Public Policy: The Patient Protection and Affordable Care Act - Research Paper Example

Public Policy/Federal Law Table of Contents Introduction 3 of the Policy/Law – History and Current Situation 4 Rationale for Public Policy – Market or Government Failure 5 Analysis of Policy’s Efficacy 7 Implementation of the Public Policy 9 Evaluation of the Public Policy 10 Recommendations and Conclusions 11 References 13 Introduction Countries, in the modern day context, intend to place themselves in a comparative position where they can act or depict themselves as superior from other nations of the world. Contextually, the approach of government in any nation, towards the formation of public policies can also be depicted as an attempt to enhance the performances of the public sector of the nation. In order to obtain an in-depth comprehension in this regard, this particular study will focus on conducting a research on one of the most widely argued public policies of the United States of America, i.e. The Patient Protection and Affordable Care Act (PPACA). The Patient Protection and Affordable Care Act (PPACA), which is also known as the Affordable Care Act or the Obamacare, can be categorized as a public policy enforced by the government with an intention to reform the health care sector of the US. The PPACA can be succinctly explained as the ‘federal statute’ of the US, signed in the year 2010 by the 44th president of the country, Mr. Barrack Obama, to reform the health care system of the nation with the primary intention to assure quality health care product and services to the citizens at an affordable price (DPCC, n.d.). In this research paper, the discussion will emphasize a thorough review of the PPACA, following a systematic process. In the first step of the research, the history along with the current situation of the policy or the law will be determined. In the next step of the research, the reasons that motivated the government to enact the law will be depicted. In the subsequent step of the research, discussion will aim at depicting the efficiency of the law with comparison to the primary objective of enacting the law. The subsequent step will analyze the policy to obtain a critical view on its various characteristics and principles. Ultimately, in the next stage of the research, focus will be shifted towards analyzing the effectiveness of the policy in the present day context along with providing recommendations in the subsequent stage. Description of the Policy/Law – History and Current Situation As mentioned earlier, the Patient Protection and Affordable Care Act (PPACA) is also widely known as the Affordable Care Act or the Obama Care Act. The reason for depicting the act as the Affordable Care Act is owing to the aspect that it promises quality health care products and services to each and every citizen of the United States at an affordable or reasonable spending. The act is also termed as the Obama Care Act, since it has been enacted under the leadership of the current president of the nation, Mr. Barrack Obama in the year 2010. Observably, this law primarily depicts that citizens of the nation will be provided with better quality health care services whenever and wherever they are in need for the same within the country. The Act also intends to prevent further growth of health care spending of the nation, which has shown a continuous rise over the years. From a generalized perspective, the Act stated that those who are acquiring a health insurance benefit with their identification as an American, will be liable to get access to a considerable number of benefits, rights along with protections from the federal law. This particular benefit is further expected to ensure that the common public will be able to obtain treatment with affordable spending along with avail protections from the commonly reported abuses in the health care setting as well as the insurance sector of the nation. The Act also proposed to reduce the premium of the health care insurance, further making it affordable for majority of the citizens of the nation, which currently amounts to approximately 32%. After the implementation of the act, more than 90% of the citizens are deemed to get insured to health care insurance benefits irrespective of the bars raised by the private insurance providers. The law further distributes the risk equally to the people who are insured making further eliminations to the aspect of discrimination, which was apparently observed in the past where discrimination on the basis age, sex and race was allegedly practiced in the health care insurance sector. Furthermore, the act also deemed to ensure maximum competitiveness in the healthcare sector as it provides consumers (i.e. the patients) in the health care sector with a collective buying power where they will be able to compare their treatment plans and receive cost assistances for their health care spending (Cannan, 2013). It is worth mentioning in this context that the historical facts associated with any Act or legal reform mainly depicts the chain of events related to its creation. Contextually, the emergence of the ACA also has a noteworthy history associated