Affordable Care Act
‘You Can’t Make Me Do It, but I Could Be Persuaded: A Federalism Perspective on the Affordable Care Act’ is an article discussing the acceptance of ACA by the states in the United States. The acceptance of the ACA by the different states in the United States is diverse and changing which makes it hard for all the states to comply with the changes. The article reviews the implication for the future health reforms which are likely to be affected by different factors. Affordable Care Act aims at changing the healthcare system of the United States at large which will ensure universal health insurance coverage. The implementation of the ACA depends on many factors of the states so that its key coverage provisions which are health insurance marketplace, pre-existing condition insurance plan, and expansion of Medicaid are met. The federal and state government must work together to ensure that implementation of ACA is successful.
Affordable Care Act is a federal program that requires involvement of the states so that they can assist in the implementation. According to the article, the ACA recognizes the importance of collaboration of States and federal governments so that both can achieve the substantial goals of the program. Different states have diverse and dynamic responses which make it hard for the implementation of ACA in all the states. This will be a challenge in the future reforms expected for a healthcare system. The collaboration of state and federal government and state government is not easy because state government takes advantage of the incentives that are offered to them by the federal government to cater for their local preferences and political circumstances rather than sorting out the healthcare reform case.
From the article, issues that limit the cooperation of federal and state government in the implementation of the Affordable Care Act include slow and uneven implementation. This is because the federal government relies on the state government to ensure that programs are implemented in all states which might take decades for complete implementation. Another hindrance is the fact that programs vary from one state to another which makes it hard for the implementation of ACA in all states. This means not all states will be ready to participate the in the program of ACA if they do not require the program. The accommodation made by the federal government regarding the differences in states gives the states various pathways of implementation which minimize uniformity in implementation. The conflicts within the Congress itself can lead to the early implementation or late implementation. When the state requires the reform, it will be easy for them to hasten the implementation unlike when the reform is not important for the state. When states are given incentives and grants, implementation of ACA will be done since some states require the incentives to motivate them to comply with the federal government. In some states, not all eligible individuals will enroll in a program which can be useless for a state if implemented and not in use. The past programs in a state can serve as a stepping-stone for better programs in a state rather than initiating a new program. This is the reason why some states may not comply with the state-federal programs like the Affordable Care Act.
The shared programs of the Affordable care Act between the state and federal government include PCIP, Medicaid expansion, and insurance marketplace. The article discusses the progress towards implementation of these programs and the factors that lead to delayed implementation. All these components are essential for complete implementation of Affordable Care Act as they require changes so that they can fit in the health care reforms required. Different views arise in the implementation of these programs where some people support the implementation while others do not support it. Medicaid expansion requires plenty of resources that should be made available to the different states, but the benefits associated with it are immense. This has been supported by many hospitals and consumers, unlike PCIP and insurance marketplace which leads to reduced resistance to implementation. Despite the efforts made in the implementation of the programs, neither of the programs has been successfully implemented. Strong public support will lead to the implementation of ACA programs in all states.
Strengths of the Article
The article has discussed the importance of Affordable Care Act and how the state and federal government collaboration in the implementation is hindered by different factors. The article brings out the acceptance of the ACA is changing and viewed differently by different people. The author discusses the components of ACA and importance of each component to citizens. The article brings out why it is hard for the federal government to operate without the support of state government.
Weaknesses
The weaknesses of the article include not including the statistics of the states that have already implemented the program. The article is also biased on state government but does not show efforts of the federal government towards implementation of ACA.
Impact of Information to Nursing
The information is important to nursing as it includes the already active programs which will assist in ensuring coverage of all citizens of the United States. The States require incentives so that they can comply with state-federal programs. The information also gives the benefits of ACA to citizens as it will increase medical coverage to both poor and rich.