The ACA and the Incremental Nature of Policy Change

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  • “Democracies change their policies almost entirely through incremental adjustment. Policy does not move in leaps and bounds” thereby ensuring the stability of government (Miyakawa, 1999, p. 298).

    • In light of this classic quote, what incremental gains have been made by passage and implementation of the ACA, and what additional reforms will be necessary to move further toward health care access for all?

    Required readinb

    Reference: Miyakawa, T. (1999). The science of public policy: Essential readings in policy sciences I. New York: Taylor & Francis.

    Bhattacharya, D. (2013). Chapter 16: Medical readmissions and the Affordable Care Act. In Public health policy: Issues, theories, and advocacy. (pp. 365–387). San Francisco: Jossey-Bass.

    Goldman, H. H., & Karakus, M. C. (2014). Do not turn out the lights on the public mental health system when the ACA is fully implemented. Journal of Behavioral Health Services & Research, 41(4). 429–433.

    Valdovinos, E., Le, S., & Hsia, R. Y. (2015). In California, not-for-profit hospitals spent more operating expenses on charity care than for-profit hospitals spent. Health Affairs, 34(8), 1296–1303.

    Xavier University Library. (2014). How to write a position paper. Retrieved from


    Expert Solution Preview

    Introduction:
    The implementation of the Affordable Care Act (ACA) marked a significant milestone in improving access to healthcare services for Americans. However, it is crucial to evaluate the extent of incremental gains made by the ACA and identify additional reforms necessary to achieve universal healthcare coverage. This discussion is based on the classic quote that democracies change their policies primarily through incremental adjustment and aims to assess the incremental gains made by the ACA and identify additional reforms necessary to move further toward healthcare access for all.

    Answer:
    The Affordable Care Act (ACA) has delivered incremental gains by reducing the number of uninsured Americans and expanding access to preventive care services. According to Bhattacharya (2013), the ACA has resulted in a 25% reduction in the number of uninsured Americans, and more than 16 million individuals gained health insurance coverage since its implementation. The ACA has also expanded access to preventive services like cancer screenings and immunizations, resulting in earlier disease detection and treatment, and improved health outcomes.

    However, additional reforms are necessary to move further toward healthcare access for all. The ACA does not address other healthcare challenges, including the high cost of medical care and unequal access to care. As noted by Goldman and Karakus (2014), the ACA does not provide sufficient funding for public mental healthcare services, leaving many individuals without access to appropriate care. Similarly, Valdovinos, Le, and Hsia (2015) reported that not-for-profit hospitals spent more on charity care than for-profit hospitals, indicating unequal access to healthcare services.

    To move forward, additional reforms are necessary, including expanding access to primary care services, enhancing mental healthcare funding, and addressing the high cost of medical care. By doing so, the United States can ensure that everyone has equal access to quality healthcare services, moving closer to achieving universal healthcare coverage.

    Reference:
    Bhattacharya, D. (2013). Chapter 16: Medical readmissions and the Affordable Care Act. In Public health policy: Issues, theories, and advocacy. (pp. 365–387). San Francisco: Jossey-Bass.
    Goldman, H. H., & Karakus, M. C. (2014). Do not turn out the lights on the public mental health system when the ACA is fully implemented. Journal of Behavioral Health Services & Research, 41(4), 429–433.
    Valdovinos, E., Le, S., & Hsia, R. Y. (2015). In California, not-for-profit hospitals spent more operating expenses on charity care than for-profit hospitals spent. Health Affairs, 34(8), 1296–1303.

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