by those who
believe in free-market economics, meaning that private companies should not
have any involvement with government funding or services.
Financial/Economic
The Affordable Care Act 2010 is a
federal statute that has been in effect since 2010, aiming to improve access to
health care for all Americans by increasing its affordability and reducing its
dependency on the private health insurance system. The law includes several
provisions, including expanding Medicaid eligibility, instituting penalties for
those who do not have health insurance, providing incentives for businesses to
provide health care benefits to employees, requiring businesses with more than
50 employees to provide health care coverage, and establishing state-based
health insurance exchanges (Mahal
et al., 2020). There are also several taxes on the wealthy and the
medical industry included in the law. It is important to note here that critics
of the Affordable Care Act argue that it is not affordable since there are many
taxes on the citizens for it to work.
Theoretical
Underpinnings
The Affordable Care Act 2010 impacts
individuals, families, businesses, health insurances and hospitals. These are
the main stakeholders of interest in this area. The ACA aims to promote access
to affordable health insurance, improve the quality of care, and ensure that
those who do not have health insurance can get the medical care they need.
Moreover, The Care Act was designed to expand health insurance for people who
were not offered coverage through their employer and could not afford it, for
unemployed people and those with low incomes, uninsured children and teenagers,
elderly persons, and disabled persons. The Affordable Care Act strives to
provide the uninsured with the opportunity to purchase good health insurance at
a reasonable price (Mahal et
al., 2020). From employers to individuals and the uninsured, everyone
stands to gain when more Americans can secure quality health care coverage.
However, there are some concerns about implementing the law and its impact on
the stakeholders.
Policy Options
The following are the policy options
available when addressing the Affordable Care Act 2010. These policy options
affect insurance companies, health care providers and employers. The current
law is to keep the Affordable Care Act 2010. A second option would be to repeal
the Affordable Care Act 2010 as a whole, a radical change (ADA et al., 2019). The
third option would be to only partially repeal certain parts of the law, such
as allowing children up to age twenty-six years old to stay on their parents’
insurance or no longer requiring expensive preventative care such as
mammograms.
No change
No change is when the Affordable
Care Act 2010 does not happen. This would greatly affect health advocacy and
leadership skills because it would leave healthcare as it is now. This is not a
good thing for anyone currently in the healthcare system. With this option,
people are still left with high premiums, prescription drug prices, and no care
to those who cannot afford a plan. There is more need for health advocacy and
leadership skills in situations like this because the people would be fighting
for their rights to affordable healthcare. Some critics of the ACA argue that
it should be repealed entirely. Other critics, however, prefer to keep some
aspects of the law in place while eliminating others (Chavez et al., 2018). Replacing a tax with a
penalty is one example of this approach. Keep in mind that even if Congress
repeals all or part of the ACA, some states might continue to implement its
provisions. Nevertheless, this option has its one disadvantage in that this
means keeping everything as it is now until there is a major reason for the
change. This could mean problems since there will not be any improvement of the
Affordable Care Act 2010 soon.
Partial
change
Partial change is when only some of
the options within the Affordable Care Act 2010 are fulfilled. For example,
employers must cover employees based on their income level or provide them with
a subsidy to help pay for their insurance premiums if they have been with their
company for at least three months. This partially changes the health advocacy
aspects and leadership skills because it gives people some benefits of having
healthcare but not all of them. People will still be fighting for what they
need most: affordable insurance and lower-paying plans that fit. One example
would be to allow Americans to keep their existing health coverage even if it
doesn't meet ACA standards. Another would be to delay implementing key
provisions like Medicaid expansion and tax subsidies until they can be
implemented properly. Moreover, expanding Medicare to cover people under 45
would save money, increase efficiency and improve the quality of health
insurance available (MacCallum-Bridges,
and Margerison, 2020). Expanding Medicare to include everyone under 45
would not be feasible without first reforming Medicare to be sustainable for
the long term. The current Medicare system will not remain financially viable
if it is expanded beyond those currently eligible for coverage.
Radical or
Maximum Change
The passage of the ACA fundamentally
changed the health care system in America. The new law requires all citizens to
have health insurance, provided by either an employer or the state. This is a
radical change from how things were before. However, according to stakeholders,
not all changes were for the better, who saw many issues with these new
reforms. When looking at recommendations for change, it was difficult to
distinguish between advocacy and leadership because they are so closely linked.
It seems like leadership is required for advocacy to happen effectively and
vice versa. Both are needed for successful reform implementation. The
differences become clearer when looking at specific aspects of the legislation,
like cost controls, prevention policies, choice and access, which are typically
considered advocacy issues rather than leadership ones (Kaye, 2019). Consequently, the government
should use its purchasing power to drive down costs by creating a unified,
single-payer system that would take all Americans (including illegal immigrants)
off private health insurance and put them on a government plan that negotiates
rates with doctors and hospitals. As the ACA does now, it would also cover all
Americans for basic medical services rather than just emergency services.
However, this option would run into political and practical difficulties,
especially in terms of funding.
Building Consensus
In this case, it would be vital to
promote radical changes within the Affordable Care Act 2010. To build consensus
around a solution that addresses the ACA's flaws and improves upon it, we will
first need to understand what elements of the ACA are working well and which
are not. We will then evaluate different policy options for improving upon the
ACA's current structure. The ACA can transform the health system from one that
treats patients when they become ill to one that focuses on keeping people
well. This is a major paradigm shift, with many implications for providers,
payers, and government agencies (Olfson et al., 2018). For instance, there are several ways that
healthcare providers can improve patient care, reduce costs, and increase the
current system’s efficiency. One way that is being implemented is the adoption
of electronic health records. This is meant to help doctors keep accurate records
and provide better patient care. Finally, it is significant to propose a
specific reform that builds upon those positive elements within Obamacare while
addressing its shortcomings.
In conclusion, the paper has
discussed the policy framework, theoretical underpinnings and building a
consensus regarding the progress and solutions to the Affordable Care Act 2010,
specifically in providing equal and cheap health care services to the citizens.
The Affordable Care Act 2010 is the first major healthcare reform ever passed
in the United States. On March 23, 2010, President Obama signed it into law. It
attempts to address the problems caused by uninsurance in the United States by
fulfilling Americans' right to have health care and making costs more affordable.
The Affordable Care Act 2010 is important for the rich and elder people and the
young and healthy people who have to buy their health insurance. Additionally,
as mentioned above, one of the goals of the ACA is to extend coverage to an
additional 32 million uninsured Americans. The ACA also includes provisions that aim to reduce
racial disparities in health care access, such as an extension of Medicaid
eligibility to include those with incomes under 133 percent of the federal
poverty level.
References
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