The Policy Process
Part 1: Discuss five stages of policy process identified in Longest (2016)—at least 100- 150 words to describe each stage:
Formulation
Whenever a policy is being made formulation process comes first. Typically, investors and organizations identify a societal concern. At this point, the stakeholders recognize the significance of the problem and why it must be resolved (Longest, 2016). Information is utilized to challenge the status quo and produce a strategy that should be adopted to replace the current one. Typically, Congress, the legislature, or the president may be engaged and have various solutions to the problem. Typically, remedies to difficulties are developed before the agreement is presented. Policy development in medical care facilities, for example, occurs after stakeholders involved request modifications and the ideas are drafted into legislation.
Legislation
Following the creation of legislation, it must be debated in a legislative body such as Congress. As a result, the concerns at hand are brought before the legislature. It could begin in either the Senate or the House of Representatives (Longest, 2016). Before proceeding, each of the parties must reach an agreement on the modifications. At this point, the bill passes through phases such as reviews and committee members phase so that the numerous components can be considered before being presented to guarantee that it contains contributions from diverse stakeholders in parliament. After passing in one house, it must proceed via another where amendments might be made before being sent to the head of state to be signed into law.
Implementation
The implementation stage is where the administrative departments of government utilize the legally recognized legislation to impact adjustments in their respective areas (Longest, 2016). An implementation of a medical care facility may entail insurance companies adjusting their practices and regulatory authorities guaranteeing that sector stakeholders follow the legislation. Individuals become aware of the law’s modification as it is implemented. In the context of the Affordable Care Act, for example, regulatory bodies may guarantee that the provisions are implemented and that health insurance companies do not prejudice. Legislations are only implemented when they have been authorized by the legislature. Depending on the statute, the implementing organizations vary. In the medical industry, medical care facilities, insurers, and various other stakeholders may be engaged.
Evaluation and analysis
Following the implementation process, stakeholders must continue to evaluate the modifications to guarantee that they produce the expected benefits. In some circumstances, legislation may have unintended repercussions, necessitating modifications (Longest, 2016). For example, a law aimed at making medical care facilities more affordable may diminish the standard of medical treatment, necessitating modifications. The utilization of information from the execution to assess the degree and magnitude of modifications is what evaluation entails (Eibner & Nowak, 2018). Monitoring the number of covered persons and the affordability of services, for example, may assist in identifying ineffective aspects of the legislation or whether the legislation generates the desired improvements. Regular monitoring is carried out.
Revisions
After the organizations in charge of evaluations have monitored and evaluated the execution and the modifications that have resulted from it, they may feel the need to recommend adjustments (Longest, 2016). Laws may impose obligations on individuals while producing unsatisfactory outcomes. Legislation may have certain advantages, but it may also have substantial limits that must be changed. As a result, revision occurs once monitoring has revealed that changes are required. The revision will necessitate the drafting of amendments, and the procedure will begin again with policy development. Any amendments to the law must be debated and approved by the legislature.
Part 2. Explain how the Affordable Care Act advanced through each stage of the policy process
How the law was formed/ proposed and then passed by Congress.
The Affordable Care Act (ACA) was initially launched in Congress in 2009 when Senate Speaker Nancy Pelosi and many other Democrats presented a proposal to reform the medical care industry. Various people were engaged in the first proposal’s development. The national government, insurance providers, the entire public, and other relevant parties who provided ideas were among those who took part in the conceptualization. The drafting was done by Democrats with the Speaker’s approval. When the law was introduced in parliament, it was supported by a majority of Democrats and a few Republicans. Amendments of the ACA were proposed in both chambers in 2009. The Senate version of the legislation was afterward presented in the House of Representatives, which passed it by a vote of 219-212. (Jost & Keith, 2020). The bill was subsequently presented to President Barack Obama, who approved it.
How it has been implemented, and what agencies primarily implement the law.
Numerous bodies were engaged in the execution of the Affordable Care Act. State governments are amongst these bodies involved. State administrations decided on whether to extend Medicaid initiatives to ensure more individuals. The state medical departments controlled the execution on a state basis (Jost & Keith, 2020). The Health and Human Services Department was in control of essential segments as well as monitoring. The Centers for Medicare and Medicaid Services (CMS) also incorporated components relating to practitioner payments and public coverage (Béland, Rocco, & Waddan, 2018). CMS departments from several regions were in control of the various states. The Internal Revenue Service (IRS) is also involved in the implementation (Jost & Keith, 2020). For example, it provides tax benefits to enterprises based on their compliance with insurance regulations.
One or two ways the ACA can be evaluated
Individual’s insurance can be used to evaluate the Affordable Care Act. Medical care coverage goals were established, and variations in the percentage of persons who obtained coverage assessed whether or not the execution was proceeding as intended (Eibner & Nowak, 2018). For example, coverage premiums have improved. As a result, the legislation made it easier for individuals to get medical care insurance. Cost-cutting measures can also be utilized to assess if the law was successful or not.
List at least one revision to the law since it has been passed.
The personal mandate provision of the statute has been repealed. The Tax Cuts and Jobs Act mitigated the legislation’s personal mandate. Individuals who do not obtain coverage are fined under the personal mandate. As a result, it provided individuals with a reason to obtain insurance coverage that complied with the ACA’s legal criteria (Eibner & Nowak, 2018). The removal of the legal part allows consumers to choose whether or not to obtain insurance without suffering the fines imposed by the ACA.
References
Christine Eibner, & Sarah Nowak. (2018). The effect of eliminating the individual mandate penalty and the role of behavioral factors. Commonwealth Fund. https://www.commonwealthfund.org/publications/fund-reports/2018/jul/eliminating-individual-mandate-penalty-behavioral-factors
Daniel Béland, Alex Waddan, & Philip Rocco. (2018, October 30). Policy feedback and the politics of the Affordable Care Act. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1111/psj.12286
Longest, B. B. (2016). Health Policymaking in the United States (AUPHA/HAP Book) (6th ed.). https://www.amazon.com/Health-Policymaking-United-States-Sixth/dp/1567937195
Timothy Stoltzfus Jost, & Katie Keith. (2020, March 2). The ACA and the courts: Litigation’s effects on the law’s implementation and beyond | Health affairs journal. Health Affairs: Leading Publication Of Health Policy Research & Insight. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2019.01324
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