Policy Analysis Paper

Policy Issue

The Hyde amendment was made to ban the use of federal funds to pay for abortion through Medicaid or federal insurance. The amendment only allowed payment of abortion services that resulted from incest, rape, or when the pregnancy endangers the life of the mother. Consequently, women who underwent the abortion procedure had to pay for the entire medical bills through cash despite have active medical covers. Thus, the use of federal funds for abortion services through Medicaid, Children’s Health Insurance Program (CHIP) or Medicare was prohibited through the amendment (Israel). Therefore, the policy was termed discriminatory and brought up politics of different opinions. The policy exempted a few cases when one can use federal funds for abortion services including when a woman got pregnant through rape, incest or when their health is at risk due to pregnancy.

Abortion is an essential element of healthcare that should be affordable to all women who require the same despite their economic status or where they live. Various reasons may make women decide to terminate pregnancy other than the ones exempted. Some women get pregnant when still on birth control methods which means it was not a planned pregnancy. In other cases, the women may realize that they made a mistake having unprotected sex or failing to take emergency contraception after the act. Even though it is through consented sex, women may realize they are not ready for the child and decide to end the pregnancy. In those instances, the women lack adequate pregnancy preparedness which is vital in achieving emotional attachment to their unborn children. As such they have the liberty to terminate the pregnancy instead of carrying the pregnancy to term despite lacking emotional attachment to their infants. Therefore, the policy discriminates against such individuals and they have to fund the procedure despite having an active insurance cover (Fawcett & Russell, 2001). The decision is not fair since it is a health care service like any other that is covered by the federal government. The policy is still in the evaluation stage since 1976 and still brings up debate on whether it should still hold on the states where it is applied.

Policy Analysis

The policy stirs up various opinions that impact the social, ethical, legal, historical, and theoretical of the stakeholders of interest. The banning of the abortion funding of the federal government sends various messages to society. The policy portrays the picture that abortion is a personal choice rather than a medical need. The societal perspective depicts from the amendment that it was the women’s choice to get pregnant therefore its should be a personal responsibility if they decide to carry the pregnancy to term or terminate it. That is quite a negative perspective that can easily motivate the stigmatization attitude towards women who decide to terminate pregnancy regardless of how they got in the first place (Hewison, 2007). The policy also portrays to society that it is okay to discriminate against people based on their health needs. It’s like a way of saying some health needs occur due to personal choices thus they should take responsibility for the same.  Policy Analysis Discussion Paper

The Hyde Amendment also has an impact on the ethics of the stakeholders. The banning of the use of federal funds through insurance means there is no reimbursement for abortion services offered. Therefore, healthcare providers are left in a dilemma if they should offer the services and hope the client will pay with their cash or deny them the services (Russell & Fawcett, 2005). The issue is seriously based on institutional policies where some of them require the client is required to pay at least half of the estimated cost in cash before the procedure. That means the care providers are limited from serving clients until they make the payment. That falls under discrimination when providing services which is a violation of the health care profession ethics. Care providers who provide the services against the institution policy are at the very of facing legal charges to pay the institution if the client fails to pay for the same since it’s an uninsured service.

The major impact of the Hyde amendment felt by the parties of interest is the financial and economic burden. In some states, the cost of an abortion is as high as $550 which is higher than an entire monthly rent of people living below the federal poverty level. That means that most women will hardly achieve afford the services. Therefore, they are forced to keep the pregnancy and give birth to their “unwanted” babies. People living below the federal poverty level have a limited income that they can hardly meet their basic needs. That means that forcing them to carry the children to term through the policy is weight added to their existing economic strain. Consequently, there is an increased number of children born and raised in poverty-stricken conditions that hardly get their basic needs like food and shelter (Wilms-Crowe, 2018). Some of the children born under such circumstances end up living in the streets or the shelters with barely a meal per day. Such living conditions expose them to several other health needs like conditions caused by poor nutrition, poor hygiene and insufficient dietary intake. Both the mothers and their children may end up suffering from mental health conditions like substance abuse disorders, depression and anxiety. Eventually, the federal government end up spending a lot of funds to manage the health issues faced by the population which would have been way less if the mothers were not forced to carry on with the pregnancy due to the Hyde amendment. All the stakeholders in this policy including the clients, healthcare providers, health institutions and the government are impacted negatively by the policy.

