Introduction
Medicaid is a government social healthcare program meant to give insurance cover to low-income individuals, families and special categories of people who are deemed vulnerable or disadvantaged—it is a public policy initiative. Public policy is a tough balancing act of competing interests. It is no easy task because it involves making compromise decisions that times will favor certain interests and override others. Hardly any public policy decision can pass without some disgruntled and dissenting voices against it. In a democracy such as the United States, it is the duty of the elected representatives to ensure that a policy decision that takes into account and balances all the competing interests prevails. For this to happen, the public policy decision-making process must be transparent, credible, and legitimate. This paper looks at how well the Florida Medicaid expansion bill referred to in three news articles meets these criteria (Aboraya 2014; Curry, 2014; Health News Florida Staff & Aboraya, 2014).
Transparency
Transparency is about ensuring that everybody is involved and is made aware of the intended effect or outcome of a public policy decision. It is about making information available to all people poised to be affected by the policy decision whether positively or negatively. The media takes centre stage in adjudicating this role. In the instance of the Florida Medicaid expansion Bill, media centres and other information platforms steps in to execute their role of informing the public. Information should not be biased or one sided—it must be honest. Public policy decisions are shaped by competing interests and when information is honest people are able to make informed decisions. Through the three articles, we get to know the various competing interests about the Bill (Aboraya 2014; Curry, 2014; Health News Florida Staff & Aboraya, 2014).
Credibility
Credibility is about ensuring that there is fairness and integrity in the decision process. In the Florida Medicaid expansion Bill, there are various stages and processes followed in developing and passing the bill. At the federal level, Medicaid under the Affordable Care Act (AFA) was stretched to cover individuals with income up to 138 percent of the national poverty level (Curry, 2014). This was however not all that was required to implement the bill. Individual states are diverse with needs and interest and must play an integral role in any matter affecting their residents. In this respect, the U.S. Supreme Court stepped in to issue a ruling that made expansion optional for individual states (Curry, 2014). At the Florida state level, Medicaid expansion though initially passed by senate was finally dropped by a Republican dominated house of elected lawmakers (Aboraya, 2014).
Legitimacy
Legitimacy is about ensuring that the law is observed and upheld. Public policy decisions must be lawful and widely acceptable across the spectrum. It is worth to note that public policy decisions reflect public interest more than any other interest. The rejection of the Medicaid expansion bill was preceded by charged re-election victories of Republican law makers who had voiced opposition to the Bill (Curry, 2014). Even though the Florida senate had initially succeeded in passing the Bill, the move was not popular with many Florida residents. This ignited them to rally their dissatisfaction through the electoral process to vote in Republican lawmakers which went in to ensure the Bill did not come to take into effect.
Conclusion
The narrative in the three articles teaches us very important lessons in public policy decision making. Firstly, the government is the custodian of public interest—it therefore must take a central role in public policy formulation. Secondly, public policy decisions should be made with wide consultations with all the affected and interested parties. Third and most important, public policy decisions must advance public interest more than any other interest to gain acceptance.
References
Aboraya, A. (2014). Florida CHAIN Calls on Lawmakers to Expand Medicaid. WGCU News. Web.
Curry, C. (2014). Health care activists continue push for Medicaid expansion. The Gainesville Sun. Web.
Health News Florida Staff and Aboraya, A. (2014). Rally Urges Lawmakers to Expand Medicaid. Health News Florida. Web.