| 1981 | The Budget reconciliation act (OBRA 81) enacted, and it introduced two types of Medicaid waivers. The waiver allowed states to manage care enrolment of certain Medicaid groups and to cover home and community-based long-term care for those facing the risk of institutionalization. The Federal Budget reconciliation act also required states to make additional Medicaid payments to hospitals who have low-income patients. |
| 1982 | The state introduced a new policy that allowed an expansion of health care to children with disabilities. Children with disabilities would now be able to be taken care of at home instead of the hospital as they would still qualify for Medicaid even when they are not confined in medical institutions (Kaiser Family Foundation, n.d.). The Medicaid expansion was widely known as the Katie Beckett. |
| 1983 | The legislature made some amendments on Medicare, where they introduced Diagnostic Related Groups (DRGs) as a new hospital payment system. |
| 1986 | The (COBRA) Consolidated Omnibus Budget Reconciliation Act of 1985 was enacted to enable employees who have left employment to continue benefitting from the cover for 18 months. |
| 1986 | The emergency Medical Treatment and Active Labor Act (EMTALA) was enacted, which required hospitals that participated in Medicare to stabilize and screen patients who come to their emergency room. |
| 1986 | The federal government amended the Federal Budget Reconciliation act (OBRA 86), which gave Medicaid participating hospitals the mandate to cover children, women, and families regardless of their poverty levels and whether they receive any public assistance. |
| 1988 | The Family Support Act was enacted, which required states to extend one year cover to families leaving on welfare. |
| 1988 | The Medicare Catastrophic Coverage Act (MCCA) was enacted, which mandated Medicare cover to include prescription drugs and also provided a cap on out of pocket expenses (Kaiser Family Foundation, n.d.). The act faced a negative reaction regarding the cost outweighing the benefits. And as a result, it was repealed the following year. |
| 1989 | In 1989 the Federal government amended the Federal budget reconciliation act (OBRA 89) by adding mandate that required health coverage of pregnant women and children under the age of six with a 133% federal poverty level. |
The Federal government of the United States has been on the forefront to ensure health rights to every citizen are fulfilled. In the 1920s, employer-sponsored insurance was introduced, and after World War II, the government-imposed taxes and wage controls and declared employee benefits such as health insurance. The move proved significant as by 2018, 55 % of the USA population had been covered by employer-sponsored insurance ( Leider, Tung, Castrucci & Sprague, 2015). In the 1960s, the government initiated the first public health insurance, which led to other reforms over the years. The main government responsibility becomes setting national strategies and legislations which guide how systems and health care was being administered in the USA. Secondly, the government not only enacted public health insurance acts but also supported the actions financially (The Common Wealth Fund, 2017). For instance, the government sponsors the Medicare Program adopted in 1965 and also funding health insurance for employees working in the federal government and past military survivors together with their families. Thirdly, the federal government also provides regulations for pharmaceutical products and services and medical devices.
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Furthermore, politics have an impact on how healthcare is provided in the country. Majorly, public health, together with health insurance, occurs in federal agencies. These agencies are dependent on government funds and support. Therefore, sometimes, the allocation of funds and the building of fare strategies can be political. The most known political leverage is congressional earmarks (Leider et al., 2015). These are legislative provisions that direct spending of approved funds for projects. In this case, a health insurance project or programs attract political games and, in the long run, affect health care. For example, the House of Representatives can get political over health bills that are not suitable or any health bill because of several reasons. They might cite economic reasons, even party-affiliated reasons.
References
Leider, J. P., Tung, G., Castrucci, B., & Sprague, J. B. (2015). Health spending and political influence: the case of earmarks and health care facilities. Journal of Public Health Management and Practice, 21(2), 161.
Kaiser Family Foundation (n.d.). Timeline: History of Health Reform in the U.S. Retrieved July 25, 2020, from https://www.kff.org/wp-content/uploads/2011/03/5-02-13-history-of-health-reform.pdf
The Common Wealth Fund . (2017, April 10). Health Care System Profiles . Retrieved July 25, 2020, from The Commonwealth Fund: www.commonwealthfund.org
