Organizations & Policy Objectives Bruce Rhodeback-2

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752

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Health Science

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Jan 9, 2024

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Organizations & Policy Objectives 1 Organizations & Policy Objectives Bruce Rhodeback HCM 752: Health Policy Franklin University Dr. Monica Taylor

Organizations & Policy Objectives 2 Abstract: This paper explores the process of implementing the Health Insurance Marketplace segment of the Affordable Care Act (ACA) by the U.S. Department of Health and Human Services (HHS). It delves into the roles and responsibilities of the Centers for Medicare & Medicaid Services (CMS) and the Center for Consumer Information and Insurance Oversight (CCIIO) in ensuring equitable, quality, and affordable healthcare access for all Americans. The paper also highlights the extensive experience and expertise of CMS in healthcare programs and its pivotal role in ACA implementation. Introduction Once a health policy has been enacted through the enactment of legislation, the next step in the policymaking process involves the implementation of that policy by the executive branch through the promulgation of rules and regulations and their actual implementation by the executive branch. In the instance of the Health Insurance Marketplace (Healthcare.gov), a section of the Affordable Care Act (ACA) was implemented on October 1, 2013, by the Health Insurance Marketplace (HHS, n.d.). This assignment explores the process of accessing the Affordable Care Act's health insurance marketplace through the U.S. Department of Health and Human Services (HHS), in addition to the roles and responsibilities of the agencies responsible for implementing the provisions of the Affordable Care Act and their respective competencies. The Path to the Health Insurance Marketplaces Segment of the Affordable Care Act Determining which entity is responsible for implementing the Health Insurance Marketplaces segment of the Affordable Care Act within the U.S. government is a challenging task. The exploration begins with the Department of Health and Human Services (HHS, n.d.). Initially, the main website of the Department of Health and Human Services (HHS) is explored.

Organizations & Policy Objectives 3 The "Programs and Services" section of the website ( https://www.hhs.gov/programs/index.html ) provides information regarding "Health Insurance Options" ( https://www.hhs.gov/programs/health-insurance/index.html ). Within this section, the healthcare insurance marketplace option is located, and the link to Healthcare.gov ( https://www.healthcare.gov/ ) is followed. While the Healthcare.gov website offers various resources related to enrolling in, canceling, and changing health insurance plans, the focus is on the "Resources" section at the bottom of the page, which is expected to provide the necessary information. By selecting "Regulatory and Policy Information" within the "Resources" section, the website of the "Center for Medicare and Medicaid Services" (CMS) (CMS.gov, n.d.) is accessed. The introductory page of CMS confirms that the agency is responsible for overseeing the implementation of provisions related to private health insurance, particularly the establishment of new health insurance marketplaces in collaboration with states. Liabilities and Mission of CMS and CCIIO A federal agency within the Department of Health and Human Services (DHHS) known as the "Centers for Medicare & Medicaid Services (CMS)" administers the Medicare program in addition to its collaboration with states to support Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards. Through surveys and certification procedures, CMS is responsible for maintaining nursing home quality standards, ensuring compliance with HIPAA administrative simplification requirements, offering Medicare Advantage Plans in Spanish, maintaining clinical laboratory quality standards, managing Medicare and home-related services, and overseeing HealthCare.gov. Also, the organization facilitates the acquisition of health insurance plans by selling CMS-1500 forms, the official standard Medicare and Medicaid health insurance claim form, available at U.S. government

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