with it. The implementation of the law involved a large number of issues and debates, which further require it to follow certain procedures to obtain the clearance. Observably, the law was enacted with the combination of two separate legislations, which included Patient Protection and Affordability Care Act (PPACA) along with the Health Care and Education Reconciliation Act (HCERA). This aspect imposed significant challenges for the law as both the legislations offered different sets of legislative norms. Owing to such differences, the law was merged or aligned in the THOMAS (i.e. the “Library of Congress’s legislative database”) before presenting it for final passage where a thorough and careful reading of all the associated legislative documents accompanied with the decisions of the concerned authorities (Cannan, 2013). Rationale for Public Policy – Market or Government Failure Apparently, the Obamacare policy was enacted with the intention to ensure affordability along with quality in the health care setting. The act was also intended to control the continuous spending of the country in the healthcare sector owing to lack of proper legislation. However, reasons for the emergence of the Affordable Care laws can better be justified from some of the practices that have been inappropriate in the health care settings. Prior to the proposition of the Act, issues and challenges were continuously emerging in the insurance and the health care sector of the nation. Observably, before the emergence of the act, the health care sector of the US was privatized. This primarily worked towards profit gaining that further affected the quality of the health care services provided in an unfavorable manner. Many of the practices were considered as far as the perceptions and experiences of the patients are to be considered, which again depicts the need for the reformation of the health care sector. Previously, the conduct of the healthcare sector was observed to be entirely objective oriented towards offering high quality medical treatment, which confined its benefits to only middle and high-income people. While on the other hand, people who were unable to obtain a medical insurance were entitled for health care facilities in the scenario of emergencies only, with the assistance of other regulated health care programs such as Medicaid and Medicare among others. Such segregations in the health care services sector impacted the balance of full medical coverage to each and every citizen of the nation. The Obamacare Act was certainly vital in this regard, as it enables the people of the nation to get full coverage of the health care programs equally (The White House, 2013). Furthermore, it has also been analyzed that prior to the formation of the act, the health care insurance companies operating in the sector has been extensively involved in increasing the price of the insurance in an unfair manner, further depicting the needs of having a proper regulation in that regard to control the unfair approach of the healthcare insurance companies. Additionally, the insurance policies of the companies also raised various issues owing to the aspect that the conditions set by insurance companies hinder the deliverance of proper medical services to the uninsured citizens, which again affects the motive of total coverage through health care services towards ensuring social interests to medical assistances. Obamacare assured that each and every citizen of the nation can afford a health care insurance, which further makes them liable to get access to each and every healthcare service equally (Obamacare Facts, n.d.). Hence, it is apparent that failure of the past approaches of the legal authorities, with regard to control the health care sector of the nations along with the insurance companies of the sector, has certainly resulted in the formation of the Obamacare Act or the ACA. Analysis of Policy’s Efficacy As depicted earlier, the ACA is regarded as one of the most significant developmental aspects in the healthcare setting of the country. Observably, the law was enacted with the intention of enhancing the quality as well as the affordability of the healthcare insurance amid the citizens of the nation. The law primarily comprises specific revised rules for the insurance companies as well as the healthcare organizations of the nation in order to overcome the challenges of the health care industry of the country (Tate, 2012). However, analyzing the effectiveness of the policy in the practical scenario will also be a crucial to comprehend about this particular act. Observably, the effectiveness of the act can be directly depicted from the changing situations in the healthcare sector. As per the report of Ungar (2014), it was predicted that the Obamacare Act will negatively affect the full time employment owing to the aspect that it will reduce the working hours of the employees, which will allow them to get proper health care services for themselves. However, results obtained in lieu of the implementation of the Act suggests that the scenario is entirely opposite to that of what is predicted, rather positive results has been ascertained in the domain