Competency

Discuss  the role and impact of lobbyists, special interest groups, and other  consumer advocates on the development of healthcare policies in the U.S.

Scenario

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 program’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 “opt”  out of the Medicaid expansion program. As a result of the various  states’ decision to “opt” out of the ACA’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.