The Issue of the Future of Health Care Reform in the United States

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The public policy problem in the US that I believe qualifies a place in the public policy agenda is the issue regarding the future of healthcare reform. Americans have been yearning to know the likely outcome of the Affordable Care Act. Since its implementation in 2010, the majority of the Americans have attained medical coverage mainly through the health exchanges that have been established by the act. With the federal subsidies that exist in the US, the prices of those who qualify for the health coverage is significantly lowered resulting in more people seeking plans that cost less a month. However, with the new Congress and administration, these subsidies are experiencing uncertainties. Indeed, without them, millions of Americans are likely not capable of affording medical coverage because in the contemporary economy health insurance costs are consistently rising (Lays, 2017). In essence, this warrants this issue to be on the public policy agenda because it is of public concern.

Internal and external stakeholders greatly influence the formation of a policy agenda. Firstly, during the formation of policies policy makers are required to consult both stakeholders. Hence, it is from their suggestions that more productive policies are developed. Secondly, before the implementation process, policymakers are mandated to give them an ample time to evaluate the established policy efficiently. Indeed, this affirms that both internal and external plays a significant role in the formation of a policy agenda.

The internal stakeholders that are most relevant to getting the issue of the future of health care reform on the agenda are patients and physicians. This is because the experienced uncertainties experienced in subsidies will make patients seek no coverage due to high costs. Therefore, they will put pressure on the government to formulate health policies that favor their wellbeing. Similarly, with few patients visiting hospitals physicians are more likely to push for the issue on the agenda since no profits are gained (Cafasso, 2011). The external stakeholders relevant to the problem include insurers and hospitals. With the new reforms, insurers have been placed in an ironic situation since they are likely to experience decline in the number of individuals who seek coverage. Hence, they are influenced to call for policies that favor their existence. Notably, decrease in federal subsidies resulted in the reduction of the reimbursements given to hospitals (Cafasso, 2011). Therefore, to offer quality medical services hospitals will fight for better health care reforms.


Cafasso, E. (2011, March 21). How health-reform stakeholders will be affected by recent changes. Retrieved from

Lays, J. (2017, January 1). The big issues of 2017: Lawmakers have plenty to ponder beyond presidential politics. Retrieved from

August 01, 2023



Healthcare Politics

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Health Insurance Policy

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