of full time employment. The report of Ungar (2014) also depicted that after the emergence of the Obamacare Act, the percentage of uninsured Americans has fallen considerably from 17.1 % in the year 2013 to 15.9% in the early days of 2014. This depicts that a large number of people have been able to afford health insurance with the virtues of ACA (Ungar, 2014). Correspondingly, the report by Pickert (2014) depicted that the number of people enrolling for health care insurance, as per the new health care reform laws, has been quite significantly rising, which although lesser than expected does not neglect the efficiency of this law. The number is rising considerably, which is currently accounted at 4.2 million and is expected to rise even further in the coming years. It will also be important to mention that more than 80% of the people who have enrolled for health care insurance as per the Obamacare Act will be liable to get a considerable reduction in their costs of insurance premiums. Apart from that, they will be able to access each and every medical service with assured quality level from the health care sector in the present day context. The report of Pickert (2014) also depicted that the Act has been quite successful in targeting the uninsured citizens of the nation in terms of health care policies (Pickert, 2014). Correspondingly, a survey report of Sendor (2014) stated that around 55% of the uninsured adults of the country affirmed that they would surely purchase a health care insurance for themselves in the coming months owing to the benefits they would be liable to get as per the ACA. Again the fact that more than 6 million uninsured people of the United States, as were accounted prior to the formation of the Obamacare Act, has now been insured with a health care insurance also implies that the law has been effective in reducing the number of uninsured and offering better health care facilities to the citizens in the nation (Sendor, 2014). All these reports depict that the Obamacare reforms have been moving quite smoothly and effectively towards its ultimate destination, i.e. to ensure proper and quality health care services to each and every citizen of the country. Though some reports also suggest that the Act has not been able to attain the predetermined targets but the slow and the steady growth of the positive affect of the Act throughout the nation, certainly affirms the effectiveness of the ACA. Implementation of the Public Policy The Obamacare Act is regarded as one of the most important reforms in the health care sector that has attracted the attention of maximum number of people throughout the country. The Act has passed through several debates and challenges before it has finally stated to ensure an extensive implementation throughout the nation. With several delays in some part of enacting the law, the Act has taken a considerable number of years before it was finally passed by the concerned authorities. The implementation of the law has several political aspects associated with it. However, the political parties associated with the formation of the Act believes that a positive start will reduce the hindrances towards implementing the law in an extensive manner altogether. Again, the federal government has offered a certain degree of liberty in making some of the decisions regarding the implementation of the law with the state government, which indicates that the ACA might not have equal implications in all the states and have different effects in satisfying the health care needs of those societies. The concerned authorities associated with the law are aware of the complexity of the law for the general people. Therefore, a set of people called ‘navigators’ will be trained in every state to acquaint the people with the policies associated with the new law and assist people in purchasing health care insurance, which is also regarded as the first and the most important steps of the policy implementation. The training of the navigators will be directly funded by the federal government through state government. However, in some states, the operations of the navigators have been affected by the negative approach of the state government towards ACA. After ensuring that each and every citizen of the nation is insured with medical insurance, the other benefits of the law will become extensively applicable. In the next step of the process of implementation, the policy makers will judge the success or failure of the law based upon certain criteria. Some of these criteria include whether there is a decrease in the number of uninsured people post ACA implementation and whether there is a decrease in the health care spending of the nation while enhancing the functions of the nation thereupon. This criteria will help in the evaluation of the policy in the future context (Burke & Kamarck, 2013). Evaluation of the Public Policy As mentioned in the above discussion, the evaluation of ACA will be made on the basis of certain criteria based on which, the success or the failure of the law will be depicted. One of the important criteria noteworthy in this regard is the rate of reduction of the number of uninsured