30 Dec 2022


Medicaid and Medicare Health Care Policies and Stakeholders Involved

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Academic level: College

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How the evolution of health care policy has influenced programs such as Medicaid and Medicare. 

The evolution of health care and adjustments to the policy has considerably altered the Medicaid and Medicare landscapes. Unlike in the past, Medicaid and Medicare enable seniors to age in nursing homes, pharmaceuticals are now common in the care continuum, and payment methods are constantly evolving (Contandriopoulos, 2011). In fact, with the introduction of the Affordable Care Act (CA), we have witnessed notable changes to the government-assisted health insurance such that it covers more people. The aim of this law is to expand Medicare and Medicare to low-income families and cover those who qualify for Medicaid but cannot afford to purchase private insurance. By covering over twenty million Americans, the current healthcare policy has contributed to changes that were not observed in the past five decades when Medicaid and Medicare were operational. Evolution of healthcare policy has also reformed the Health Care Payments and Quality that has eventually increased quality across the board. For instance, the Omnibus Budget Reconciliation Act establishes quality standards for Medicaid and Medicaid approved nursing homes (Contandriopoulos, 2011). This has caused higher vaccination rates, better training, and reduced cases of restraints among residents. 

A Medicaid policy in your state that should be amended, and explain how you would amend it and why. 

In its short time of adoption, the ACA has recorded significant successes (Contandriopoulos, 2011). Despite widespread public misunderstanding and an uncompromising political opposition, this policy has greatly succeeded as far as its prime task is concerned; enrolling millions of Americans in health insurance coverage. These accomplishments notwithstanding, our healthcare system still confronts major challenges, traceable to the weaknesses and flaws in the ACA. Some of the ACA’s approaches were poorly targeted and ineffective in addressing care problems. 

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Most of the challenges in our health care system reflect the path-dependency and the inherent complexities of the system. In fact, the most rampant problem is the inadequacy of ACA’s subsidies to deal with the issues of low-income families (Contandriopoulos, 2011). For these families, even cost-sharing and modest monthly insurance premiums are normally critical barriers to health care and coverage. I recommend that the government must improve Medicaid for Low-Income Americans. This move could help fix recognized flaws in the ACA besides bolstering its accomplishments. This may be achieved through having the federal government to cover costs of the Medicaid expansion from state budget-based cutbacks. 

Describe the stakeholders involved in the Medicaid and Medicare health care policy in your state, and explain the role of these stakeholders in policy development for this issue. 

Stakeholder support is crucial for successful amendments to the above policy (Contandriopoulos, 2011). Stakeholders must be engaged in each stage of the policy reformation to build support for the changes, suggest improvements and contribute to continuous quality improvement activities. In this case, the stakeholders include the Governor’s office, the patient community, the Centers for Medicare and Medicaid Services (CMS) and the provider community. Involving these stakeholders throughout the stages may result in early buy-in, the establishment of lasting support and successful policy changes. 


Contandriopoulos, D. (January 01, 2011). On the Nature and Strategies of Organized Interests in Health Care Policy Making.  Administration & Society, 43,  1, 45-65. 

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StudyBounty. (2023, September 15). Medicaid and Medicare Health Care Policies and Stakeholders Involved.


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