Affordable Care Act and Medicaid Expansion: A Policy Analysis

This essay provides a detailed analysis of the Affordable Care Act (ACA) and its Medicaid expansion, addressing issues such as accessibility and coverage of healthcare services. It explores the policy's background, key stakeholders (government, insurance companies, employers, pharmaceutical firms, patients, and physicians), and their perspectives. The analysis differentiates between advocacy groups (physicians, government) and business interests (insurance companies, pharmaceutical firms), highlighting their respective impacts on consumers, healthcare organizations, insurance companies, and providers. The essay also examines the roles of state and federal agencies in implementing the policy and ensuring compliance, referencing relevant laws and regulations. The essay concludes by citing multiple sources.

Affordable
Health Care Act
and Medicaid
Expansion
Name of the Student:
Name of the University:

Issues Addressed
The Patient Protection and the
Affordable Care Act was
formulated to
address(Sommers et al. ,
2015) :
•Lack of accessibility of quality
healthcare services.
•Lack of adequate coverage of
healthcare insurance .
The Affordable Care Act
presented the following
features (Wherry & Miller,
2016):
•Expansion of Medicaid to
families with 138% income of

Policy Formulation:
Background
•The Affordable Care Act
(ACA) was federally approved
by Barrack Obama on March
2010.
•The ACA’s core principle was
based on the belief that basic
healthcare security is the
right of every citizen.
•The ACA, aimed to increase
accessibility of insurance to
over 30 million uninsured
Americans.
•Despite opposition, who the
ACA came into effect upon
the re-election of Obama in

Involvement of Key
Stakeholders
The key stakeholders include
the following (French et al.,
2016):
•The government
•Insurance companies
•Employers
•Pharmaceutical firms
•Patients
•Physicians

Stakeholder Perspectives
The perspectives of various stakeholders
include (Ortega, Rodriguez & Vargas
Bustamante, 2015):
•Government: Aims to provide
healthcare subsidies for the disabled,
economically underprivileged and poor.
•Insurance Companies: Engage in
selling coverage and healthcare
insurance plans.
•Employers: Engage in offering
healthcare insurance to employees with
varying co-pays and deductibles.
•Pharmaceutical Firms: Formulate and
sell physician-prescribed medications for
patient treatment.
•Patients: Engage in reception of
treatment and coverage.
•Physicians: Engage in provision of high

Advocacy
GroupsAdvocacy groups include
(Ornych et al., 2015):
•The government: Carries
duties and responsibilities to
ensure adequate, affordable and
accessible healthcare services.
•Physicians: Aims to maintain
the salient physician-patient
relationship.
•Pharmaceutical companies:
Should practice responsible and
honest marketing.
•Patients: Possesses the right
to receive affordable and
accessible care with duties to
utilize coverage benefits

Business
Interests
Business interests include
(James & Van Ryzin, 2016):
•Insurance companies:
Charges high premiums to
ensure high stockholder
wealth.
•Pharmaceutical firms: Often
charge high rates in
medication for greater
stockholder wealth and
organizational profits.
•Employers: Provide
insurances as ‘employee

Differentiation
•How: Physicians and the
government are ‘advocacy
groups’ due to their
fundamental duty of ensuring
positive health outcomes.
Insurance companies and
employers are ‘business
interests’ due to their aim of
generating profits (Béland,
Rocco & Waddan, 2015).
•Why: Both groups must
strike a balance and work
collaboratively to achieve the
greater good of positive

Impact of Policy: Consumers
•All citizens have access to affordable,
subsidized healthcare services and
insurance.
•The ACA prioritized public health
assessments, resulting in positive
community.
•Expansion of Medicaid ensured
insurance through tax credits on on
premiums.
•Children’s health till the age of 26
could now be covered by families
health insurance plans.
•Free preventive care services were
provided to consumers.
•Consumers dependent on private and
employment based insurances were

Impact of Policy:
Healthcare
Organization
•Medicaid expansion reduced
uncompensated healthcare costs.
•Medicaid expansion and free
preventive services resulted in
reduced patient admissions to
expensive emergency
departments.
•Hospitals had to redirect their
profits towards community health
programs.
•Patient admissions to critical and
trauma care departments
increased.
•Uninsured individuals received

Impact of Policy:
Insurance
Companies
•Insurance firms had to cover
the 10 ACA healthcare benefits.
•Insurance companies were
unable to charge limits on
annual and lifetime coverage.
•Insurance companies had to
ensure coverage of pre-existing
health conditions.
•Private insurance provides
were compelled to cancel their
plans due absence of 10 ACA
benefits (Hu et al., 2016).

Impact of Policy:
Providers
•Businesses cancelled their
insurance to employees since
these did not cover the ACA’s
benefits.
•Businesses repealed their
policies since increased
benefits were available in
governmental policies.
•The ACA implemented the
Cadillac tax on businesses
(Fitzgerald, Bias & Gurley‐
Calvez, 2017).