people within the nation. The law intends to assure that maximum percent of the people of the nation are insured with some kind of medical insurance in order to attain the benefits provided by the ACA. Contextually, the reports of Ungar (2014) suggested that the number of uninsured people in the country have reduced from 17.1% (approx) in 2013 to 15.9% in the present day context. This can be regarded as a strength of the act where it could assist a large number of uninsured Americans to buy Health insurance. However, Sendor (2014) depicted that the results obtained is not equivalent to the predetermined effects of the policy makers. This might act as a weakness for the act. Again, the next criterion is whether the number of people, who need to pay penalties because they are insured, has decreased. In this context, the report of Sendor (2014) depicted that more than 55% of the people (as per a particular survey) are willing to get health care insurance in the coming years rather than paying penalty of $95. This can be regarded as strength for the ACA. Another criterion of evaluating the success or failure of the policy is to analyze whether there is a decline in full-time employment owing to avail proper time for employees to get medical treatment as per ACA. Contextually, the report of Ungar (2014) stated that the number of full-time employees has increased over the recent years of fact that ACA instructed employees to assure proper time for them to get basic medical attention. This shows that people are able to make a balance amid their job responsibilities and medical requirements, which can again be specified as strength for this particular policy (Burke & Kamarck, 2013). Notably, there are some more criteria to evaluate the policy for its effectiveness, but owing to fact that the policy is in its initial phases of implementation, very little can be affirmed in that regard. Recommendations and Conclusions As apparent from the above discussion, the ACA has to face certain challenges with regard to reach its ultimate goal, which is to reform the health care sector in a positive direction. One of the most crucial in this regard is the concept of enrolling a large number of people in a privatized insurance plan, which further raises questions regarding the aspect that the approach of the government is more towards a profit making venture. In this regard, in the future context, the policy makers will need to take measures to deal with such scenarios and conceive ideas to ensure that it acts entirely towards the wellbeing of the people in the society. Again, it is often argued that the ACT will impact the economy of the nation as spending will increase considerably for ensuring its total implementation (The Washington Post, 2013). Contextually, in the future context, policy makers will need to consider the aspect of governmental cost as well, while enforcing any public, which if ignored might impact the economy in an unfavorable manner altogether. Undoubtedly, Obamacare act is one of the most vital reforms in the health care sector of the US when compared to other public policies enacted in the last few decades. It has intended towards ensuring a better health setting where the citizens of the nation are able to access quality healthcare services. Passed in the year 2010, the law has faced numerous social and political challenges, which further hindered its extensive implementation as observable in the current scenario. However, the preliminary results, with regard to the implementation of the law have been quite positive and are expected to continue likewise in the future context. References Burke, S. & Kamarck, E. (2013). The Affordable Care Act: A Users Guide to Implementation. Centre for Effective Public Management, pp. 1-35. Cannan, J. (2013). A legislative history of the affordable care act: how legislative procedure shapes legislative history. Law Library Journal, 105 (2): 131-173. The Washington Post. (2013). Two problems that could undermine the affordable care act. Retrieved from http://www.washingtonpost.com/opinions/design-flaws-in-the-affordable-care-act/2013/12/13/905571ce-636e-11e3-aa81-e1dab1360323_story.html DPCC. (n.d.). The patient protection and affordable care act. Retrieved from http://www.dpc.senate.gov/healthreformbill/healthbill04.pdf Obamacare Facts. (n.d.). Obama care bill: Obama health care bill. Retrieved from http://obamacarefacts.com/obamacarebill.php Pickert, K. (2014). Obamacare enrolment up to 4.2 million. Retrieved from http://time.com/20389/obamacare-enrollment-affordable-care-act/ The White House. (2013). Why we passed the affordable care act in the first place. Retrieved from http://www.whitehouse.gov/blog/2013/10/30/why-we-passed-affordable-care-act-first-place Sendor, J. (2014). Surprise! Obamacare is really working. Retrieved from http://www.refinery29.com/2014/03/64164/obamacare-uninsured-rate Tate, N. J., 2012. Obamacare survival guide: the affordable care act and what it means for you and your healthcare. USA: Humanix Books. Ungar, R., 2014. The real numbers on the Obamacare effect are in-now let the crow eating begin. 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