Healthcare Policy Making in the Federal System

Topics: Government, Federal government of the United States, Health care Pages: 5 (1028 words) Published: May 25, 2014

Health Care Policy Making in the Federal System

Hali Briggs
POL 201 American Government

Prof. Amy Lyons
May 5, 2014




Patient Protection and Affordable Health Care Act
Open policymaking in the United States is molded on a basic level by American federalism. Federalism in the United States is defined as “a governmental system whereby power and authority are shared by national and state governments, with ultimate authority derived from the people” (Levin-Waldman, 2012). The interaction between the levels makes a muddled approach process. Government policymakers and bureaucrats at diverse levels of the elected framework – national, state and local – regularly have truly distinctive interests and points of view on how specific policies ought to be developed and implemented. In regards to health care policy, the national government has accepted essential obligation, with states playing a significant but auxiliary role. For national and state policymakers, there are three key objectives in healthcare policy: control services expenses of health care, improve the quality of health care, and allow for all citizens to have access to health care. The challenge is to beat the long-standing status of the U.S. as a nation with high medical costs paired with deficient coverage for a number of its citizens.

On March 23, 2010, after a multitude of debates and votes, Congress approved and President Obama signed into law the Patient Protection and Affordable Health Care Act ( This is the most comprehensive health care law passed at the national level, and possibly the most controversial too. This enactment is giving a real test of American federalism. Each state is required to create an exchange in which people can look for a competitive plan. This online exchange will offer individual people, families, and small businesses a venue in which to review suitable and affordable plans. In the event that a state does not make an exchange, the national government will do so.



There are many debates surrounding this new law as many feel it will do more harm than good. Under the law, tens of millions of uninsured will get access to competitive, quality, health insurance. In order to help cover the many millions who require monetary assistance, there are new taxes, generally felt by the upper income levels. These taxes are in the form of mandates; either as an individual mandate or an employer mandate. These mandates require individuals to obtain coverage, get an exemption, or pay a fee. However, it is estimated that over half of those uninsured prior to this new law, will be able to obtain free or low cost coverage thru their State’s exchange. Similarly, employers with an equivalent of 50 full time employees must provide health insurance coverage to their employees or they will have to pay a fine. This has prompted some businesses to cut employee hours to avoid meeting the criteria, although small businesses can qualify for up to 50% of their employees premium costs. ( While the law allows young adults to remain on their parents plans until the age of 26, there is concern that the premiums these young adults could be paying on their own would help offset the rise in premiums due to the sick. In order for the premiums to remain low, there needs to be a significantly large healthy pool of insured. Their premiums will offset the expenses the insurance company will have to pay for the claims of those that are sick. If healthy young adults remain on their parent’s plans longer, it decreases the cushion the insurance company has to cover such claims. Since you cannot be...

References: Levin-Waldman, O. M. (2012). American government. San Diego, CA: Bridgepoint Education,
Liptak, A. (2012, June 28). Supreme Court Upholds Health Care Law, 5-4, in Victory for
Obama. The New York Times. Retrieved from
Is the Patient Protection and Affordable Care Act (Obamacare) Good for America? (2010,
September). Retrieved from
The Pros and Cons of Obamacare. (n.d.). Retrieved from
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