Running head: THE AFFORDABLE CARE ACT POLICY ANALYSIS
The Affordable Care Act Policy Analysis
Rodriko Sankey
Rick Humphress
Public Policy Analysis
May 14, 2017
1
THE AFFORDABLE CARE ACT POLICY ANALYSIS
2
Executive Summary
Affordable Care Act (ACA), alias the Obama Care Act, is a healthcare policy in the
developed and implemented in the US. The three government arms, the legislature, judicial and
the executive actively involved themselves in its development approval and implementation.
ACA was a significant healthcare reform made by the government of US under former President
Obama since the creation of Medicaid as well as Medicare in the year 1965. The ACA was
developed to aid the poor, the elderly and the disabled that were unable to afford medication bills
to have access to the required healthcare by increasing the coverage of Americans who could
access medication and other healthcare aspects. Affordability, quality, and accessibility were
healthcare issues the ACA was intended to achieve. For more than the past four years, many
Americans had no access to medical care due to unaffordability. The number of American
individuals who were uninsured was high as 49 million in 2010. The uninsured population was
not able to pay for medical care bills, and this made their health poor. Apart from, the
government of US, other players have been involved in the process of enhancing the application
of the ACA, and they include, the public, interest and lobbying groups, pharmaceutical firms
among other stakeholders. Recommendations and suggestions of the ACA include increased
coverage of people who were able to afford the cost of healthcare through insurance cover,
improved quality of the medical care and accessible care to all individuals including the disabled,
the poor and the elderly. The policy also recommended those small businesses with less than 50
full-time employees and made below $ 250,000 would benefit more from a new affordable
quality cover.
THE AFFORDABLE CARE ACT POLICY ANALYSIS
3
Introduction
ACA is a healthcare policy in the developed and implemented in the US. The three
government arms, the legislature, judicial and the executive have actively involved in it
development approval and implementation (Coffin & Rak, 2013). The cost of healthcare services
significantly affects the economy of America, the state budget, and virtually every family's
health. When the cost of healthcare are high-priced, schooling for children, adult employment,
and health lives of the elderly become difficult to endure. This made the government of US
develop and the ACA. The policy advocated for improvement of health insurance that has
enabled children access schooling without difficulty, grown-ups to work in a more productive
way and the elderly live a healthier longer life (Obama, 2016). According to Garunay (2016), the
ACA has reformed the health care through expansion and improvement of medical coverage
since the population or the uninsured American had been reduced from 16 percent (9 million
people) in 2010 to 9.1% (29 million) in 2015. This a significant decrease of 46%. This paper
outlines players alongside the roles and functions played, who enhance the development
approval and implementation of the ACA that was purposely made as a health reform in the
health sector to save and improve lives of the Americans who could not afford the medical costs.
Players Involved in the Policy
There are many players who have made ACA deliver as planned. Actors that participated
in the creation, approval, and execution of the ACA are both government and private
stakeholders. These actors played different roles and functions in the insurance policy of the
ACA. Examples of these players include the US government, pharmaceutical firms, insurance
companies, physicians, employers, patients, interest or lobbying groups, and the general public
(Saint Joseph's University, 2017). The government is the overall body that controls all activities
THE AFFORDABLE CARE ACT POLICY ANALYSIS
4
involve in the creation, authorization, and execution of the policy. Pharmaceutical firms are
companies that manufacture and sell medicine and other medical products and facilities. They
can either be public or private. Insurance companies can also be run on either private or public
basis. They offer protection services in the healthcare sector. Employers are owners of
businesses who provide employment opportunities to American citizens and pay them for labor
services they provide to their firms or companies. Physicians are one of the service providers in
healthcare facilities. Patients are citizens who are customers to some of the actors such as doctors
and pharmaceutical firms. On the other hand, interest groups are significant players in the
creation as well as the implementation of ACA. They push for legislation while focusing on their
targeted benefits. The functions and roles played by these actors are interrelated in nature as
highlighted next.
Roles and Functions of the Players
Patients
Patients receive medical services from the physicians (Saint Joseph's University, 2017).
They are customers to healthcare providers such as doctors, and they consume medical care
services and products. They have a right to health services, and they are responsible for ensuring
they are healthy. Their function in the ACA was raising issues of quality of services given in
healthcare facilities as well as accessibility to medical care. Also, they provided opinions on
medical costs that make it difficult for them to have medical care.
Physicians
Physicians can be grouped as employees because they provide services they are paid for.
They provide services to patients since it is their fiducial responsibility to do so (Shipherd,
Walton, & Johnson, 2016). Although they are different from other actors in the healthcare
THE AFFORDABLE CARE ACT POLICY ANALYSIS
5
system, they are paid for services they provide to patients but a connection between a patient and
physician sacred faith that surpasses monetary payment. In the ACA doctors played a great
function in soliciting for policies that improved their working environment to improve patient
care and protection. Employers under the Obama Care Act provided provide the medical
insurance covers to their workers and varied with deductibles and co-pays. According to
Garunay (2016), ACA insurance policy also provided that those small businesses with less than
50 full-time employees and make below $ 250,000 would benefit more from a new affordable
quality cover. In this manner, employers enhanced access to healthcare to people who could not
afford the cost of medical services.
