Health Policy Analysis
The author of this report has been asked to cover two major subjects over the course of four pages. The first half of the paper will pertain to a health policy topic of the author's choosing. The author will use a health policy provision that could or should be implemented and then it will be discussed why that provision might not be implemented. The topic in question will be the Patient Protection and Affordable Care Act as it will be implemented in the state of Maryland. The second half of the paper will pertain to the seven factors that are present within an environment of continuous implementation and fostering of a plan. As before, this will pertain to the Affordable Care Act in Maryland. While some states and government personnel may be apt to resist federal mandates and programs, doing so can come with some strong drawbacks and this is especially true if there is not a contingency plan in place.
Analysis
When it comes to the impacts for the Affordable Care Act in Maryland, the results that have happened and are bound to happen are decidedly mixed. Per the Kaiser website, the Affordable Care Act is designed to extend coverage to many of the 47 million non-elderly people in the United States that lack healthcare coverage. Indeed, the elderly are covered by Medicare and many of the poor are handled by Medicaid. However, there are many in those forty-seven million that are not covered by either act and thus they should be addressed. As for the reasons the Patient Protection and Affordable Care Act might not be implemented, there are a couple of reasons. One reason is that the Patient Protection and Affordable Care Act might be repealed at the federal level. The GOP-controlled House of Representatives has certainly tried this multiple times. However, it always gets stopped in the Senate. Even if that were not the case, the sitting President, that being President Barack Obama, would veto any repeal of the Patient Protection and Affordable Care Act. As for the second reason the Patient Protection and Affordable Care Act might not be implemented, that would be the fact that there might be problems implementing the healthcare exchanges that are supposed to be set up. They are currently apparently in place but funding issues and federal spending spats might lead to problems with that being maintained and upheld (KFF, 2015).
A third reason the Patient Protection and Affordable Care Act might not be sustained is state funding of Medicaid. Indeed, states have discretion to fund Medicaid as they wish with the understanding that the federal government will match a lot of the dollars spent. However, the state is largely not required to do anything in particular and thus the outcomes for the patients will be different from state to state. This would be to the extent that some people might realize the benefits and upsides of the Patient Protection and Affordable Care Act while others may not. Further, not everyone in subsidized and helped by the Patient Protection and Affordable Care Act. Indeed, the Kaiser foundation shows that whether it be childless adults, parents and children, there are chunks of all three population groups that are not subsidized in the least because they are at or above four times the federal poverty level (KFF, 2015).
When it comes to the implementation process, the most important parts, at least as the author of this report sees it, would be the planning and getting the buy-in from the powerbrokers and stakeholders that exist for the project. When the change is something regulatory or legal like the Affordable Care Act, getting buy-in is not optional because it is a matter of law and thus is not negotiable. The planning process would be the first overall thing that would have to be done of those two. Indeed, it has to be figured out where things are right now, where things need to be and what barriers exist between "here" and "there." The barriers could be fairly simple or they could be exceedingly hard to traverse. Either way, there needs to be a measurement of how things came to be as they are and what needs to happen to change things. Of course, major changes will require a large amount of people, resources, money and buy-in. For example, if a computer system needs an upgrade to be compliant with and otherwise...
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