Applying Policy Concepts to the ACA

Part 1 What form of policy is the ACA, using Longest’s form categories (laws, rules and regulations, operational decisions, judicial decisions)? Part 2 For each of the selected ACA provisions, answer the following questions: • According to Longest’s descriptions, is the provision allocative or regulatory? If allocative, name the group that it is intended to benefit. Name one reason this may miss its intended purpose and/or audience. Is the provision a subsidy? If so, to whom? • What went wrong with the competition in the market for health services that precipitated government intervention with this provision? • Name and describe one potential implication of the provision for a small acute care hospital. Selected ACA Provisions Provision A: Require employers with more than 200 employees to automatically enroll employees into health insurance plans offered by the employer. Employees may opt out of coverage. Provision B: Expand Medicaid to all non-Medicare eligible individuals under age 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 133% of FPL based on modified adjusted gross income (as under current law undocumented immigrants are not eligible for Medicaid). Provision C: Impose additional requirements on non-profit hospitals to conduct a community needs assessment every three years and adopt an implementation strategy to meet the identified needs, adopt and widely publicize a financial assistance policy that indicates whether free or discounted care is available and how to apply for the assistance. Part 3 Discuss the importance of policy competency in regard to the provision C, assuming you are the CEO of a small hospital.

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Applying Policy Concepts to the ACA

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