Nov 19, 2020 in Politics

Policy-making in the Federal System

Policy-making in the Federal System

Federal health care policy has been faced with various challenges in its implementation. The state and federal government have been reading on a different page in terms which policy to adopt to improve provision of healthcare in America.


ObamaCare, which officially means Patient Protection And Affordable Care Act (PPACA), has been the centre of debate at the federal, state and local levels. The goal of this policy is to give more affordable, high quality and available health insurance. It is supposed to be achieved through the use of consumer protection, subsidies, regulations among other reforms. The point of argument by both locals and federals is that the ObamaCare is violating taxation powers by the Congress as well as forcing the states to participate in the provision (Pear, 2012). Some are arguing that the policy is meant to regulate the health insurance in the country.

On one hand, federal government has been running new health exchange in a number of states. It is the reason why they have been against the policy with the aim of stopping the subsidies being awarded to the states that they run. On the other hand, the locals argue that ObamaCare allows an employer to cover birth control arguing that it is against the popular religious beliefs. Notably, the D.C. Circuit Court upheld this challenge arguing that it indeed curtails religious freedom (Wallace, 2012). It is a big blow to the Obama administration that has been fighting day and night to have the policy adopted for the benefit of Americans.

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The policy raises issues of federalism in that the state is said to be constitutionally violating the Congress taxation powers. Moreover, the federal government argues that the state should not in any way force the Medicaid provision in the states that they are already running their exchanges. It is clear that the federals are feeling the state of interfering with their autonomy or jurisdiction (Pear, 2012). As a result, their battle at the Supreme Court led to the ruling that no state will be coerced to participate in the provision. The declined participation from the states has negatively affected expansion of the Medicaid.

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The effectiveness of ObamaCare health policy can be beneficial to the public if the federal government and the state would come together to address the contentious issues in the policy. For instance, the policy seeks to enable the low and middle working class to access health insurance. In addition, the policy includes new taxes, especially on high income earners and businesses, which makes it possible to subsidize the cost of insurance for the low and middle income earners. In my view, this policy is effective in that it seeks to devolve wealth by ensuring that even the poor can access quality and affordable health care services.

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ObamaCare has been challenged constitutionally in the federal courts because the policy is said to violate taxation powers enshrined in the Congress (Wallace, 2012). The court ruled that no state can be compelled to participate in the expansion of Medicaid. Hence, it has allowed states to voluntarily join or jolt out of the provision. In this regard, the federal government is not ready to allow the state to reward premiums to the states that they are already in. They insist that the Act should only be applicable in state-run exchanges. However, the federal government is not consistent with its stand on the ObamaCare (Pear, 2012). According to Carvin from the Obama administration, the policy does not only focus on running the exchanges in their states. On the contrary, federal government has interpreted it to mean that subsidies cannot be applied in their states. They are not consistent in explaining how the policy will affect their states.

In conclusion, the standoff between the federal and the state has worsened the condition of healthcare in the United States. Indeed, several states have rallied the Republicans to reject the Medicaid provision in the Act. Although ObamaCare is promising, especially to the low and middle income earners, he has failed to consider the jurisdiction of the federal government. In fact, it got worse when the federal government removed its health exchanges from its states accusing the government of its failure to cooperate with them. The state and the federal government should find a solution to their standoff and adopt a policy that will benefit the public.


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