NUR 506 Influencing Health Policy Paper

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Eron111

Health Medical

NUR 506

NUR

Description

This assignment is an analysis of local, state, or federal health policy.

Select a state health policy reform innovation ( Please select the state of Georgia)

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.

  1. Examples of state innovations include Maryland’s hospital rate setting, Vermont’s single payer system, and Massachusetts’ health reforms

Explanation & Answer:
7 pages
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Explanation & Answer

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State of Georgia Health Policy Reform Innovation – Outline
I. Introduction
A. The U.S Department of treasury and health and human services approved the
State Innovation Waiver that was submitted by Georgia under section 1332 of the
Patient Protection and Affordable Care Act (PPACA).
B. Under this state innovation waiver, the state of Georgia expects to increase the
number of insured residents and implement lower premiums.
C. Besides that, Georgia expects to increase consumer choice by increasing the
participation of private organizations in the access model.
II. Description of the Health Policy Reform Innovation
A. How it was Adopted
i.

The health policy reform innovation is based on State Innovation Waivers.

ii.

Section 1332 of the PPACA permits any state to apply for an innovation
waiver to implement policies for improving quality care access and
delivering affordable health coverage.

iii.

Based on specific state circumstances, the states aim to use the reinsurance
program and Georgia access model not only to improve health coverage
but also to reduce premiums for consumers, increase consumer choice and
improve the stability of the market.

iv.

The State Innovation Waiver of the state of Georgia became effective as of
January 1, 2022, and the waiver is expected to last for five years up to
December 31, 2026.

v.

The waiver allows the state of Georgia to develop a reinsurance program
that minimizes individual market insurance premiums and enables
residents of Georgia to buy health insurance or coverage directly from
insurance companies or web brokers rather than from HealthCare.gov

vi.

The reinsurance initiative is anticipated to decrease premiums for all the
state’s residents in the individual market by about 10%.

vii.

The second part of the waiver is the Georgia access model.

viii.

Under this model, the state does not use its healthcare portal and instead
private firms are tasked with conducting outreach and marketing to
consumers and at the same time, providing enrollment operations and an
adequate consumer shopping experience.

ix.

To ensure the access model is efficiently implemented, Georgia has
integrated the model with its Medicaid eligibility system, enhancing the
application process and consumers’ determination process.

B. The Funding Structure
i.

The state of Georgia will fund the health policy reform innovation in
several ways.

ii.

One of the ways it will fund the innovation is through the state general
fund.

iii.

Also, Georgia will fund the policy through a state-user fee that is
accumulated after issuers participate in the Georgia access model.

iv.

The other method to fund the innovation is federal-pass funding.

C. The Rationale for the Policy

i.

As a result of the policy, residents of Georgia are expected to pay lower
premiums.

ii.

Besides, the health policy reform is anticipated to increase enrollment.

iii.

The health policy reform innovation under the state waiver has resulted in
an increment in marketplace enrollment in Georgia.

iv.

Apart from low enrollment rates and the fact that many uninsured
residents of Georgia qualified for health coverage, these aspects justify the
reinsurance program and Georgia access model.

v.

Hence, providing many uninsured Georgians with affordable health
coverage without increasing the national deficit was a core part of
Georgia's rationale for implementing the health policy reform innovation.

III. The Impact of the Policy
A. As outlined, the state ...


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