Reflect: The U.S. Government's Expansive Role In Public Poli ✓ Solved

Reflect: The U.S. government's expansive role in public policy

The U.S. government's expansive role in public policy is caught in a swirl of conflicting crosscurrents. On one hand, popular expectations about the government's responsibility to solve problems often exceed the capacity of state and local authorities to respond effectively. On the other hand, policies developed at the national level may not sufficiently reflect the great diversity of interests across the U.S. to be effective at the local level. Moreover, the search for effective policy is further complicated by theoretical debates about the constitutional framework of federalism, including what limits on national power can be derived from the Tenth Amendment. Write: Select a policy or piece of legislation that directly impacts your current or future profession (i.e., your major). In your initial post, identify your profession or future profession, define federalism, and then select a specific piece of legislation that will directly impact it. Discuss the federalism challenges that the policy you have selected is creating or facing.

For example: If you are an education major, how are local, state, and federal government policies affected by the Every Student Succeeds Act or some other piece of education-related legislation? Fully respond to all parts of the prompt and write your response in your own words. Your initial must be at least 300 words. Support your position with at least two of the assigned resources required for this discussion, and/or peer reviewed scholarly sources obtained through the AU Library databases. Please be sure that you demonstrate understanding of these resources, integrate them into your argument, and cite them properly in-text and in a references list at the end of the post.

Paper For Above Instructions

In this analysis, I will explore the complex interplay of federalism and public policy in the context of the Affordable Care Act (ACA) and its implications for my future profession as a healthcare administrator. Federalism in the United States refers to the division of power between the national government and the state governments, allowing both to enact and enforce laws within their respective jurisdictions. This system is designed to cater to the diverse needs of states while providing a unified framework of governance at the federal level.

The Affordable Care Act, enacted in 2010, represents a significant shift in how healthcare is delivered and financed in the United States. It was designed to expand access to healthcare, improve quality of care, and reduce healthcare costs. From a federalism perspective, the ACA poses several challenges, particularly regarding the roles and responsibilities of state and federal governments in healthcare delivery.

One of the most prominent issues related to the ACA is the expansion of Medicaid, which provided states the option to expand eligibility for Medicaid programs to cover more low-income individuals. However, this expansion also faced numerous challenges. While the federal government offered financial incentives to encourage states to expand Medicaid, many states opted not to participate, citing concerns over long-term sustainability and the costs involved (Kenney et al., 2018). This decision highlights a critical conflict in federalism: the tension between federally mandated policies and states' rights to make decisions that reflect their populations' interests and needs.

This decentralized approach often results in a patchwork of healthcare policies, where residents in some states have access to expanded Medicaid while others do not. As a healthcare administrator, I am particularly concerned about how these disparities affect healthcare access and outcomes. States that chose to expand Medicaid have generally seen improved health outcomes and financial security for low-income residents (Cohen et al., 2017). In contrast, states that declined the expansion have witnessed increased rates of uninsured individuals and poorer health outcomes.

Another significant challenge posed by the ACA is the implementation of health insurance marketplaces. These marketplaces are intended to facilitate the purchase of health insurance by providing consumers with information and choices. However, states have had varying degrees of success in establishing and operating these marketplaces. Some states have developed their own marketplaces with robust participation, while others have opted to use the federally facilitated marketplace, which can lead to inconsistencies in consumer experience and access (Gruber et al., 2019).

The concept of federalism becomes increasingly relevant as states navigate the complexities of the ACA and its implementation. Federal guidelines and incentives incentivize states to adopt specific policies, yet states retain significant authority to modify or reject these guidelines. This dynamic creates a situation in which healthcare delivery is not uniformly regulated, leading to variances that can significantly impact communities. As a future healthcare administrator, understanding these dynamics will be crucial for effectively navigating the evolving landscape of healthcare policy and ensuring equitable access to care.

In conclusion, the Affordable Care Act illustrates both the potential and challenges of federalism in public policy, particularly in the healthcare sector. The concurrent authority of state and federal governments complicates the implementation of policies that aim to ensure equitable healthcare access. As I pursue a career in healthcare administration, it will be vital to recognize and address these federalism challenges to promote effective, inclusive health policies that serve diverse populations.

References

• Cohen, R. A., & Zammitti, E. P. (2017). Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January–March 2017. National Center for Health Statistics.
• Gruber, J., & Simon, K. (2019). Crowd-Out Ten Years Later: Home Health Care in the Era of the Affordable Care Act. Health Affairs, 38(9), 1459-1466.
• Kenney, G. M., & Schwartz, K. (2018). Medicaid Expansion Under the Affordable Care Act: A Look at Party Affiliation and Variance in State Decisions. Health Affairs, 37(12), 1873-1878.