Purpose of the Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act (PPACA) became law on March 23, 2010. The policy network approach was implemented for formulating the policy of the health care reform under consideration. The collaboration of the interested actors was important for enhancing governance and improving the formulation of legislation through their active communication and coordination of their efforts. The reformation program covered a wide range of health care problems, ranging from the expansion of Medicaid eligibility to the economic support of medical investigations. The purpose of this paper is to discuss the issue of limiting the insurers’ opportunities for denying coverage for patients based on pre-existing conditions.
Acknowledging the fact that the existing insurance system requires transformation, various actors expressed compelling views concerning the measures which need to be imposed for making the necessary changes and enhancing governance. The problem is that contemporary insurers have unlimited opportunities for denying coverage in case if an individual’s health is not perfect. The PPACA aimed to limit the permissiveness of the insurance companies and protect the patients’ rights. The main actors who have competing interests and expressed their compelling arguments in the process of policymaking include the insurance companies, members of Congress, and doctor’s groups such as the American Medical Association (AMA), for example. The contribution of each of these actors was valuable for improving the quality of legislation which became the result of the collaborative work of the interested parties.
Significances of Reform
With the shift towards democratic governance, the concept of policy networks has been applied to the process of policymaking in various spheres. Thatcher (1998) noted that “Continuous expansion has allowed network approaches to be adaptable, but the result has been an increasing gap between their aims and achievements” (p. 389). For reducing these gaps, policymakers should select effective methods of communication and coordinate their efforts, trying to find the solutions for the issues instead of focusing on the interests of their group. One of the most effective models is the advocacy coalition framework (ACF). “The basic strategy of this framework [ACF] is to use the structure of beliefs in the governing coalitions of policy subsystems to predict changes in shared beliefs that lead to changes in policy over time” (Stich & Miller, 2008, p. 63). Despite the current level of development of strategies, the sphere requires further improvements. Grant (1990) pointed at the need to develop further a range of types of policy-making structures (p. 319). Participating in policy networks, actors need to pay attention to the dynamics as one of the main characteristics of the process (Kjun, 1996, p. 90). Therefore, a wide range of approaches to creating the policy networks can be implemented for enhancing governance and improving the results of collaborative works.
The PPACA as the result of a collaboration of policymaking networks demonstrates the effectiveness of the strategies which were used by the participants. Expressing their considerations, the groups with compelling interests allowed viewing the problem from various perspectives and selecting the solutions considering the complexity of the issue. Balancing the competing interests of various groups, the network managed to complete the project of the reform. Limiting the opportunities of insurers to deny coverage without proper argumentation of this decision, the reform under consideration is aimed at protecting patients’ rights.
Reference List
Grant, J. (1990). Sub-governments, policy communities and networks: Refilling the old bottles? Journal of Theoretical Politics, 2(3), 319–338.
Kiun, E. H. (1996). Analyzing and managing policy processes in complex networks: A theoretical examination of the concept policy network and its problems. Administration and Society, 28 (1), 90–119.
Stich, B., & Miller, C. R. (2008). Using the advocacy coalition framework to understand freight transportation policy change. Public Works Management Policy, 13(1), 62–74.
“The basic strategy of this framework [advocacy coalition framework] is to use the structure of beliefs in the governing coalitions of policy subsystems to predict changes in shared beliefs that lead to changes in policy over time” (Stich & Miller, 2008, p. 63).
Thatcher, M. (1998). The development of policy network analyses: From modest origins to overarching frameworks.