HCS455 Wk3
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Dec 6, 2023
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Influencing Skills Report
Kristen Draper
University of Phoenix
HCS/455 Health Care Policy: The Past and The Future
Marilyn Ketchum
11/7/23
Proposed Legislation
The proposed legislation H.R. 4531: Support for Patients and Communities
Reauthorization Act is a bill requesting reauthorization through FY2028 in which it modified
various grants, programs, and activities that address substance use and misuse. The bill
proposes reauthorization of the SUPPORT Act of 2018 which provided funding for community-
based drug addiction treatment and recovery programs and is composed of various titles, most
of the 2018 policy provisions have a five-year lifespan, which is where this proposed
reauthorization act comes into play. The reauthorization includes expansion of funding for
overdose crisis, make medications for opioid use disorder (MOUD) more accessible and include
reevaluation by the FDA and MDHHS for buprenorphine-naloxone drug class scheduling to a
lower class to make it more available, as well as includes illicit xylazine to be moved to a
schedule three class. The reauthorization will also allow expanded Medicaid services to those
who are incarcerated or on trial. In 2018 when the SUPPORT bill was passed there were
approximately 70,000 American lives lost to drug overdose, five years later, that number has
increased to 110,000, which is a huge driver for the approval and expansion of the SUPPORT act
reauthorization, without the approval the number of overdose deaths could significantly
increase over the next two years.
The SUPPORT Reauthorization Act as of September 18, 2023, is currently in the
Legislation phase of formulation. The bill was introduced to the House of Representatives and
was referred to the committee of energy and commerce, committee on the judiciary and the
committee of education and the workforce, the committees will review, research, and revise the
bill before voting on whether to send the bill back to the house of representatives. Currently
consideration and mark-up sessions have been held for two of the three committees. Once the
third committee completes its review and mark-up, the bill will leave the committees and return
to the house of representatives and will be scheduled for floor consideration and debate and
may be amended. After the bill is debated and all changes have been made the house of
representatives will vote on the bill viva voce (voice vote). If majority says yes, the bill is then
passed onto the senate and the same steps are repeated, and if approved the bill passes onto
the president where the president can approve the bill, veto the bill or do nothing (pocket veto),
if the president approves the bill the bill is signed into law and enforced by the government.
Stages of the Policy Process
For a bill to become a law, it must be approved by the U.S. House of Representatives, the
U.S. Senate, and the President. Once a bill is proposed it must go through the process of
becoming a law. The process has many parts including formulation, legislation, implementation,
evaluation, analysis, and modification. Each phase has significant importance and helps the bill
become a law.
The formulation phase
involves agenda setting and the development of legislation, this
is where problems are identified, and viable solutions are discussed, congress must
introduce the bill to legislation and the bill must be sponsored.
The legislative process
is when the bill is referred from the house of representatives to a
committee where the bill is added to the committee’s calendar the committee can
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review the bill or refer it to subcommittees where the bill is examined, reviewed, and
make changes, if the subcommittee votes not to report legislation the bill dies. If the
subcommittee reports the changes the bill returns to the committee and the committee
votes on its recommendations which is called “ordering a bill reported.” Once approved
the committee will order a written report on the bill which describes the bill's intent and
the scope of legislation, impact on existing laws and programs and the views of the
committee. The written report is then referred to the house of representatives where it
is then placed on the calendar for debate. Once the bill is debated and amended the
house of representatives votes on the bill and once approved the bill is then referred to
the U.S. Senate where the same process and procedures are followed. If the senate
makes changes, then a conference committee will reconcile the differences, if the
committee cannot reach agreement, then the bill dies, if the committee can reach
agreement a report is drafted, and the house of representatives and the senate must
approve the conference report. Once both the house of representatives and senate
approve the bill, the bill is referred to the president and the president decides if the bill
becomes a law or is vetoed. If the president veto's the law, congress can attempt to
override the veto which requires two-thirds of vote.
The implementation phase
starts after the bill is signed into law. Implementing
organizations are executive branches of federal and state governments responsible for
carrying out the law enacted by legislation. Implementors are required to establish
regulations and policies to support the law and bring those policies into operation. The
policies and regulations are then evaluated and analyzed to ensure that the policy is
effective, that the policy has been beneficial, and that the policy objectives have been
achieved
(Meacham, 2020).
The modification phase
happens continually as policymaking is not perfect and is a very
intricate process. Modification helps make accommodations for changing circumstances.
Modification efforts can allow prior decisions to be reviewed and modified if needed.
Stakeholders
There are many stakeholders that are involved in the policymaking process, stakeholders help
identify areas of agreement and disagreement and provides an opportunity to understand more
fully what may be driving the stakeholder's differences
(Lemke & HarrisWai, 2015). Having input
from various stakeholders is also a key factor for increasing quality and trustworthiness of
health care policies aimed at improving healthcare quality and outcomes. A stakeholder is a
person, group or organization involved or affected by a course of action. The main stakeholders
can include politicians, government officials or employees, insurance companies, physicians,
and patients. Policymakers will look to patients identify key data that can then be used to
compose a healthcare bill that can be presented to government officials in hopes of obtaining
sponsorships and be presented to legislators. Having strong stakeholder relationships helps
facilitate credibility, understanding, collaboration and cooperation.
References
GovTrack.us. (2023). H.R. 4531 — 118th Congress: Support for Patients and Communities
Reauthorization Act. Retrieved from
https://www.govtrack.us/congress/bills/118/hr4531
Lemke, A. A., & HarrisWai, J. N. (2015). Stakeholder Engagement in Policy Development:
Challenges and Opportunities for Human Genomics.
Genetics in Medicine: Official
Journal of the American College of Medical Genetics
, 17(12), 949-957.
https://doi.org/10.1038/gim.2015.8
Meacham, M. R. (2020).
Longest's Health Policymaking in the United States
(7th ed.). Health
Administration Press.
https://bibliu.com/app/#/view/books/9781640552135/epub/OEBPS/xhtml/21_chapter-
title-4.html#page_223
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