Insurance Companies
Insurance companies offered insurance services by selling the series in from premiums to
Americans. The sales of insurance covers were done either directly to patients or indirectly
through intermediaries of the government. They prioritize insurance covers in such a way that
they make high premiums sold. The firm link between insurance companies and the government
formed one of the major parts of the implementation of the ACA (Abraham, Simon, & KaracaMandic, 2015).
Pharmaceutical Firms
Pharmaceutical companies manufacture and sell medicines and other medical products
recommended by professional medical doctors. Just like insurance companies, pharmaceutical
firms can either be private or public. The played the role of ensuring the manufacture products
are of met the required health standards quality and quality. They also ensure the product are
available at the time of need. The companies receive salaries through the lawmaking drug-benefit
THE AFFORDABLE CARE ACT POLICY ANALYSIS
6
programs of health insurance as necessary by the ACA. It helped the government make medical
costs affordable. (Philipson, Koijen, & Uhlig, 2016).
Government
The government is the core driver of the insurance policy in the ACA. Its response to the
poor, disable and elderly American who were unable to afford medical bill was the primary
trigger towards the health reform. The role of government in the ACA policy ran throughout the
process its development and adoption. The government has three arms, the legislature, judicial
and the executive that helped gear towards ACA implementation. The legislative branch created
and enacted the ACA, the judicial interpreted the policy, and the executive played the role of
implementing it (Joshi, 2015).
Interest Groups
Interest groups can be other actor discusses above or any other associations that help in
the entire process of enacting and adoption of the ACA policy while pursuing interest benefits.
Lobbying groups that include political individuals, some legislative, judicial and executive
members were also helpful in enforcing the legislation and implementation if the policy.
Pharmaceutical firms are interest groups that put pressure on legislation and execution of the
ACA insurance coverage so that at the end of it all they have profited through the sale of medical
product the improve the quality of healthcare.
Political Influence of the Players
Interest Groups or Lobbying Groups
THE AFFORDABLE CARE ACT POLICY ANALYSIS
7
Interest and groups had the energy to face the government and exert pressure on the
legislation and policy adoption. Interest groups such as pharmaceutical firms have the motive of
gaining more profits in their businesses apart from meeting the requirement of the ACA policy,
of manufacturing quality medical benefits and availing them accordingly. Pharmaceutical firms
are interrelated with the government since it is the government that sets the standards required
for the products. There have been conflicts in the prices established by private and public firms
about the products manufactured. They affect the ACA policy by enhancing quality healthcare
through production and sale of quality products.
Insurance Companies
These firms affected the prices of premiums they offer to individuals. Their primary
motive is to ensure all the poor, disabled and low-income earners in America have access to
healthcare by providing subsidized insurance covers. They also have the purpose of making
profits from the sales of insurance covers. They have an interrelation with the government in a
way that they receive funds from the government to cater for a given percentage of premium
prices on medical covers for the poor, disabled and elderly Americans. Conflict in fluctuation of
premium prices due to inflation as well as disputes among insurance firms themselves due to
negotiated rates of premiums. These businesses have an influence on the policy in that it fosters
healthcare access (Abraham, Simon, & Karaca-Mandic, 2015).
Conclusion
The ACA policy was enhanced by many actors. The government, insurance firms,
pharmaceutical industries, physicians, patients and interest groups are among the players in the
adoption of this policy. The various functions and role played by these actors were essential tools
for the success of the ACA policy. Establishment of the policy, enacting, and implementation,
THE AFFORDABLE CARE ACT POLICY ANALYSIS
8
provision of insurance covers, manufacturing and sale of medical products are among the roles
that realized expansion and in the delivery of healthcare among the American. In turn, the ACA
positively impacted the health of American by increasing the coverage of people who have
access to quality and affordable medical care.
THE AFFORDABLE CARE ACT POLICY ANALYSIS
9
References
Abraham, J. M., Simon, K., & Karaca-Mandic, P. (2015, January 01). IS The Medical Loss Ratio
a Good Target Measure for Regulation in the Individual Market for Health Insurance?
Health Economics, 24(1), 55-75.
Coffin, J., & Rak, S. (2013). Affordable Care Act. , 28, 5.). The Journal of Medical Practice
Management : Mpm, 28(5).
Garunay, M. (2016, July 11). President Obama Writes on Health Care Progress in the Journal
of
the
American
Medical
Association
_
whitehouse.gov.
Retrieved
from
obamawhitehouse.archives.gov: https://obamawhitehouse.archives.gov/
Joshi, N. K. (2015, March 01). Party Politics, Governors, and Healthcare Expenditures.
Economics & Politics, 27(1), 52-78.
Obama, B. J. (2016, August 2). United States Health Care Reform: Progress to Date and Next
Steps. Journal of American Medical Association: Clinical Review and Education, 525532. doi:10.1001/jama.2016.9797
Philipson, T. J., Koijen, R. S., & Uhlig, H. (2016, January 01). Financial Health Economics.
Econometrica, 84(1), 194-245.
Saint Joseph's University. (2017, January 27). Institute of Catholic Bioethics: Health Care
Reform. Retrieved from sites.sju.edu: https://sites.sju.edu/icb/health-care-reform-dutiesand-responsibilities-of-the-stakeholders/
Shipherd, J., Walton, H. M., & Johnson, L. (2016, January 01). The Psychologist's Role in
Transgender-specific Care with U.S. Veterans. Psychological Services, 13(1), 69-77.
Purchase answer to see full
attachment