Health Policy and Law: Medicaid Expansion and Stakeholder Engagement

This report delves into the complexities of health policy, focusing on the ethical dilemma faced by Governor Jadyn regarding Medicaid expansion and the establishment of a state-run insurance exchange. It explores the financial burdens associated with the Affordable Care Act and the challenges of providing healthcare access in a fragile economy. The report provides a detailed analysis of the issue, considering factors such as the governor's concerns about state resources, the potential impact on state agencies, and the implications of federal government involvement. It examines the benefits of Medicaid expansion and a state-run insurance exchange, while also addressing the financial constraints and stakeholder engagement. The report suggests a strategy for the governor, emphasizing the importance of stakeholder engagement, cost-cutting measures, and ethical considerations to ensure healthcare accessibility and affordability for all citizens. It highlights the need to streamline public and private hospitals, channel federal government support, and focus on the value of beneficence to align stakeholder needs and healthcare goals. The report concludes with recommendations for policy implementation and improvement of service delivery within the state, with references to relevant research and policy documents.

RUNNING HEAD: HEALTH POLICY AND LAW 1
HEALTH POLICY AND LAW
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HEALTH POLICY AND LAW 2
The affordable care act also known as Obama care refers a health bill that was enacted by
the United States House of Representatives to expand Medical insurance, eligibility to adults and
children who were not previously insured under the governments Medicare insurance (Obama,
2016). The bill was enacted in 2010 under presidents Obamas administration however the 2016
led trump’s administration brought some changes to the bill ,initially the USA government
insurance was Medicare which mainly funded permanent legal residence who were 65years or
older In age. Younger people were only eligible under several limited conditions.
The affordable care act expansion however, brought about several implications on state
as the state were required to also cover low income adults without additional funding from the
federal government .Based on the supreme court ruling of June 2010 states were allowed to
choose whether and when to adopt the Medicaid expansion. According to Dranove, Garthwaite, ,
& Ody, 2016) this brought about several different reactions as some states approved while others
did not. Some states however such as Michigan and Ohio only approved section 1115 wavers to
implement Medicaid expansion in their own ways. This paper focuses on an ethical dilemma
about a certain governor who supports Medicaid expansion but her state does not have enough
resources to fund the expansion.
Health is an inherent human right, it is therefore important that the governor goes ahead
to expand Medicaid by creating a state run insurance policy.it is a paradox to find out that USA
has a very large economy base yet it does not have a universal health care policy unlike other
countries that do not have an equally stronger economy such as Australia yet they have universal
health care in addition endowed with all its resources the united states still has the most
expensive health care. The main reason behind the increased cost is the hospital charges and not
the cost of care. This makes a state run insurance exchange programme not only possible but also

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a necessity. The governor therefore needs to engage key stake holders in the state to focus on
how they can cut down hospital charges to make the insurance programme possible.
It is necessary that the governor focuses on ethical values and principles in order to align
stake holders’ needs and healthcare needs. This requires to the governor to persuade the stake
holders to not only focus on the technical efficiencies of their firms but also on the value of
beneficent. In addition (Barnett,, & Vornovitsky, . 2016) explains that the governor should also
focus on giving certain enticements to stake holders such as wavers from state enacted taxes so
as to be able to convince them to support the health insurance. Lastly the governor should also
focus on the procurement path of state prescribed medications and health services by pulling
resources together and searching for cheaper markets so as to save on extra cost incurred in the
procurement process while at the same time benefit from economies of scale.
In conclusion it is recommendable that the government under stake holders focus on the
enactment and implementation of policies that focus on streamlining of both public and private
hospitals in order to improve service delivery and reduce on cost. Dickman,.Himmelstein, &
Woolhandler, (2017) argues that in addition, they should also improvise ways of channeling
federal government support to fund the state health care insurance programme so as to seal any
gaps that would not be covered by the insurance strategy plan.

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References
Barnett, J. C., & Vornovitsky, M. S. (2016). Health insurance coverage in the United States:
2015. Washington, DC: US Government Printing Office.
Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care
system in the USA. The Lancet, 389(10077), 1431-1441.
Dranove, D., Garthwaite, C., & Ody, C. (2016). Uncompensated care decreased at hospitals in
Medicaid expansion states but not at hospitals in no expansion states. Health
Affairs, 35(8), 1471-1479.
Obama, B. (2016). United States health care reform: progress to date and next
steps. Jama, 316(5), 525-532.