Public Policy Obamacare Chapter

Length: 5 pages Sources: 10 Subject: Healthcare Type: Chapter Paper: #71933313 Related Topics: Obamacare, Affordable Care Act, Public Vs Private, Monetary Policy
Excerpt from Chapter :

Public Policy the Affordable Care Act

The Patient, Protection and Affordable Care Act transformed the landscape of modern American healthcare. It is changing how people receive a variety of services ranging from primary care to specialized procedures. The current issues are showing a divide that exists between liberals and conservatives. At the heart of this approach, is the role of the federal government vs. The free market. This means that each side will make statements which are designed to support their arguments and illustrate the long-term effects on everyone. Once this happens, is the point they will state how this will make the underlying problems better or worse. (Emanuel 2014)

Describe this health care policy from the Affordable Care Act as being an issue

In the next 20 years, there will be a dramatic expansion of Medicare and Medicaid. This is because the Affordable Care Act is transforming who can qualify to receive coverage and the types of services that are provided. One of these changes is taking place with the creation of state exchanges. They will offer healthcare to individuals who are unemployed, self-employed or do not have coverage at work. In most situations, there will be a focus on using preventive medicine (i.e. primary care, community-based services and support). This will change the kinds of solutions that are offered in order to reduce costs.

The second transformation is from the elimination of denying coverage for preexisting conditions. This will lead to greater expenses for individuals with significant health problems. As the physician they are seeing and the support they require, are much higher in contrast to other patients. ("Affordable Care Act," 2014) To create positive changes, the government could make the exchanges offer more plans. That is providing basic services and major medical through the gatekeeper system. This is when the person's primary care provider must approve the use of expensive services (such as: visiting a specialist). In the long-term, costs can be controlled through having a system in place to prevent abuses. To make certain that all insurance companies are following these provisions; requires having the National Association of Insurance Commissioners compare them with other rates offered on similar policies. This will ensure that consumers are not being abused based upon the condition of their health or economic related factors. (Davidson, 2013)

Describe the gaps in healthcare in the United States that this policy will address

There are a number of individuals who are typically without health insurance. The most notable include: the unemployed, middle class, self-employed and part time workers. In the case of the unemployed, they cannot receive any kind of assistance with costs unless they qualify for Medicaid. The problem is that many are receiving unemployment benefits and earn more income than the program allows. This means that their coverage has lapsed, when they were laid off from their jobs, by not being able to afford the premiums from their group policies. The middle class is impacted based upon the fact that they cannot pay the premiums for additional amounts of coverage (which is not included with their policy). These gaps will cost them more for healthcare services and have higher deductibles with limited amounts of protection. The self-employed are impacted as they cannot afford a group or individual policy. This is because they run their own businesses and will put more money back into their operations. The result is that health insurance is considered to be a luxury they cannot afford at the moment. Part time workers are not covered by their employer's group policy. In these kinds of situations, they do not earn enough money to pay for the premiums on an individual policy. This means that they will have to forgo any protection until their status changes to full time. Each one of these individuals' financial states is predictable. This is because they are facing monetary challenges and simply cannot afford the costs of seeking out coverage on their own. Once this takes place,...


(Tate, 2013) (Murdock, 2012)

The Affordable Care Act is changing the kinds of protection offered to the ordinary person. This requires insurance companies offering them with coverage regardless of previous ailments / conditions. While at the same time, select individuals can receive assistance from higher standards to qualify for Medicaid. It also makes it more expensive for those who do not receive protection through a $450.00 tax on the uninsured. (Tate, 2013) (Murdock, 2012)

To improve competition, the Affordable Care Act is allowing providers and consumers to purchase low cost solutions in the Health Exchange Marketplace. This is run by the states and the federal government. It offers everyone with the ability to compare rates and determine which insurance companies can meet their requirements. This impacts the typical person by providing them with more options. (Tate, 2013) (Murdock, 2012)

Provide Evidence from the literature that indicates this policy will be effective correcting the gaps in U.S. healthcare

The U.S. healthcare system is a market failure. This is when the free enterprise system is not delivering various products and services to consumers efficiently. Instead, costs are increasing and quality is declining. The combination of these factors creates a situation, where corporations are unable to effectively meet demand. In healthcare, a market failure occurs when the entire sector is unable to achieve these objectives. This is problematic, as these kinds of challenges will hurt the services that are provided. Over the course of time, this makes it difficult to keep up with these shifts in the long-term. The result is that more people are being priced out of the system and unable to receive affordable care. Once this happens, is the point they will be unable to pay for coverage. This increases their risks of not seeking out treatment for various conditions until much later on. (Gruber, 2011)

A good example of this can be seen with observations from Nathanson (2011). He found that there are certain segments that are overlooked by the system (i.e. older adults). In this case, someone from this demographic, who has individual coverage and is wealthier, is experiencing better levels of health. This is problematic, as these people often do not have enough coverage and cannot afford the high costs. Evidence of this can be seen with Simantov saying, "We find that adults in this age group covered by non-group plans tend to be healthier and wealthier than the average for their peers, yet more of them go without care and experience high medical bills relative to their incomes. Individual-market premiums rise steeply with age in most states and are well above employer-group rates. Costs are likely to be unaffordable for most uninsured older adults, even with large tax credits or in states with community rating. These findings indicate a need to include risk and age pooling to reach the uninsured in this age group." (Nathanson, 2011) This is illustrating how a market failure exists inside the healthcare system. As a result, one could argue that it creates a survival of the fittest atmosphere.

In these situations, the government is not regulating the industry. This is because it is mainly relying on the free markets to provide these services and set prices. The combination of these factors makes it difficult to ensure that the industry is effectively responding to the needs of consumers. Instead, the majority of providers and insurance companies are focused on maximizing their profit margins. During this process, they will decrease coverage and expenses. This causes many people, who want healthcare, to not be able to afford it. The government can offer universal coverage, by forcing insurance companies to accept everyone. (Gruber, 2011)

At the same time, they can impose price caps on how much providers can charge for services. This is what is utilized by Medicare and Medicaid. In these situations, the government has negotiated lower costs in comparison with private programs. If this type of model is used, the government can regulate the industry and ensure that the free market system is functioning properly. The best way to deal with the issues of market failure; is through more effective regulation. This will ensure that better quality is provided to consumers at affordable prices. (Gruber, 2011)

Describe from the Affordable Care Act how the effectiveness of this policy is going to be evaluated. What are they going to measure to determine effectiveness after the policy has been implemented.

There are different views about the law and its effectiveness. In many cases, they are divided along ideological lines (i.e. liberal and conservative). Liberals argue that the Affordable Care Act is necessary. This is because healthcare costs, insurance premiums and out of pocket spending are skyrocketing. The law was passed to deal with these issues and make certain that more people can receive coverage at affordable prices. If the law were to fail, these disparities will become more pronounced. This will lead to greater numbers of people not being…

Sources Used in Documents:


Affordable Care Act. (2014). Medicaid. Retrieved from:

Davidson, S. (2013). A New Era in U.S. Healthcare. Stanford, CA: Stanford University Press.

Emanuel, E, 2014, Reinventing American Healthcare, Public Affairs, New York.

Fine, P. (1993). Herd Immunity. Epidemiologic Reviews, 15 (2), 265-298.

Cite this Document:

"Public Policy Obamacare" (2015, May 11) Retrieved January 20, 2022, from

"Public Policy Obamacare" 11 May 2015. Web.20 January. 2022. <>

"Public Policy Obamacare", 11 May 2015, Accessed.20 January. 2022,

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