Redefining US Healthcare: A Closer Look at Proposed ACA Replacements


The current issue in healthcare that is being debated about is the Affordable Care Act (ACA). Republicans are faced with the task of replacing this policy with a new plan that President Donald Trump considers to provide better health care at a lesser cost. According to Pear (2017), the significance of Obamacare is that the majority of Americans can access affordable and quality healthcare. Conversely, Republican are against this healthcare reform on the ground that the policy has failed to control the growth in healthcare spending. Also, Republicans have cited that the policy forces people to buy health insurance against their will. 

The two competing solutions to this problem include the following. First, lawmakers have proposed the idea of a public option. Proponents of the public option state that this system would be a government-run insurance plan that is offered through public exchanges (Pear, 2017). Every country in the world experiences the problem of rising costs of healthcare. However, they have handled this issue by signing up the entire population into a single-payer system and taking advantage of the bargaining leverage to drive down costs. Therefore, support for a public option in the U.S would provide competition to private insurance plans and drive down costs for consumers. The second solution is to create a reinsurance program. This program will help to stabilize the insurance markets by allowing them to offset the cost of covering older and less healthy individuals. According to Feldscher (2017), from 2014 to 2016, there was a transitional reinsurance program established under the ACA, which helped in stabilizing premiums, and it would be significant if the federal government continues with this program. 

Given the two solutions, the one which is preferable is the idea of a public option. Although Democratic politicians have championed a public option for long, the inclusion of this plan in the ACA will help to alleviate issues facing the policy. The problem that most Americans are facing is the rising cost of healthcare, and the introduction of a government-run insurance plan will help to stabilize competition thus lowering healthcare costs. 

The federal, state and local government play a significant role in promoting healthcare. The federal government has a role in regulating health care services by establishing minimum health care standards (Tang, Eisenberg & Meyer, 2004). Also, the federal government is the purchaser of care. The government purchases strategies to improve health care quality. Lastly, the federal government is the provider of health care, that is, it assumes ownership of healthcare organizations.

The state government has the role in regulating insurance markets and overseeing the proposed health insurance rates. Also, it provides health education and participates in initiatives that promote healthy living (Niles, 2016). Other responsibilities include licensing hospitals and physicians and creating Medicaid eligibility rules (Larrat et al., 2012). The local government oversees the quality of healthcare the public and private sector offer to patients. Also, the government engages in health monitoring, sanitation and disease control. 

The three branches of the federal government have the following responsibilities. The role of the legislature is to create health policy and allot resources for implementation (Niles, 2016). The executive branch ensures that health departments and related agencies implement the legislation and establish regulations to discharge the health policy. Lastly, the judiciary has the role in interpreting laws and dealing with legal disputes (Larrat et al., 2012).  

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  1. Feldscher, K. (2017). Reinsurance program critical to shoring up the ACA. Harvard T.H. Chan. Retrieved on 21 September 2017 from 
  2. Larrat, E. P., Marcoux, R. M., & Vogenberg, F. R. (2012). Impact of federal and state legal trends on health care services. Pharmacy and Therapeutics, 37(4), 218-226. 
  3. Niles, N. J. (2016). Basics of the US health care system. Jones & Bartlett Learning.
  4. Pear, R. (2017). Issues facing Republicans in replacing Affordable Care Act. The New York Times. Retrieved on 21 September 2017 from 
  5. Tang, N., Eisenberg, J. M., & Meyer, G. S. (2004). The roles of government in improving health care quality and safety. The Joint Commission Journal on Quality and Safety, 30(1), 47-55.
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