Review other posts submitted by your classmates.  In your responses, consider the impact that stakeholders had on the outcome of both reform efforts.

In your opinion, which stakeholders had the most significant impact on the outcome of each reform effort and why?

Post #1

Maria Duarte Bracamontes posted Oct 7, 2020 2:10 AMSubscribe

            There were a couple of factors that lead Obama’s healthcare reform legislation to succeed. First, the Obama administration used Clinton’s plan as a guide for what to do and what not to do during the process of getting the reform passed. It is said that Hillary Clinton had a significant impact on the planning of the first health reform plan back in 1993, which then became a blueprint to future health reform plans (Gottlieb et al., 2015). I believe the two reforms played out differently due to the blueprints left by Clinton. Obama analyzed what worked with Clinton’s plan and what did not, which led him to use strategic planning to pass his healthcare reform with the modifications he believed were necessary. Clinton moved slowly on the health care process while Obama was consistent in passing the legislation through congress quickly. Clinton’s administration gave a detailed health plan whereas Obama did not elaborate a detailed description of the plan, leaving congress to work out the details (Oberlander, 2010). This, in the long run, was beneficial because congress was able to work more freely with the plan.  

Both attempts to pass the healthcare reform was a learning process for any political party. The process of the health reform showed that it is important to keep an open mind and analyze with precautions the “mistakes” and “successes” of others. The process is the same for everyone and there will always be hardships, but what makes the difference is how those hardships are handled. The process also showed the importance of compromise due to those hardships. While not everyone in the policymaking process will agree with each other, it is crucial to find ways of compromising to be able to help as many individuals as possible. 

References    

Gottlieb, S., Epstein, R., & Rauch, J. (2015). The Clintonian Roots of Obamacare.https://www.nationalaffairs.com/publications/detail/the-clintonian-roots-of-obamacare.

Oberlander, J. (2010, June 1). Long Time Coming: Why Health Reform Finally Passed.https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010.0447.

Post #2

Savannah Ventura posted Oct 7, 2020 10:48 AMSubscribe

As opposed to the Clinton Administration, there are two primary reasons behind President Obama’s healthcare reform’s success. One, democrats, after the Clinton’s failed plan, adjusted their strategy, as well as their goal. Secondly, congressional leaders in the Democratic Party made up most interest groups, which benefited Obama’s reform. Additionally, the Affordable Care Act (ACA) was much less ambitious than the Clinton plan (American Public Health Association [APHA], 2015). 

The Clinton plan called for a global budgeting system. State insurance exchanges, also known as regional health alliances, were the sole providers of health insurance for individuals under 65 years old (APHA, 2015). Also, the rate of growth for average premiums contained limits. However, in the ACA, exchanges are only set for small-group markets and the individual. Furthermore, the ACA is less intimidating as there are no limits on premiums and fewer means of imposing controls on costs (Teitelbaum & Wilensky, 2017). 

The Affordable Care Act is the most critical health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care (Obama, 2016). In 1993, Democrats were all over the place, and President Clinton could not overcome those divisions. By 2009, democrats had coalesced behind the Massachusetts strategy of expanding Medicaid, subsidizing private coverage in limited insurance exchanges, and backing it up with a weak individual mandate (APHA, 2015). With a more unified Democratic Party and interest-group support, Obama was able to succeed in getting legislation adopted.

References

American Public Health Association (APHA). (, 2015). The role of health education specialists in a post-health reform environment. Retrieved from https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2016/01/27/13/58/role-of-health-education-specialists

Obama, B. (2016). The United States health care reform: Progress to date and next steps. Journal of the American Medical Association, 316(5), 525-532. DOI:10.1001/jama.2016.9797

Teitelbaum, J.B., & Wilensky, S. E. (2017). Essentials of health policy and law (3rd ed.). Burlington, MA: Jones & Bartlett Learning.