Introduction
The U.S. is one of the developed countries with advanced healthcare systems. Consequently, the country has formulated legislation that ensures all Americans have access to medical care. The Affordable Care Act (ACA) was a hallmark for the provision of healthcare services to Americans regardless of their financial status. Various states adopted policies that promote the implementation of ACA. Washington State is one of the states that developed a policy that allowed the expansion of the Medicaid program. The policy allowed the state to extend the Medicaid program to serve poor and low-income adults. ACA played a significant role in promoting access to healthcare services by poor Americans through the Medicaid program.
Affordable Care Act Brief
The U.S. Constitution promotes the well-being of Americans by allowing the Congress and government as a whole to develop healthcare legislation. The ACA is a comprehensive healthcare reform in the U.S. that was signed into law in 2010 (Howell et al., 2022). President Barrack Obama was in charge during the signing of the Act. Various healthcare policies are provided under the Act, ensuring that millions of Americans are insured. Some of the policies in the ACA include expanded Medicaid eligibility, created health insurance exchanges, and prohibition of insurance companies from denying coverage on basis of pre-existing conditions (Blume-Kohout, 2022). The ACA plays a crucial role in promoting the well-being of Americans.
Healthcare services can be expensive to Americans who live below the poverty line. ACA was designed to promote and reform the health insurance industry (Howell et al., 2022). Consequently, the legislation helps reduce the cost of health insurance coverage for Americans who are eligible for various covers. Premium tax credits and cost-sharing reductions are approaches that ACA uses to lower healthcare costs for low-income individuals (Blume-Kohout, 2022). According to the Act insurance plans should cover preventive services at no cost to policyholders (Howell et al., 2022). Various states have adopted different policies associated with ACA. The expanded Medicaid program is one of the policies under the ACA that have been adopted.
Expanded Medicaid Program in Washington (WA) State
Washington is one of the states whose population is increasing rapidly due to favorable social conditions. The state’s population grew from 5.9 million in 2000 to 7.8 million in 2022 (Office of Financial Management, 2022). Meanwhile, about 10.2% of the residents in WA state are poor, and cannot afford basic needs including healthcare services (Office of Financial Management, 2022). The state has recorded a long-term decline in elderly poverty levels among people ages 65 and above. The significant decrease is associated with the expansion of Social Security and Medicare benefits. The state adopted the expanded Medicaid program policy from the ACA to increase access to healthcare services for low-income adults of 18 years and above.
Policy Brief
The expanded Medicaid program follows the initial program before the formulation of the ACA. The initial Medicaid program was limited to Americans aged 65 years or older (Blume-Kohout, 2022). Additionally, the beneficiaries had to be disabled and with limited income and resources (Blume-Kohout, 2022). However, following the formulation and the signing of the ACA, the program included an expansion of the Medicaid program. The expansion policy allows adults under the age of 65 years with an income of up to 138% of the federal poverty level to benefit from the Medicaid program (Blume-Kohout, 2022). Therefore, in WA state all adults can qualify for Medicaid benefits, offloading them the burden of medical insurance.
Policy Promotion
The Medicaid program is one of the oldest healthcare policies in the U.S. The policy dates back to July 30th, 1965 when President Lyndon B. Johnson signed into legislation allowing Medicaid and Medicare. While the program was beneficial to adults of ages 65 years and above, President Barrack Obama promoted its expansion in 2010. The Washington State Health Care Authority was responsible for writing the Medicaid Expansion policy upon adoption of the ACA in the WA State (Sabbatini et al., 2022). The authority, through its Apple Health, provides for expanded Medicaid eligibility criteria.
Adoption of the expanded Medicaid program in WA state presented a significant improvement in healthcare services. About 1.96 million residents in Washington were covered by the expanded Medicaid program in May 2021 (Sabbatini et al., 2022). Consequently, the state reduced the uninsured rate by 54% between 2010 and 2019 (Donohue et al., 2022). Moreover, Medicaid enrollment increased by 76% since the adoption of the program expansion policy. Therefore, the expanded Medicaid program attracted many Washingtonians since it reduced age limitations.
Trade-off Offered
Although the expanded Medicaid program in WA State is beneficial to many Americans, it offers some trade-offs to bring balance to the healthcare stakeholders. Medicaid program beneficiaries, healthcare services providers, and medical researchers, among others, are some of the involved stakeholders. Firstly, there is a need to train new healthcare professionals due to the increased number of Washingtonians accessing healthcare services. The State can consider improving offering grants to students and professionals pursuing medical courses.
