Health policy is a term that is commonly used to refer to plans, decisions, and initiatives that are carried out to accomplish specific goals relating to delivery of health care and promoting the well-being of individuals within a community. As a result, these plans, decisions or initiatives usually incorporate a vision for the future, which is essentially the expected outcome of its implementation. The vision for the future helps in establishing specific targets and references in the short- and long-term of the implementation of the policy. Notably, the development and implementation of the policy is characterized by some major political forces since politics is the basis of policy making. An example of a current health care policy is the Affordable Care Act of Maryland. Affordable Care Act of Maryland

The Affordable Care Act of Maryland is an example of a current health policy issue that was enacted in 2010 to deal with some major health care problems in the State as well as other parts of the country. The enactment of the Affordable Care Act in 2010 was the first time in United States' history that the country developed a legislative commitment towards ensuring all Americans could afford and easily access health care services (Powers, 2014, p.95). This health policy was enacted in Maryland to help extend coverage to 756,000 uninsured Marylanders who are part of the 47 million nonelderly uninsured people throughout the nation. The policy seeks to achieve this objective by establishing coverage provisions in nearly all income spectrums and expanding the eligibility of Medicaid for adults. As a result, when the full implementation of this health policy in Maryland will be achieved, approximately all nonelderly uninsured Americans, especially adults will be eligible for coverage expansions. Therefore, this health policy will help provide coverage for low-income individuals who are common in Maryland.

Problems to be Addressed by the Policy

The first problem to be addressed by this policy in Maryland is the prevalent issue of accessibility and affordability of health care services. Maryland has a high population of low-income individuals and families who cannot afford health insurance plans. This policy was enacted to help in dealing with the problem of coverage to this population of low-income individuals and families. Secondly, Maryland's Medicaid program has been characterized by gaps in coverage for adults given restrictions to certain categories of low-income individuals like the disabled, children, and pregnant women. The Affordable Care Act of Maryland was enacted with the aim of filling these gaps through expanding Medicaid across all income groups.

The Affordable Care Act is relevant to the State of Maryland since it has approximately 1 million uninsured people. The need to cater for the uninsured Marylanders and expand Medicaid coverage for all adults regardless of their income demonstrates the significance of this policy. The policy seeks to help close gaps in coverage for adults by increasing accessibility of care services to nearly all non-elderly uninsured people across the state. Notably, the Act seeks to help many uninsured Marylanders obtain health insurance coverage through offering coverage options throughout the income spectrum for low- and middle-income individuals and families.

Major Political Forces

The process of formulating health policy and other policies is usually characterized by involvement of various political forces. Politics play a major role in policy making since politicians act as policy makers in the current system of governance. In addition to political forces, health policy making is also affected by some social and economic factors.

Social Factors

One of the major social factors in Maryland that influenced the development of this health policy is lack of access to health care services, which is a major obstacle in the effectiveness of the State's health care system. Secondly, the development of Affordable Care Act of Maryland was influenced by the need to transform eligibility for health coverage, particularly because most low-income individuals and families live in Maryland. The third social factor that affected the origin, development, and enactment of the policy is the need to improve access to affordable coverage and ensure continuity of care even when switching insurance policies.

Economic Factors

The economic relevance of this policy to...

The economic factors that influenced the origin, development, and enactment of this policy include the huge population of low-income individuals and families. This population has difficulties in affording health insurance coverage because they do not have adequate finances for health coverage. Secondly, most of the uninsured nonelderly people in Maryland are not eligible for financial help that would help them afford and access health care services. Third, most of the State's population cannot purchase unsubsidized coverage in the Marketplace ("How Will the Uninsured in Maryland Fare?" 2014). The other economic factor that influenced the origin, development, and enactment of this health policy is the need for the State to lessen its health care costs while enhancing efficiency of the health care system.
Political Factors

Since its development, the Affordable Care Act has acted as the source of political differences and contentions. This health policy has generated significant political differences between Republicans and Democrats in Maryland. Actually, one of the Republican candidates for the next U.S. election has promised to repeal this policy in all states if he wins the elections (Kitces, 2015, p.28). The enactment of Affordable Care Act of Maryland was largely influenced by concerted efforts from all politicians across political parties to revamp the State's health care system. Lawmakers focused on revamping the health care system because of increasing hospital costs and increasing levels of the uninsured population. Despite agreeing on the need to revamp the existing health care system, Maryland's lawmakers had different opinions regarding the policy. These opinions, especially on its provisions, were largely fueled by the lawmakers' political affiliations and persuasions.

Major Institutions, Population Groups and Interest Groups

Given the significance of political factors in the enactment of this policy, there were various major institutions, population groups, and interest groups involved in the political process. The major institution involved in this political process was the State's Legislature, which focused on revamping Maryland's health care system despite political differences and opinions between Republicans and Democrats. The State Legislature was the major institution in this process because of the role of politicians and lawmakers who develop policies to address the various challenges across the state.

The major population groups involved in this political process of enacting Maryland's Affordable Care Act include low-income individuals and families and the uninsured and underinsured populations. These population groups played a crucial role in this political process because they were largely affected by issues of affordability and accessibility of care services. The main interest groups involved in the political process are health insurance providers and employers since they play a crucial role in the provision of health insurance coverage to Marylanders in relation to their income and socio-economic status.

Winners and Losers in the Current Political Process

One of the major winners in the current political process relating to Affordable Care Act of Maryland is Democrats. Despite opposition from Republicans in Maryland regarding some of the provisions of this policy, Democrats still managed to ensure its enactment. The other winners in this political process include uninsured and underinsured population and low-income taxpayers. In contrast, Republicans, employers, and health insurance providers are some of the losers in this political process. Contrary to claims by Republicans and insurance providers, the Affordable Care Act is not a catastrophe but is working effectively. The other losers were insured Marylanders who opposed the policy on the premise that it would not benefit them but affect them financially by forcing them increase their contributions to insurance to help the poor.

Current Policy (Status Quo) and Potential Policy Alternatives

Even though the Affordable Care Act of Maryland had some unexpected problems, the policy is working effectively largely because of political pragmatism. Through political pragmatism, the major winners demonstrated willingness to establish agreements and deals with groups in the health industry that contributed to its eventual enactment. During this process, the major interest groups and population groups were co-opted, which resulted in the acceptance of the policy by the State's health industry. Despite political constraints, the implementation of the Affordable Care Act of Maryland is an example of how political pragmatism can help innovate and coordinate reforms through development of effective policies (Murray, 2009, p.1404). Since its enactment in Maryland, the number of people with health coverage has increased while there is increase in support in new marketplaces, decrease in the costs of marketplace premiums, and relatively stable employer premiums (Cohn, 2014). Therefore, the policy has performed well since its enactment relative to the effort and resources channeled to it.

Despite these gains, there are some possible alterations or options that could enhance the effectiveness of the Affordable Care Act of Maryland. The alterations or options would help improve the State's health care system that has been characterized by several challenges despite the significant gains made since enactment of the policy. A suitable alteration to this policy is…