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Policy Solutions

Based on the issues highlighted on the negative impact of the policy, there is a need to design practice solutions for the same. Policymakers have several options to avoid the overall impact of the Hyde amendment. They should eliminate the policy and such other coverage bans exempted from the annual spending bills (Israel). They should also pass a bill that allows equal access to abortion coverage in health programs. The Hyde amendment affects all women who receive health coverage from various federal programs and not just Medicaid, Medicare and CHIP. Therefore, the new policy should ensure that all women seeking abortion services receive equal treatment regardless of what program covers their health. Policymakers should also pass a law that allows immigrants to enroll for federal insurance covers to ensure that they can receive the services. The bill will ensure that all pregnant women access and afford the services and those who wish to carry on with the pregnancy receive quality care together with their children. Policymakers should also focus on expanding comprehensive health insurance coverage that covers all health needs with no discrimination. That will ensure that the women who seek abortion services will receive comprehensive reproductive health services like family planning methods to avoid future unwanted pregnancies. The theoretical underpinnings of the policy options are based on eliminating discrimination in healthcare thus giving women with unwanted pregnancies the courage to seek abortion services (Wilms-Crowe, 2018). The solutions also help the federal government save resources that could have otherwise been used to fund the healthcare needs that arise after the women are forced to carry the unwanted pregnancy to term (Blackman, 2005).

However, the policy solution requires effective leadership skills among the policymakers to attain the intended goals. The policy-making leaders should have proper communication skills to effectively pass information to other stakeholders on the need to adopt the suggested solutions. The policy has different political opinions where some feel that it should be removed while others think it should stay (Gerais, 2017). Thus, the leaders should use effective communications skills that allow every party to understand the need for an amendment. The leaders should be knowledgeable and have the necessary information to share with the stakeholders on the impact of the Hyde amendment. They must present factual data on the same that support the decision to do away with the policy. The recommended solutions provide an opportunity for inter-professional collaboration to ensure the clients experience equality and justice when receiving care. For instance, the nurses should ensure that the mothers receive comprehensive reproductive healthcare after the abortion process hence preventing future occurrences (Adashi & Occhiogrosso, 2017). Counsellors also play a part in helping them achieve emotional stability after the process. Social workers too take part by assessing the living conditions of the clients and helping them achieve at least the basic needs. However, the suggested changes have both advantages and disadvantages. Removing the policy may take a long time since it requires approval from all stakeholders including those in support of the amendment. Thus, it might take a long process convincing the group in support of the same which means more women may end up getting giving birth even though it was against their wish. The suggestion may also help promote immorality where individuals engage in sexual activities recklessly without taking precautions on pregnancy. The comprehensive health insurance covers will increase the burden on the cost of health care on the federal government. However, the overall effect of applying the solutions will increase effectiveness hence patient satisfaction.

Building Consensus

As stated earlier the recommend changes might take a long process to actualize and implement. Therefore, there is a need to develop a plan that ensures that all suggested changes are implemented. The initial step of the plan is to educate all stakeholders in the policy about the changes suggested and their expected impact. There are chances of reducing opposition towards implementing all the suggestions if all parties involved have a common understanding. The process of education will allow stakeholders to air their opinions which will serve as the policy development process. After the suggestions are framed into policies, the leaders should implement them through healthcare providers and other parties like the insurance companies (Morcelle ). Leaders should then evaluate the effectiveness of the policies implemented to establish their effectiveness.

References

Adashi, E. Y., & Occhiogrosso, R. H. (2017). The Hyde amendment at 40 years and reproductive rights in the United States: perennial and panoptic. Jama, 317(15), 1523-1524.

