Policy Discussion Board 2
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School
Walden University *
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Course
6205
Subject
Political Science
Date
Dec 6, 2023
Type
docx
Pages
2
Uploaded by MattM5
Reflect on how federalism affected the evolution of health policy in the United
States. For your initial post, examine your particular state and its implementation
of a policy such as Medicaid or the Affordable Care Act. Describe how the
tension between Federal and State initiatives impacts the implementation of a
particular policy.
…………………………………………….
Federalism has a major affect on the evolution of healthcare policy in the United States
because of the allocation of responsibility between the individual state and the federal
government. Healthcare is mandatory and can be fulfilled through joint federal and state
programs such as Medicaid. Depending on the state, policy, administration, and financing, the
implementation of such programs is impacted. In many cases there is shared control unless there
is no national consensus or there is a new issue.
In California 20 percent of the population in 2012 were uninsured (DeNavas-Walt,
Proctor, and Smith 2012). The Affordable Care Act (ACA) expanded federally funded Medicaid
to individuals who had not previously been eligible such as the nondisabled or those above the
federal poverty level. Because of such a high percentage of the population that was uninsured the
financial aspect of implementing a policy at a state level may be inappropriate, yet
implementation of such a policy nationwide may assist the state and provide increased support.
Such an initiative impacts the policy and implementation in California because states can better
tailor their policy to meet local needs, yet the ACA was implemented as a federal policy. Because
of the disparity between state’s uninsured population the impact of the ACA the federal
government gave states more flexibility by letting them opt out of the policy to expand the
shared control program.
The shared control can be tension between both the federal and state governments.
Federal policy can be more easily redistributed and yields better uniform policies to achieve a
goal, but some control is lost by the state (GW Nursing, n.d.) . The legislation will impose new
costs for the state government and allow the federal government more authority over health
insurance regulation. State lawmakers will want to protect their constituents from the adverse
effects. In addition, as this program expands state legislators need to continue to plan for new
legislative sessions and plan for changes to their current budgets.
References
DeNavas-Walt, Carmen, Bernadette D. Proctor, and Jessica C. Smith. 2012.
Income,
Poverty, and Health Insurance Coverage in the United States
: 2011. Suitland,
MD: Census Bureau.
GW Nursing. (n.d.). American federalism. Retrieved from:
http://learn.gwnursing.org/Education/LearningObjects/Federalism/index.htm
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