Synopsis of Affordable Care Act

Title Your Name Subject and Section Professor’s Name Date The Affordable Care Act of 2010 The Affordable Care Act (ACA), or Obamacare, is a highly politicized and transformative shift in healthcare delivery in the United States. Enacted in 2010, it is the culmination of an extensive campaign to address persistent healthcare issues within the United States, in which significant concerns are the lack of access, poor quality, and high costs (Martin et al., n.d., pp. 49-52). Problem Identification Identifying issues within the U.S. healthcare system was very critical for the development of the ACA. The three main problems detected were the significant number of Americans with no medical coverage, skyrocketing healthcare expenditures, and how the insurers treated patients with pre-existing conditions by rejecting coverage. Accordingly, the USA obtained 27.4 million non-elderly people without insurance by 2017; 45% of them cited expensive medical treatment as the reason, thus preventing them from possessing private insurance. From this information, we can now see that the work goes on to make the health insurance plans cost-effective and equal even to low-income families with at least one working member (Martin et al., n.d., pp. 49-52). Policy Design and Development The ACA was negotiated after extensive talks, and a tradeoff was spotted among various stakeholders, such as insurance firms, drug companies, and politicians. One of the critical changes to the system has been the establishment of the individual mandate that requires all Americans to have health insurance or face a penalty and expands Medicaid to adults with an income of up to 138% at the federal poverty level. Stakeholder engagement undertaken during the policy design step was comprehensive, and the policy was made comprehensive and politically feasible by these engagements. At this juncture, the public health insurance option was removed from the bill due to agreement about the final bill between the Democratic and Republican parties (Martin et al., n.d., pp. 99-101). The Decision-Making Approach The decision-making approach of the Obama administration towards the development of the ACA combined rational and incremental approaches, with the accommodation of the political realities of the need for compromises to ensure policy objectives are achieved (Martin et al., n.d., pp. 99-101). In the early stage of the policy design process, President Obama identified a critical issue: controlling healthcare costs through managing unnecessary sources of excessive costs such as emergency services and chronic diseases. This connection of policy purpose with cost reduction highlights a rational way of solving the problem, confirming evidence-based analysis and causal links (Martin et al., n.d., pp. 99-101). Nevertheless, the incremental outlook gained much ground during the administration's dealings with Congress and other stakeholders, especially over the inclusion of a public option insurance plan (Martin et al., n.d., pp. 100-101). Incrementalism refers to gradual changes to existing policies, such that previous policies are continued and amended instead of creating new policies from a blank state (Martin et al., n.d., p. 93). President Obama utilized this strategy because he knew that sacrifices and compromises were to be made to get the reform package through Congress. This adjustment can be seen as a reactive pragmatic strategy that the leader had to use tactically to transit from the original plans, which were designed to engage the relevant policymakers with the problem (Martin et al., n.d., pp. 100-101). Additionally, an incremental approach was applied as the law's key provisions were gradually integrated into the existing policies, which was done over several years. This strategy allowed for proper adjustments that are based on real-world impacts. Furthermore, the administration opted to take a collaborative and inclusive stance regarding policy development, forming a coalition of ma...