PAD 632 (8-1)

PAD 632 (8-1) Student’s Name Institution Affiliation Course Name & Code Instructor’s Name Date PAD 632 (8-1) Policy Formation Introduction The former president enacted the Affordable Care Act (ACA) in 2010, which prompted it to become known as "Obama Care." ACA was primarily created to expand affordable healthcare access while minimizing costs among individuals, therefore boosting the healthcare quality in the U.S. One of the main reasons some individuals fail to have healthcare services was because they were uninsured or underinsured due to the existing inequities. The ACA was created to close the healthcare inequities by offering insurance coverage while offering subsidies to low-income individuals and expanding Medicaid admissibility. It can be challenging to evaluate the law since it requires the reflection of factors, design, and results. The paper will reflect on the ACA advocates, stakeholders, and critics and how these critics have had an impact on this program design. Moreover, it will reflect on how interest groups, media, lobbyists, and vested interest groups have affected the intended and actual outcomes. Intended Program Beneficiaries This program was aimed to benefit different groups. One of the groups was the uninsured group. Since there were many uninsured individuals, this program aimed to offer these people affordable insurance options. Even though the program was looking to provide all individuals with affordable insurance options, it prioritized those with pre-existing conditions, which prompted them to be denied insurance (Persad, 2020). The other group was the low-income individuals. Since poverty was one of the reasons that made some people fail to take insurance, ACA aimed to control this problem. It controlled this problem by controlling Medicaid and income-based subsidies for impoverished people. How Society Benefit The ACA significantly benefited society as a whole. It minimized long-term healthcare costs and boosted public health outcomes. Furthermore, this program helped society by preventing insurance companies from denying coverage to people with pre-existing conditions (Persad, 2020). This process boosted the stability and security of healthcare access, saving society from financial strain. This policy also gave society holistic health, improving mental and preventative care. Evidence of Issue scope that caused the policy or program creation Before the ACA introduction, there was a problem of Americans being uninsured or underinsured. This problem made this individual delay seeking medical care while others avoided it, which made this group suffer from serious health complications. The other problem was that some insurance markets excluded individuals who had pre-existing conditions, increasing health access inequities. The other issue was that healthcare costs rose considerably, putting an unsustainable strain on the healthcare system. Since these challenges were worsening the healthcare system, it was clear that the country required a policy intervention such as ACA. How Does the Evidence Support Policy Creation The evidence shows that lack of insurance caused healthcare outcomes to deteriorate while the healthcare costs increased progressively. Since the number of uninsured people continued to grow, it made the policymakers experience pressure since they noted that the healthcare system could face growing challenges such as increasing costs and a rise in inequalities if it were not controlled (Kostiaev et al., 2023). This challenge made the health economists and public health experts explain the social and economic benefits that could result from affordable healthcare, which acted as the foundation for setting up ACA. Democratic Process The ACA formation was created by state, federal, state, and local levels of government since they conducted an intense legislative process. This program went under extensive debate in Congress after President Obama proposed it, and a small margin passed it. The Senate Finance Committee and the House Ways and Means Committee negotiated compromises while examining this program's impact on different stakeholders. The Congress also embraced public hearings and consultations to consider varying voices. In addition to the Congress, ACA was regulated at the federal level. Some laws regulated at the federal level included the Patient Protection and Affordable Care Act, among other rulings from the Supreme Court, which influenced the implementation nature. Additionally, the state governments helped implement this program. One crucial role it played was the Medicaid expansion (Guth et al., 2020). The main reason was that the states had the power to expand Medicaid eligibility, a critical element of the ACA approach. This process helped to give low-income populations access to care. Moreover, various federal agencies, such as the Department of Health and Human Services (HHS), helped with ACA enforcement. Stakeholders for the Democratic Process The democratic process included different stakeholders who affected the creation of the selected policy. One of the stakeholders was the federal government, the main party in ACA formation, where President Obama and the other congressional Democrats were spearheading this reform. On the other hand, the Republicans also shaped the compromises made since it was a significant opposition force, shaping the compromises to be made. State governments were the other critical stakeholders. Their impact was evident since they set up state-run health exchanges. Since some states embraced all the reforms while others rejected Medicaid expansion, there has been variation in this policy in different parts of the country. Insurance companies and