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Federal and State Policies
This article analyzes and identifies both the positive and negative effects of federal and state healthcare policies on consumer costs. Healthcare coverage and the associated costs are major political issues in the U.S. Health care coverage plays the role of protecting people from high health care spending burdens and aiding access to healthcare. These policies affect how American citizens get health insurance and what coverage it provides. Further, many coverage policies change how families pay for health care, usually by adjusting what government programs pay for the cost or by redistributing the burden of health care costs among people with different levels of health care needs (Fiedler & Young, 2019).
Affordable Care Act (ACA)
As part of a federalist system, governing responsibility is divided between the federal and state governments. This structure is reflected in the Affordable Care Act (ACA), which expanded Americans' options for insurance coverage. In general, the federal government provides most of the financing for subsidized coverage and sets the federal floor for insurance market regulations. States have the freedom to implement this law (Collins & Lambrew, 2019).
Positive Impact
ACA was designed to cover a substantial number of households below a certain income level with Medicaid. Medicaid reduced the cost of healthcare for consumers as well as the federal poverty level (Weiner, Marks, & Pauly, 2017). Medicaid is free for those who qualify. Tax subsidies are also available to households with income levels up to 400% of the federal poverty level (Health Reform, 2020). However, the ACA policy has also led to a rise in health care costs (Amadeo, 2021).
Negative Impact
ACA, health insurance coverage expands, and as a result, health care spending increases as well. By requiring insurance companies to provide additional coverage, some people have seen an increase in the cost of their insurance. Many of the concerns raised by critics pertain to small businesses. Furthermore, companies are compelled to keep their employee count low due to the Affordable Care Act since companies with 50 or more employees must provide health insurance. In turn, this can affect the number of people employed full-time by small businesses. Lastly, while more Americans have access to health insurance due to the Affordable Care Act, the underlying cost of medical care has not decreased. Despite having medical insurance, Americans usually have difficulty affording medical expenses, and 40% of all bankruptcy cases in the United States involved medical debt (Fawbush, 2020).
In conclusion, the ACA has primarily functioned as it was designed; more Americans have access to medical insurance. Consequently, better and more comprehensive coverage has become more expensive, and the cost of medical care has also increased. Those who believe that the federal government should help Americans get decent health insurance plans will likely approve the ACA. However, those who believe that the federal government should not play a role may think that the ACA is interfering with the free market and raising taxes and premiums for people who could otherwise find health insurance on their own.


Amadeo, K. (2021, March 27). See for Yourself If Obamacare Increased Health Care Costs. Retrieved from https://www.thebalance.com/causes-of-rising-healthcare-costs-4064878
Collins, S. R., & Lambrew, J. M. (2019, July 19). Federalism, the Affordable Care Act, and Health Reform in the 2020 Election. Retrieved from https://www.commonwealthfund.org/publications/fund-reports/2019/jul/federalism-affordable-care-act-health-reform-2020-election
Fawbush, J. (2020, November 25). The Pros and Cons of the Affordable Care Act (Obamacare). Retrieved from https://www.findlaw.com/healthcare/patient-rights/the-pros-and-cons-of-the-affordable-care-act--obamacare-.html
Current debates in health care policy: A brief overview.

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