Week 5

Part 1: Public Policy in the US Federal System

By: Ameki Lee

MPA6501  SU01  State and Local Government and Internal Government Relation

Dr. White

08/25/2018

My policy choice for this particular assignment would revolve around healthcare. This is one sector that interests me so much in that the healthcare is all about the people’s welfare in the country. Since inception of independence in 1776, the government has been involved in a series of healthcare legislative act with the most recent one being the affordable care act commonly abbreviated as ACA. The subject specific policy for this assignment would hence revolve around affordable care act in the country. This policy was adopted under president Obama’s administration in 2010 and has always been dubbed as ‘Obama care’.

The affordable care act received a lot of criticism especially from people allied to the Republican Party. Most recently the republicans under President Donald Trump argued that this particular policy subjected the US citizens into unnecessary taxation hence initiated a bill to cap it off. Luckily the policy survived being discontinued and is still a subject of discussion. The policy has been very critical in the US healthcare system in that it has increased the number of US citizens being insured. It has also improved healthcare quality and patients can easily acquire healthcare services at affordable costs. The affordable care policy has majorly been dispensed in similar dimensions just as compared to other previous healthcare policies such as Medicare and Medicaid insurance schemes. According to Bovbjerg, Wiener, and Houseman, (2003) the U.S government is designed in federalism way in that it has a central government and the state government. The affordable care act policy is a policy that has majorly been a responsibility that is bestowed to the federal government and at the same town the state government. This is demonstrated in funding the policy whereby the federal government has a portion of funds that it remits to all state based on a given formula. On the other hand, the state governments also fund this program from revenues that they collect from various sources within the specific states.

In dispensing services under this policy, the two government have concurrent powers is clearly outlined in the constitution. This actually dates back to the first constitution that was drawn up in Philadelphia in 1787 that adopted federalism. Under this constitution, the various states within the country were empowered to run their own affairs including healthcare services, This indicates that despite the state active role in dispensing affordable care policies, the federal government has overall powers and is even involved in financing the policy. This indicates that there is concurrent commitment to this policy as the state government funds and runs the program at their level while the federal government funds the states. The Kaiser Family Foundation. (2012)

The involvement of the state and the federal government in this particular policy is actually pegged to the US constitution. The first constitution that was adopted under by the US government defined the roles of the federal and the state governments. The constitutions outlined that the state government has the authority to control healthcare activities. This has been demonstrated by the state’s role in ensuring that the affordable care policy is implemented in all the states under governor’s leadership. Alternatively the constitution also provides that the federal government is supposed to finance all the states in dispensing their services. The federal government has ensured that they operate under this constitutional provision by providing funds every year under a particular formula to all the states in the country. The Kaiser Family Foundation. (2012)

In my own assessment I feel the constitutional distribution of power in supporting this policy has extensively been successful. Since the inception of this policy in 2010, the policy has had tremendous implications on US citizens. This is one particular policy that the various states have implemented without hurdles due to the federal government commitment in dispensing funds to support the program. The state governments have also been committed in devising ways of raising funds towards supporting this particular policy.

References

Bovbjerg, R. R., Wiener, J. M., & Houseman, M. (2003). State and Federal Roles in Health Care: Rationales for AllocatingResponsibilities. In J. Holahan, A. Weil, & J. M. Weiner, Federalism and Health Policy (pp. 25-57). Washington, D.C.: Urban Ins

The Kaiser Family Foundation. (2012). A Guide to the Supreme Court's Affordable Care Act Decision.Washington, D.C.: The KaiserFamily Foundation