Secondly, the program requires direct-to-consumer advertising to attract as many Americans as possible. WA State can consider redefining its public health education. Lastly, there is a need to improve the enrollment system to allow all eligible Americans. Promoting research activities on technology and healthcare can help in coming up with a robust automated and digitized enrollment system. Countering the listed trade-offs would help WA State to effectively implement the Medicaid expansion policy.
Public Perception and Disinterestedness
Although the expanded Medicaid program is practically beneficial, there is an intensified disinterestedness. Some Americans consider the ACA and its associated policies as means to settle political scores. For instance, more Democrats than Republicans view the Medicaid expansion policy as favorable (Donohue et al., 2022). Therefore, it is likely that more Republicans are disinterested in the expanded program than Democrats. The WA State government can hold public sensitization campaigns, outlining the benefits of Medicaid. Negative public perception and consequent disinterestedness can negatively affect the valuation of healthcare performance.
Balance for Healthcare Stakeholders
Process Innovation
Effective implementation of the expanded Medicaid program requires process innovation to create balance among stakeholders. Process innovation involves improving current organizational activities (Malinova et al., 2022). Enhancing a participatory and team-based transparent culture can promote unity among external and internal stakeholders. Additionally, encouraging services that are focused on the patient’s interests improves trust in healthcare organizations and the government. Furthermore, process innovation can involve the integration of multifaceted leadership that ensures the achievement of set objectives (Bernstein & Rodriguez, 2022). Therefore, process innovation is crucial in bringing the stakeholders’ focus to a common goal.
Risk Taking
Success and failure are inevitable in any social endeavor and must be embraced. Risk-taking requires venturing into activities that can be uncertain. The healthcare industry is multifaceted and can involve researchers and entrepreneurs. The involved stakeholder needs to take risks to learn new methods and solutions to existing problems. For instance, in promoting quality and affordable healthcare, a government can encourage medical research regardless of the uncertain outcome (Bernstein & Rodriguez, 2022). The public and other stakeholders can benefit from the positive results of medical research.
Health Policy Analysis
Health policy analysis involves an integrative and collaborative discussion of the proposed legislation. Although healthcare organizations and Congress are responsible for formulating policies, the public can be involved in discussing their merits and demerits (Bernstein & Rodriguez, 2022). Collaborative discussions allow all the affected stakeholders to make suggestions that serve their interests. Moreover, health policy analysis help in avoiding undesired outcomes that can encumber the participation of some stakeholders. Consequently, through the policy analysis, a balance is created among the healthcare stakeholders.
Governance “Sense-Making”
The government plays a central role in the formulation and implementation of healthcare policies. Collaboration between the State and Federal government is critical in determining the effectiveness of policies and legislation. For instance, implementing the expanded Medicaid program requires justification for increased funds for health insurance. Additionally, there must be transparency in projecting the outcomes and budgeting for various health policies. Effective governance and management of healthcare programs help in uniting the stakeholders.
Conclusion
Quality and affordable healthcare services are crucial for social and economic development. Consequently, the U.S. government signed the ACA into law, ensuring that Americans can access healthcare insurance regardless of their financial status. ACA provides for expanded Medicaid program policy, allowing all adults to enjoy its benefits. WA State adopted the policy for the benefit of its residents. However, the policy offered trade-offs including the need for more trained healthcare providers, an advanced enrollment system, and direct-to-consumer advertising. WA State should integrate process innovation, risk-taking, policy analysis, and “sense-making” to effectively implement the expanded Medicaid program.
References
Bernstein, A., & Rodriguez, C. (2022). The accountable bureaucrat. Yale Law Journal, 132. Web.
Blume-Kohout, M. E. (2022). The Affordable Care Act and women’s self-employment in the United States. Feminist Economics, 1–31. Web.
Donohue, J. M., Cole, E. S., James, C. V., Jarlenski, M., Michener, J. D., & Roberts, E. T. (2022). The U.S. Medicaid program: Coverage, financing, reforms, and implications for health equity. JAMA, 328(11), 1085–1099. Web.
Howell, B. A., Hawks, L., Wang, E. A., & Winkelman, T. N. A. (2022). Evaluation of changes in U.S. health insurance coverage for individuals with criminal legal involvement in Medicaid expansion and non-expansion states, 2010 to 2017. JAMA Health Forum, 3(4), e220493. Web.
Malinova, M., Gross, S., & Mendling, J. (2022). A study into the contingencies of process improvement methods. Information Systems, 104, 101880. Web.
Office of Financial Management (2022). Washington tops 7.8 million residents in 2022. Web.
Sabbatini, A. K., McConnell, K. J., Parrish, C., Frogner, B. K., Reddy, A., Zatzick, D. F., Kreuter, W., & Basu, A. (2022). Impact of a statewide emergency department information exchange on health care use and expenditures. Health Services Research. Web.