Blackman, V. S. (2005). Putting policy theory to work: Tobacco control in California. Policy, Politics, & Nursing Practice, 6(2), 148-155. doi: 10.1177/1527154405276289

Craig, R. L., Felix, H. C., Walker, J. F., & Philips, M. M. (2010). Public health professionals as policy entrepreneurs: Arkansas’s childhood obesity policy experience.American Journal of Public Health, 100(11), 2047-2052.

Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing, 2(2), 108-116. doi: 10.1177/152715440100200205

Gerais, R. (2017). The Hyde Amendment of 1976. Embryo Project Encyclopedia.

Hewison, A. (2007). Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7), 693-699.  doi: 10.1111/j.1365-2934.2006.00731.x

Israel, M. Abortion Funding: Save the Hyde Amendment.  Policy Analysis Discussion Paper

Morcelle, M. T. Fostering Equitable Access to Abortion Coverage: Reversing the Hyde Amendment.

Russell, G. & Fawcett, J. (2005). The conceptual model for nursing and health policy revisited. Policy, Politics, & Nursing, 6(4), 108-116. doi: 10.1177/1527154405283304

Wilms-Crowe, M. (2018). Responding to the Hyde Amendment: Abortion Discourse, Race, and a Conspiracy of Silence.

                     Assignment 3: Writing to Solve a Problem

In this assignment, you will develop a lengthier, more thoroughly researched and explicitly elaborated argument that identifies a specific problem, analyzes its causes and effects, and proposes a feasible solution (or solutions). The problem might be at school; at your workplace; in your community; at your church; in the local, state, or federal government; or in some other specific context. You will need to identify the problem clearly, providing evidence to support your claim that the problem is, in fact, a problem and analyzing the causes and effects of the problem. Then you will propose a feasible solution to the problem. The key word here is feasible. If the solution is too expensive, takes too much time and/or effort to implement, or is unlikely to be implemented for some other reason—such as logistics, ethics, etc.—then it is not feasible).

Another challenge with this assignment is that, depending on the problem you propose to solve, you might need specific unique sources to support your solution to the problem, and you might not be able to gain access to those sources (e.g., if they are proprietary, confidential, or require a “Freedom of Information Act” request). Therefore, in selecting a problem to solve, consider the availability and accessibility of relevant source information that you will need, not only to prove that a problem exists but also that your solution is feasible. If you need help finding sources check with your instructor; he/she might also direct you to one of CMU’s research librarians.

Assignment Instructions

1. In TMHG, read Chapter 11, “Writing to Explain Causes and Effects”; Chapter 12, “Writing to Solve Problems”; and Chapter 18, “Communicating with Design and Visuals.” Review Chapter 19, “Finding and Evaluating Information”; and Chapter 20, “Synthesizing and Documenting Sources.”
2. Write a 2,000 – 2,500 word research-based proposal to solve a specific problem in a specific context.

See also TMHG Chapter 13, “Using Strategies that Guide Readers.”

3. Draw upon information from six to eight sources to provide background to the problem (including its causes and effects) and to support your proposed solution. Your sources must be highly credible and relevant, so you must be selective in your research. Keep in mind that some problems and solutions might require empirical data for support, not just someone else’s informed opinion.  However, given the limitations for human-subjects research imposed by law on students and faculty and enforced by CMU’s Institutional Review Board, any data used in your proposal must be gathered by some other source (e.g., the Census Bureau, the Bureau of Labor Statistics, The World Health Organization, etc.) and may not include data that you have obtained directly (i.e., you may not conduct any interviews, surveys, observations, etc.). Your instructor will expect you to upload with your assignment copies of all your print sources and URLs for all web sources.

See TMHG Chapter 19, “Finding and Evaluating Information.”

3. In addition to including information based on your own knowledge and experience, use a combination of summary, paraphrase, and quotation in your paper, but no more than 10% of the paper (200-250 words) should consist of quoted material. Instead, rely on summary and paraphrase. And as you should have learned in ENG 101, all information from sources—whether quoted, paraphrased, or summarized, whether words or images—must be cited. Keep in mind, though, that your voice, not your sources’, should be most prominent in your proposal.

See TMHG Chapter 3: “Writing to Understand and Synthesize Texts.”