healthcare providers are other critical stakeholders in the democratic process since their performance was mainly affected by ACA provisions. Most of them supported the reforms, which increased insured patient bases while reducing uncompensated care despite facing other regulations that did not favor them. Advocacy groups were other stakeholders in the democratic process. Some groups, such as AARP and Families USA, supported the ACA since it expanded healthcare access, while others, such as the Heritage Foundation, opposed it mainly due to its mandate. The general public was also the main stakeholder in the democratic process. The general public shaped the ACA debate by offering divided sentiments about the government's function in healthcare. The bill's varying public hearings and opinions were necessary since lawmakers used them to formulate it. Varying stakeholders played a significant role in shaping the policy. One reason was that diverse stakeholders made compromises in the legislative process, making the final bill a product of intense negotiation that most people were okay with. Program Factors: Stakeholders ACA formulation consists of different stakeholders, including the program design. These stakeholders include healthcare providers, federal and state governments, insurance companies, patients, political parties, and the general public. ACA greatly affected hospitals, physicians, and healthcare networks, primarily by delivering reimbursed care. For example, every healthcare provider was supposed to follow rules and regulations regarding preventative care and electronic medical records. The ACA also affected how healthcare providers adopted the reimbursement approach, investing in quality over quantity care. Varying government entities also played a critical function in the program formulation. One government department that influenced ACA formulation was the Department of Health and Human Services (HHS). HHS was crucial since it embraced this role, which helped improve Americans' overall well-being. It also collaborated with varying states, which helped set up new competitive and transparent markets. These markets helped people and small businesses to compare their choices of coverage. State governments were critical individuals in deciding whether Medicaid expansion would be implemented in the ACA provision. Insurance companies were also critical stakeholders. One of the reasons was that the program forced these companies to offer new coverage plans for their insurance exchanges. Moreover, ACA forbade these companies from forbidding measures such as denying coverage of pre-existing problems. Therefore, the insurance company's response would influence the program's success. ACA limited the premium percentage insurance companies should set aside for administrative expenses and profit. It also demanded that state or federal regulators examine it according to the surge rate (Hall & McCue, 2016). This law was also formulated to include varying uninsured or underinsured individuals needing affordable care. This need made the ACA reduce the uninsured rate by a considerable margin, offering options for people who did not have affordable healthcare. The general public was also a critical stakeholder in the program design. This group offered opinions about the issues that were affecting the process. Moreover, most of the general public, primarily the uninsured, were supposed to explore the new marketplace and have insurance coverage. Furthermore, those with insurance coverage had to modify it since the ACA had some changes to their insurance coverage and some subsidies. Impact of Media, Lobbyists, and Interest Groups The media played a massive role in influencing this policy. For instance, individuals depend on media to spread the news to people using different channels. Media was also used to educate the public about the law, helping them make informed decisions. The media also polarized the people's standpoints regarding the law, improving their policy support. The Advocacy groups also played a significant role in influencing this policy. Even though there were varying advocacy groups, one of the advocacy groups that played a significant role was the American Medical Association (AMA), which helped with legislation backing. For instance, the AMA helped since it advocated that every U.S. citizen should have insurance coverage while patients should have universal healthcare eligibility (American Medical Association, 2024). This advocacy group helped the integration of this policy since it explained the benefits that will result from expanded insurance coverage. The lobbyists also helped to influence the ACA program. For example, lobbyists from pharmaceutical and insurance companies advocated for these modifications since they would help to protect their financial benefits. The ACA's success in the federal and state governments was critical since it enabled them to acknowledge long-term public health objectives, which helped to control the rise of spending among healthcare providers. They aimed to ensure that the new changes did not substantially impact the revenue and quality of care. During this period, the patients and the general public sought affordable, accessible, and all-inclusive coverage. Advocates Various advocates helped in the implementation of the ACA. The leading advocate was former President Barack Obama and other political leaders who advocated for this legislation. In 2008, when he was vying to be U.S. President, Obama interacted with different people to avoid the significant issues they were suffering from. One of the issues he noted was that some Americans were being denied insurance because they had pre-existing conditi...