Due On Or Before June 24, 2017, At 9:00 P.m. CST

Due On Or Before June 24 2017 At 900 Pm Cstmaintaining The Loyalt

Research a policy associated with the Affordable Care Act in your home state or another state that may affect healthcare reform and/or the way health care is provided in the chosen state. Describe the policy and who wrote and/or promoted the policy legislature (provide statistical data). What are the trade-offs offered to bring balance to the healthcare stakeholders? What role have public perception and disinterestedness played in the valuation of healthcare performance?

Describe how process innovation, risk taking, health policy analysis, and governance “sense-making” provide balance for stakeholders. Your paper must be 4 to 6 double-spaced pages in length (excluding title and reference pages), formatted according to APA style. Include a separate title page with the title, your name, course name and number, instructor’s name, and date submitted. Use at least four scholarly sources published within the last five years, in addition to the course text. Document all sources in APA style, and include a references page formatted according to APA standards.

Paper For Above instruction

The Affordable Care Act (ACA), enacted in 2010, represents one of the most significant overhauls of the United States healthcare system in recent history. In my home state of California, several policies stemming from the ACA have substantially impacted how healthcare is delivered and financed. This paper explores a specific California policy derived from the ACA, examines the stakeholders involved, and analyzes the trade-offs and balancing strategies employed through process innovation, risk management, health policy analysis, and governance “sense-making.”

California's Medi-Cal Expansion Policy

The most prominent ACA-related policy in California is the expansion of Medi-Cal, the state's Medicaid program. Implemented fully by 2014, Medi-Cal expansion aimed to increase healthcare access for low-income individuals by extending eligibility to those earning up to 138% of the federal poverty level (FPL). This policy was championed by then-Governor Jerry Brown and supported by the California State Legislature. According to the California Department of Healthcare Services (2019), Medi-Cal's enrollment increased by approximately 3.3 million beneficiaries following expansion, indicating a significant shift towards broader coverage.

The policy was promoted through legislative action supported by federal incentives, notably the ACA’s provision of matching funds to states that expanded Medicaid. The Federal government committed to funding 100% of newly eligible beneficiaries from 2014 to 2016, tapering to 90% thereafter, creating economic incentives for states like California to adopt expansion (Kaiser Family Foundation, 2020). The statistical data underscored the potential for improved health outcomes and cost savings by reducing uncompensated care costs and hospital emergency visits among uninsured populations.

Trade-offs and Stakeholder Balance

The expansion presented several trade-offs. On the one hand, it significantly increased healthcare access for vulnerable populations, improving health outcomes and minimizing financial strain on hospital emergency rooms operating with uncompensated care. Conversely, it increased state expenditures—though partially offset by federal matching funds—and raised concerns about long-term sustainability amid economic volatility and political opposition.

Healthcare providers, insurers, state government, and Medicaid beneficiaries are primary stakeholders. Providers benefited from increased reimbursement rates and reduced uncompensated care costs, but insurers faced increased Medicaid enrollment pressures and financial uncertainties. The state government had to balance these benefits against fiscal constraints and political opposition, especially from factions wary of expanding government-funded programs. Public perception of the policy’s effectiveness and fairness played a crucial role; positive public perception fostered support, while skepticism about cost increases and government overreach challenged its sustainability.

The Role of Public Perception and Disinterestedness

Public perception has been instrumental in shaping the valuation of healthcare reform efforts. A favorable view of expanded coverage improved political support and stakeholder cooperation. Conversely, perceptions of increased taxes and government overreach posed challenges. Disinterestedness, or objective assessment of policy outcomes, has gained importance as stakeholders and policymakers seek data-driven evaluations—such as reductions in uninsured rates and hospital ER visits—to justify continued or expanded policy measures (Hacker et al., 2017). These perceptions influence the allocation of resources, policy adjustments, and future healthcare reforms.

Balance through Process Innovation, Risk-Taking, and Governance Sense-making

Achieving stakeholder balance in healthcare reform requires process innovation—adopting new models of care delivery like integrated health systems and preventive services that improve efficiency and health outcomes. Risk-taking involves embracing innovative funding and payment models, such as value-based care, which incentivize quality over volume. Effective health policy analysis ensures that reforms are evidence-based, transparent, and adaptable to changing conditions, minimizing adverse outcomes and enhancing stakeholder trust.

Governance “sense-making” focuses on creating shared understanding among stakeholders about policy goals, operational realities, and ethical considerations. It involves collaborative decision-making structures that foster transparency, accountability, and stakeholder engagement. These mechanisms help align interests, distribute risks equitably, and promote sustainable policy implementation (Oliver & Hess, 2017). Consequently, integrating process innovation, risk management, and governance “sense-making” supports balanced stakeholder participation, promotes trust, and enhances the resilience of healthcare reforms.

Conclusion

The implementation of Medicaid expansion in California under the ACA exemplifies how strategic policy design and stakeholder engagement can foster balanced healthcare reform. While trade-offs exist—particularly related to costs and political opposition—process innovations, risk evaluation, and governance “sense-making” serve as vital tools to optimize stakeholder alignment. Equally important is public perception and disinterested assessment, guiding policy adjustments and fostering trust in healthcare reforms. As healthcare systems continue to evolve, these aspects will remain central to sustaining progress and achieving equitable health outcomes.

References

• California Department of Healthcare Services. (2019). Medi-Cal enrollment data. https://www.dhcs.ca.gov/dataandstatistics
• Hacker, J. S., Saltzman, E., & Solomon, J. (2017). The politics of health care reform. Annual Review of Public Health, 38, 147-164.
• Kaiser Family Foundation. (2020). Status of state Medicaid expansion decisions: Data from the 2020 survey. https://www.kff.org/health-reform/state-indicator/state-activity-around-Medicaid-expansion
• Oliver, M., & Hess, D. (2017). Governing health: Transformation through participatory governance. Health Policy, 121(10), 1022-1028.
• Smith, J. P. (2018). Evaluating the impact of ACA Medicaid expansion on health outcomes. Healthcare, 6(4), 130-137.
• Gonzalez, C., & Roberts, A. (2019). Public perception and healthcare policy: Analyzing stakeholder influence. Journal of Health Politics, Policy and Law, 44(3), 413-431.
• National Academy of Medicine. (2016). Innovation in health care delivery: Challenges and opportunities. NAM Reports.
• Centers for Medicare & Medicaid Services. (2021). Medicaid & CHIP: Opportunities and challenges. https://www.cms.gov/medicaid
• Brown, T. M. (2017). Risk management in health policy: Balancing innovation and stability. Journal of Risk Research, 20(5), 629-643.
• Friedman, M., & Friedman, R. (2018). The role of governance in healthcare reform. Journal of Healthcare Management, 63(4), 242-251.