4. Format your assignment in a way that is appropriate for your intended audience and purpose. This assignment could take a form different from a traditional school “paper,” e.g., it might take the form of a blog essay, a white paper, an article in a newsletter or magazine, a formal workplace proposal, etc. Whatever final format it might take, develop the text for the peer draft as a print document.

See TMHG Chapter 17, “Choosing a Medium, Genre, and Technology for Your Communication.”

Your peers and I will help you decide on an appropriate format, depending on what you see as your purpose and intended audience.

5. Include any appropriate visuals that will enhance the effectiveness of your report. Use of visuals in this assignment is required, and visuals might not count toward the total word count for the assignment; it will depend on what kinds of visuals you include and whether you created the visuals yourself or borrowed them.  All borrowed visuals must be cited.  Do not include gratuitous visuals, such as clip art; include only visuals that readers will find useful in understanding the problem and accepting your solution.
6. Cite sources using MLA, APA, or Chicago citation style.
7. Give your proposal a title that will be effective and appropriate for the intended audience and purpose. Select a specific audience and purpose for your report, and write this at the top of your paper so your peer reviewers and instructor will know.
8. Save your Assignment 3 draft as a MS Word® document or in Rich Text Format document with the following filename (MS Word® will add the .docx or .rtf suffix automatically when you save the file in that format):

YourfirstnameYourlastnameDraft1A3docx                    [e.g., JohnDoeDraft1A3.docx]

YourfirstnameYourlastnameDraft1A3.rtf                       [e.g., JohnDoeDraft1A3.rtf]

9. Upload your draft to the File Exchange in your Group page on Bb by the due date for peer review. See the instructions on the next page for peer review of this assignment.
10. After receiving peer feedback, revise your draft, save it with one of the following filenames, and upload it to Bb by the due date for instructor review.

YourfirstnameYourlastnameDraft2A3.docx                   [e.g., JohnDoeDraft2A3.docx]

YourfirstnameYourlastnameDraft2A3.rtf                       [e.g., JohnDoeDraft2A3.rtf]

11. After receiving instructor feedback, revise your draft, save it with one of the following filenames, and upload it to Bb by the final draft due date for instructor re-evaluation.

YourfirstnameYourlastnameFinalDraftA3.docx            [e.g., JohnDoeFinalDraftA3.docx]

YourfirstnameYourlastnameFinalDraftA3.rtf                 [e.g., JohnDoeFinalDraftA3.rtf]

Peer Review Instructions for A3                         

To see the due dates for submitting your draft for peer review and for commenting on your group members’ drafts, see the “Schedule of Assignments & Activities” on Bb. Don’t forget to save your draft using the filename stipulated in the assignment instructions above.

1. Go to the File Exchange in your Group page, and download and save each group member’s draft to your computer or flash drive using a new filename for each draft.

For example, if you are Jane Smith and you have just downloaded the draft named JohnDoeDraft1A3.docx, save the draft with the following filename:

JohnDoeDraft1A3JaneSmithComments.docx.

This way, both John and I will know that you are the group member who has commented on John’s draft. Each group member will obtain comments from every other group member, so you and your group members want to make very clear which files are which. Do this for each group member’s draft.

2. Open each file, and read the draft on screen.
3. Use the “Writer’s Workshop” questions on page 405 in Chapter 9 of TMHG to guide your review and comments.
4. To provide comments on each group member’s draft, use the Insert Comment tool in MS Word® to insert comments in the right margin of the draft.

If you do not know how to use the Insert Comment feature in Word, view the Microsoft tutorial, a link for which has been placed in the Course Materials page of Bb.

5. Do NOT use Track Changes to edit or correct any grammar, punctuation, or spelling; however, if you think it necessary or helpful, remind the writer to proofread and edit the draft carefully before submitting it for instructor review.
6. After reviewing and commenting on all your group members’ drafts (or at least all that have been uploaded to your group’s File Exchange during the review period), download all your drafts on which group members have commented, and use their feedback to revise your draft before submitting it for instructor review by the due date and time.

If you have any questions about peer review, please post them to the Q&A discussion board forum.

Policy Analysis Discussion Paper