BUS511 DB2
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School
University of Notre Dame *
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Course
511
Subject
Medicine
Date
Nov 24, 2024
Type
docx
Pages
4
Uploaded by BarristerWaterMosquito14
1.
Based on the videos and your readings, what role do you believe the government
should have in healthcare and why?
Role of Government in Healthcare
As the article notes, the question of how much government should be involved in healthcare is a
divisive one, and not only in the United States. The article focuses on the Affordable Care Act
(ACA) and other government initiatives aimed at achieving universal health care coverage. The
push for universal health care coverage, however, has slowed since Donald Trump's victory.
While the Affordable Care Act (ACA) has good intentions, its efficacy has been hampered by
attempts to dismantle it, particularly by the Republican-led Congress. The Affordable treatment
Act (ACA) posited that the government should have a role in establishing minimum standards
for health insurance, therefore increasing the number of people who could afford medical
treatment. There is still no consensus on how much involvement the government should have in
healthcare. (Blumenthal & Collins, 2014)
2.
From the two video presentations and the article
Universal Coverage Reforms in the
USA
, what are five things the Republican Party has been successful in achieving in
lieu of repeal of the ACA? Do you believe these five things are good health care
policy for Americans?
In place of a comprehensive repeal of the ACA, the Republican Party has instead accomplished
numerous key modifications. They were successful in getting rid of the law that required people
to have health insurance starting in 2019. Many provisions of the Affordable Care Act's (ACA)
health insurance exchange regulations were also undone by the Trump administration via the use
of administrative power. As a result, popular plans' premiums increased by an average of 34% in
2018, with more hikes expected following the requirement removal. The administration also
recommended reforms that might open the door for the selling of less expensive and less
comprehensive coverage while giving states greater leeway. The Trump administration has also
cut money for Affordable Care Act outreach during the yearly open enrollment period and
shortened the period itself. The research suggests that the number of uninsured Americans may
increase as a result of these policy changes, although this is still up for discussion. (Rice et al.,
2018)
3.
Utilizing the
Federalism and the ACA
article, describe the link between the federal
and state governments in the implementation of Medicaid expansion,
implementation of the insurance Marketplaces, and regulation of insurers.
An examination of the complex interplay between federal and state governments in the setting of
the Affordable Care Act (ACA) is provided in "Federalism and the ACA: Lessons for the 2020
Health Policy Debate" by Michael S. Sparer. (Oberlander & Weaver, 2015)
1.
Medicaid Expansion
: The Affordable Care Act initially required all states to increase
their Medicaid enrollment. The Supreme Court, however, ruled that this requirement was
unconstitutional. The increase of eligibility was thus rejected by more than a dozen states.
This case exemplifies how "partisan federalism" may impede universal coverage and
undermine the original legislative objective. Despite this, some states were able to gain
political cover to implement controversial provisions of the ACA because to the federalist
structure of the legislation. As a result, numerous states with Republican majorities have
implemented the ACA's Medicaid expansion in ways that were not anticipated.
2.
Insurance Marketplaces
: Marketplaces, or insurance exchanges, have been established
as a result of the ACA's federalist framework. Officials from each state and the federal
government have worked together to split up the responsibilities for maintaining these
Marketplaces. This partnership follows a common practice in the administration of health
care in the United States, in which state and federal representatives reach mutually
beneficial intergovernmental agreements.
3.
Regulation of Insurers
: The Affordable Care Act (ACA) instituted a set of government
restrictions with the intention of lowering the cost of private health insurance. The ACA
did not reduce the states' authority over healthcare regulation; rather, it strengthened it. It
is now the responsibility of the states to implement and regulate these federal regulations.
Furthermore, states may go above and beyond the federal minimums if they so want. In
addition, in late 2011, federal regulators made the decision to give states additional
leeway in determining the specifics of the essential health care package. The Trump
administration's attempts to reduce the scope and impact of federal insurance laws have
altered the intergovernmental relationship in insurance regulation.
In conclusion, the Affordable Care Act's implementation demonstrates the intricate interaction
between federal requirements and state discretion, with both levels of government impacting the
achievement of the ACA's aims. When thinking about the future of health policy in the United
States, the paper stresses the need of comprehending this federal-state interplay. (Sparer, 2020)
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References
Rice, T., Unruh, L. Y., van Ginneken, E., Rosenau, P., & Barnes, A. J. (2018). Universal
coverage reforms in the USA: From Obamacare through trump. Health Policy
, 122
(7),
698–702. https://doi.org/10.1016/j.healthpol.2018.05.007 Oberlander, J., & Weaver, R. K. (2015). Unraveling from within? the affordable care act and
self-undermining policy feedbacks. The Forum
, 13
(1). https://doi.org/10.1515/for-2015-
0010 Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act —
a progress report.
New England Journal of Medicine
,
371
(3), 275–281.
https://doi.org/10.1056/nejmhpr1405667 Sparer, M. S. (2020). Federalism and the ACA: Lessons for the 2020 health policy debate.
Health Affairs
, 39
(3), 487–493. https://doi.org/10.1377/hlthaff.2019.01366