Healthcare

While across the globe there are many different healthcare systems, the United States uses a mix of both private and public insurance, acting as a third party to pay the doctors and hospitals for the cost of the services to the patient. Medicare is one of the public programs that supports people who are 65 or older, have certain disabilities, or have End-Stage Renal Disease. Medicaid is for low-income individuals and people with disabilities. Some may decide to buy private insurance or use another public insurance, and 48% percent of Americans purchase private health insurance through their employer.

Healthcare policy can be influenced by legislative and regulatory processes created by lawmakers along with federal agencies, administration, and lawsuits. This change can range from the cost of healthcare, the quality of healthcare, and even how accessible it is to Americans. Accessibility is an issue often discussed in politics because about 30 million Americans are uninsured. In fact, universal health care has been discussed since the early 1900s but has never been enacted. One of the most recent significant pieces of legislation passed about healthcare is the Affordable Care Act (ACA) by former President Obama in 2010. The ACA aimed to make healthcare more accessible by providing subsidies for enrollees who have incomes within 100–400% of the federal poverty level and also to expand Medicaid to accept people within 138% of the federal poverty level. It also included mandates for everyone to have health insurance coverage and for employers to provide it for their employees based on the type of company. 

The policies proposed by politicians greatly range from significantly reducing government healthcare to having the government supply all Americans healthcare. On one side, some believe that the government should reduce its programs by making more strict requirements for eligibility, leading to less coverage while also reducing the financial burden on taxpayers. Other policymakers want to increase eligibility and the coverage for each plan so that more Americans are covered and have less financial stress when it comes to healthcare spending. This is proposed to be accomplished by either specifically focusing on those who have no insurance and are greatly impacted by healthcare bills, or it can be solved with Medicare for All, which greatly increases the necessary federal funds but then covers all Americans.

In Massachusetts specifically, health insurance coverage is required for most residents over 18 who can afford it. Residents who can afford but refuse to pay for coverage incur a penalty through their tax returns. The public program for Massachusetts is called MassHealth and it combines both Medicaid and the Children’s Health Insurance Program (CHIP). Massachusetts has the lowest uninsured rate out of all states at 3%. The Health Policy Commission (HPC), created in 2012, is the responsible government agency for analyzing spending, proposing new plans, and supporting other agencies. The HPC has created a benchmark that states that health care costs spent by all payers should not grow faster than the total state’s economy.