Perhaps the biggest success in history came recently when healthcare reform advocates were able to spur the passage of the Patient Protection and Affordable Care Act (more commonly known as the ACA). The ACA worked in combination with the Healthcare and Education Reconciliation Act of 2010 in order to provide for a comprehensive overhaul of the healthcare landscape in the United States.

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The goal of the healthcare reforms was to deal with a number of deep flaws that were present within the healthcare system in the United States; one of the primary goals was to make healthcare insurance cost effective for those who did not have it. Other goals of the reform included bringing down healthcare costs, improving efficiency of Medicare, and implementing consumer protection statutes that would eliminate discriminatory actions which were common in the healthcare system (Arts, n.d.).

Opponents of the healthcare reform efforts heavily criticized the legislative process that the bill went through, claiming that it was rushed and did not give representatives enough time to fully analyze its merits. According to Aaron and Reischauer (2010), “Democratic leadership’s decision to “ram through” reform using budget reconciliation to modify the Senate-passed bill sufficiently to make it acceptable to the House” was unappealing to many conservative representatives.

The role of outrage in policy making is complex, and high emotions can have a wide range of impacts on future debate. Some in the United States were so concerned about the passage of the ACA that they drove the debate to new heights. For example, conservative commentator Glenn Beck reached in comparison between the ACA and Nazi eugenics noting that “You have three people in the White House that are in love with eugenics are whatever it is you would call it today…Please dear God, read history.

Please dear God read the truth of what these people have said in their own words, and ask yourself this one question: Do you trust these people enough to give them control over who lives and who dies? Because that’s what health care is when you have no otherchoice but to go to the state” (Beck, 2009). Formulation Stage

Page 2 Policy Process Paper Part I Essay

The Affordable Care Act passed through the Senate on Christmas Eve of December; not a single Republican supported the measure, while all attending Democrats and Independents sided with the President. It was not until March 21st of 2010,that the bill made it through the House of Representatives with a vote of 219 in favor and 212 opposed. Thirty-four Democrats crossed the aisle and voted against the bill, which was a departure from voting patterns in the Senate. The ACA was also challenged through the court system, with various aspects of it being seen as unconstitutional by opponents. The bill survived the courts, including the Supreme Court, with three different federal courts upholding its constitutional nature.

The World Health Organization holds that it is imperative that people and organizations understand policies that are already in place before they work to create new legislative alternatives. By doing this, redundancy is avoided since it can be ascertained that the new laws will not overlap with the existing laws. In addition, consideration of preexisting policies can help the organization determine if the policies simply need updating, or if a more dramatic overhaul is necessary in the form of new law. Legislative Stage

The Parliamentary legislative process consists of three steps. The first step is the consideration stage. During this stage the law is researched and drafted. The next stage of the process is the enactment stage. It is during this stage that the parliament will actually consider what has been created and determine if it is worthy of support. The final stage in the process is implementation; this can only begin once the legislation has been validated by a vote.

Upon the determination of an agenda, the process of development can begin. This starts with the legislative proposal being made into a bill, which can then be introduced before Congress. The bill is introduced in the House or Senate, depending on which body has jurisdiction. The proposal also contains justification for the bill’s purpose and how it will help the country.

The First Amendment to the Constitution guarantees individuals and organizations the right to be heard before Congress regarding legislation. Generally speaking, this tends to come in the form of public hearings. The Founding Fathers realized that it was necessary for concerned citizens to have the right to speak their minds and have an impact on the legislative process; this helps boost the validity of the law before the eyes of the public.

The compelling need of the public to have the opportunity to influence the legislative process in Congress is obvious. However, it must also be balanced against the corrosive impact that special interests and big money have on the process, a paradigm which puts the power of influence in the hands of those with large amounts of money to donate. For example, federal disclosure requirements demonstrated the enormous uptick in donations from the healthcare industry during the second quarter of 2009 as they attempted to ensure that the bill would not impact their profitability (Eggen, 2009).

The influence that special interests have in the legislative process demonstrates the fact that there are plenty of areas in politics that are open to short cuts with regard to negotiation. Special interest groups understand that in order to be useful they must have a friendly representative willing to listen to their point of view on a matter. These legislators are individuals as well, with the concerns of individuals. President Obama noted that “in the end, this isn’t about politics. This is about people’s lives in livelihoods. This is about people’s businesses.

This about America’s future…” (Arts, n.d.). Representatives, driven by the desire to get reelected, can commonly be influenced to vote in one way or another. Special interests as well as their party’s whip play as large of a role as the executive branch does in this profess of influence. President Obama also pointed out that a great deal of the media attention was focused on the voices that were loudest. Many of the millions of individuals without access to the healthcare system were not heard from, since the healthcare companies could afford a louder voice (Arts, n.d.). Implementation Stage

Upon the signing of a bill into law, the process of implementing a policy begins. It is up to the executive branch to determine the rules and regulations so that the intentions of the law can begin to be manifested in real life. With regard to the ACA, there are huge number of foreseeable issues that will come into play, on both the state and federal level. Some of these issues are due to the fact that there are legitimate design flaws in the ACA and others exist due to opposition from state-level executives.

It is during the implementation stage the ACA process that opponents will have the opportunity to make the biggest impact. In particular, focusing on the delays in the reform schedule which have resulted in big tickets items being deferred are a ripe aspect of the law to attack. “The individual and employer mandates, the subsidies to make insurance affordable, the Medicaid expansion, and major insurance-market reforms will all start in 2014. And the tax on high-cost insurance plans goes into effect in 2018” (Aaron & Reischauer, 2009).

Provided the fact that Republicans and conservatives in Congress have demonstrated fierce opposition to the law, there are ample opportunities for them to modify the ACA; in fact, there is even a chance that the law could be repealed if enough votes are garnered.

Currently, different parts of the ACA continue to make their way before the Supreme Court. In Florida vs. the US Department of Health, Judge Roger Vinson invalidated the minimum coverage provision of the ACA stating that it ran counter to the Constitution. However, this was overturned by the Supreme Court, with Justice John Roberts proving to be the key swing vote in favor of the Obama Administration. Conclusion

In conclusion, in order for any legislation to succeed it has to be effectively written in addition to being effectively implemented. The process requires that either state or federal officials author the bill while giving specific definitions to its terms in order to avoid misunderstanding. Given the political climate in the United States, it can be expected that the legislative process will be more contentious than ever.

Legislators will have to work harder than ever in order to create bills and laws that are acceptable to the other side. Failure to do so will result in more situations like the one occurring with the ACA where the losing side spends enormous time and effort trying to defund the law or repeal it outright.

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