Discuss the role and impact of lobbyists, special interest groups, and other consumer advocates on the development of healthcare policies in the U.S.
Student Success Criteria
View the grading rubric for this deliverable by selecting the â€œThis item is graded with a rubricâ€ link, which is located in theÂ Details & InformationÂ pane.
You are the director of community affairs for the health lobby organization, Pathways to a Healthy America. In 2010, President Barack Obama signed the Affordable Care Act into law. As a result, millions of Americans who were previously uninsured gained access to the healthcare system. One of the initial provisions of the Act required individual states to expand the eligibility criteria for Medicaid. The programâ€™s costs would be absorbed by the federal government at a rate of 100% for the first three years of program participation which would decrease to 90% after 2020, still, considerably higher than previous funding by the federal government. However, in 2012, the Supreme Court ruled the mandate unconstitutional allowing individual states to voluntarily â€œoptâ€ out of the Medicaid expansion program. As a result of the various statesâ€™ decision to â€œoptâ€ out of the ACAâ€™s Medicaid expansion, millions of adults fell into the critical coverage gap. Your organization represents a state which has decided to forego participation in the ACA expansion program. The decision was met with both praise and criticism.
It has now been a few years since the decision and your organization has gathered information on the impact of the decision in order to advocate for Medicaid reform during the next state legislative session.
You are required to write an advocacy report to state lawmakers in which you advocate for either participating in the original expansion program or participating with conditions (waivers) to address the critical gap in coverage for vulnerable adults in your state. Waivers such as Section 1115 enable for alternative implementation of Medicaid expansion and allow states to impose restrictions which may result in a denial of Medicaid eligibility for individuals who do not meet those restrictions, i.e., work requirements.
Research the Medicaid expansion program offered through the Affordable Care Act (ACA) as well as Medicaid reform initiatives using waivers to increase access to Medicaid. Determine, based on your stateâ€™s profile, which process (the ACAâ€™s expansion program or the use of waivers) is most beneficial to your state. Include a comprehensive, well-supported recommendation for participation in Medicaid reform usingÂ eitherÂ the ACAâ€™s program or a modified reform process using waivers.
Your advocacy report should describe your stateâ€™s current Medicaid program including its eligibility criteria, demographics, Medicaid spending and savings since the ACAâ€™s implementation, and comprehensive details of current or pending waivers. You should also include a discussion (benchmark) on another stateâ€™s success with Medicaid reform using your recommended strategy (the ACAâ€™s expansion programÂ orÂ the use of the specific types of waivers for which you propose).
You will find a PDF containing information from the Commonwealth Fundâ€™s findingsÂ here
You will find a PDF containing information from the Kaiser Family Foundation on Medicaid ExpansionÂ here.
APA formatting for the reference list, and proper grammar, punctuation, and form are required. APA help is availableÂ here.
A – 4 – Mastery
Report includes a comprehensive, coherent, well thought out recommendation, for either the ACAâ€™s expansion of Medicaid or a modified expansion process with a justification based on comprehensive research with fully developed, well-supported reasoning.
A – 4 – Mastery
Report includes a comprehensive description of the stateâ€™s Medicaid program including eligibility criteria, demographics, spending, savings and the stateâ€™s current or pending waivers.
A – 4 – Mastery
Report includes a comprehensive assessment of another stateâ€™s successful reform efforts and a comprehensive, well-supported discussion on the criteria used in evaluating the implementation of successful Medicaid reform in that state
A – 4 – Mastery
Report includes a comprehensive discussion with significant and current details on the Medicaid expansion program offered through the Affordable Care Act (ACA). Discussion includes assertions supported by credible research.
A – 4 – Mastery
Report includes a comprehensive description of waivers (i.e., Section 1115). Discussion includes assertions supported by credible research.
A – 4 – Mastery
Includes 3 or more credible, scholarly, current (within the past 5 years), and relevant sources. Adequate integration of information included within the report. Appropriate synthesis and analysis included in the report.
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