Introduction
The development of a policy that aims at creating changes in the society must undergo a legal process before its implementation. The policy passes through different stages that determine its suitability in achieving the objectives. These stages include; problem identification, the appointment of the policy development committee, developing the formulation process, drafting policy recommendations, policy implementation, and evaluation. The following essay describes the policy process of the Affordable Care Act introduced by the American President, Barack Obama looking at formulation, legislation, and implementation phases. The United States President, Barack Obama, introduced the Affordable Care Act (ACA) policy to bring reforms the health care sector.
Objective of the policy
The main objective of the Affordable Care Act was to reform and expand health insurance coverage to overcome health disparities among Americans. On the other hand, the ACA policy development had three specific objectives. First, the policy focused on introducing reforms to the private insurance market focusing on individuals and small groups. Second, the policy aimed at enabling the working poor that has an income of up to 133 percent of the federal poverty level access Medicaid. Finally, the policy introduced new rules into medical decision-making processes. According to Silvers & Lewis (2013), the following objectives were developed with the assumption that groups and individuals will act towards promoting these reforms.
Formulation stage: The policy formulation refers to developing an effective and acceptable plan that addresses the ideas presented on the policy agenda.
The process to formulate and the involvement of stakeholders
Legislative stage
Every policy development process must pass through the legislative process formed by legal institutions in the country. The role of American's legal institutions in passing legislative rules and regulations about a specific policy is the best since legislators possess required expertise and competencies to debate about a bill. However, differences between views of legislators always appear that tend to influence the outcome of the bill. The Affordable Care Act bill faced many barriers because not all Congressional committee members agreed with the president’s policy. The ability of the legislature to influence the outcome of a policy depends on the existing powers that the legal, institutional framework gives to the legislature, the scope of actions reserved by the political system, and how the legislature interacts with the society (Saiegh, 2005).
One of the top agendas of the newly elected U.S. President was introducing reforms in the health industry. The President used a different approach by laying down broad principles and goals needed to improve the health sector by introducing the healthcare bill. The bill was later presented to the House and the Senate to determine its legal capacity. Three chairpersons of the House committees responsible for providing legislative on health care bills combined their skills and knowledge to draft legislation that would see the president's bill passed into law. The chairpersons had a series of hearings with the committeemen on the suitability of the bill and amendments needed. The bill created a market platform for consumers to buy health insurance depending on the individual's capacity to pay. Additionally, the committee debated on employees' mandates to provide insurance or pay a contribution fee. The discussion draft acted as the first public hearing on the health care legislation. Later, the Congressional committee debated, amended, and voted for the legislation after a close evaluation that involved all stakeholders (Cannan, 2013).
Stakeholders’ influence
Stakeholders play a significance role in influencing the outcome of policy. Engaging stakeholders in the policy formulation process increase chances of the policy succeeding. The main stakeholders engaged in the formulation of the ACA were consumers, employers, states, and health care providers.
Consumers: The ACA policy was expected to meet different demands of consumers including introducing changes that help reduce the cost of care. Consumers influenced the policy formulation process by ensuring it catered for health needs of the people in the society and provide care for future generations.
Employers: The ACA policy targeted employees by ensuring they provide health insurance cover to their employees or pay the employee's insurance policy based on the agreed plan. Employers influenced the policy formulation process by ensuring it offers a timetable and the number of employees that the policy considers. For example, ACA required all companies with more than fifty employees working more than 30 hours per week to offer them health insurance (Anonymous, 2013).
States: The policy targeted all states in America. Each state influenced to formulation process by ensuring the policy offers a guideline for managing ACA based on the federally facilitated exchanges and the amount of federal funds allocated to each state.
Providers: The insurance providers influenced the formulation of the process by ensuring the payments allocated meet their expectations.
Implementation stage: The implementation stage refers to the phase of the policy making a process where policy makers put adopted effects into action.
Accountable parties and their roles in various implementation stages
The success of ACA involved many parties that played different roles during the implementation process. Americans were entitled to quality and affordable health insurance as explained by members of the House Democratic Caucus. The passing of the policy into law would give more than 46 million uninsured Americans the opportunity to access quality, affordable, and available care through the availability of free preventive benefits and lowered costs of medications. Implementing the ACA also gave the opportunity to millions of beneficiaries, especially the middle-class Americans who signed up for private health insurance through open health insurance markets (The House of Democrats, 2016).
The government played a great role during the first stage of the implementation process by putting into effect the new patient’s bill. In the year 2010, the government had the responsibility of protecting consumers from abuse by the insurance company through campaigning for cost-free health services offered by the ACA. In the year 2011, the state governments allowed people with Medicaid to enjoy preventive services free and receive 50 percent discount on different brand-name drugs.
On the second phase of the policy implementation, accountable care organizations and other stakeholders involved in the policy formulation process such as the state ensured health care providers work together towards promoting the new policy. Doctors and other health providers went through a series of education programs to equip them with knowledge and skills on the performance of the new healthcare policy. The program focused on increasing the number of people accessing care through the Affordable Care by offering voluntary options for long-term care insurance that assisted old adults (HHS, 2015).
Conclusion
The success of the policy process depends on the collaboration between policy makers, stakeholders, and the legislature. The Affordable Care Act did not follow the much-expected legal processes but the anxiety of the society and the government to have health care reforms in place made it undergo all stages without many challenges. The analysis of the policy development process reveals that the President's power played a significant role in the success of the policy formulation. Additionally, the government and society played a big role in ensuring the success of different stages during the implementation phase. Policy makers should have good objectives for their policies that attract the attention of stakeholders’ increases chances of passing the bill into law.
References
Anonymous. (2014, April). The ACA in 2013: What Can Stakeholders Expect? Health Capital
Consultants, 6(4), 1-3.
Cannan, J. (2013). A Legislative History of the Affordable Care Act: How Legislative Procedure
Shapes Legislative History. Law Library Journal, 105(2), 131-173.
HHS. (2015, August 13). Key features of the Affordable Care Act by Year. Retrieved 22 May,
2016 from http://www.hhs.gov/healthcare/facts-and-features/key-features-of-aca-by-year/index.html#2013
Saiegh, S. M. (2005). The Role of Legislatures in the Policymaking Process. University of
Pittsburgh: Department of Political Science.
Silvers, J. B., & Lewis, p. B. (2013). The Affordable Care Act: Objectives and Likely Results in
an Imperfect World. Annals of Family Medicine, 11(5), 402-405.
The House of Democrats. (2016). Implementing the Affordable Care Act & Strengthening
Medicare. Dems.gov. Retrieved 22 May 2016 from http://www.dems.gov/healthcare/
