passed to make insurance more attainable, it did not prevent policies from being developed to
undermine it. Policies can be helpful in many cases, but in the Case of the Affordable Care Act,
they were not.
Legislative and Institutional Policies
Although plans are different than laws, there are classifications for the types of policies
developed. Legal systems are prepared and implemented by the legislative bodies of
government to accompany rules or sometimes even to initiate the change of legislation.
Institutional policies are developed my private institutions and may or may not be reflective of
legislative bodies. The ACA is a public health policy, and all public health systems come from

HEALTH LAW, REGULATION, AND POLICY
4
local, state, or federal government (Abood, 2007). Originating at the executive level of the
federal government, the ACA outlines the fundamental requirements for state government,
local government, and the health industry to comply. The entire healthcare system, including
public and private sectors and the political powers that influence it, are formed by the
healthcare policy making process (Abood, 2007).
On the other hand, institutional or business policies in healthcare are originated in the
private arena through agencies like healthcare organizations, accrediting organizations, and
managed care organizations (Abood, 2007). These policies are acceptable industry practices for
administering a systemized established activity in a regulatory environment. Institutional
policies are more confined than legislative policies. Legal procedures outline the fundamental
requirements while institutional policies describe acceptable industry practices for fulfilling
federal requirements within the healthcare industry. The ACA has become part of institutional
policies within health care and business owners, mandating that healthcare is provided for all
employees.
Political Influences on Health Care
Politics always plays a role in the development of legislative law or policy. The politics
can often make or break a bill trying to be passed into law. Often there is a lot of negotiation
and strategy that must take place for a law to pass, and health care is no exception. Our political
system is divided into two main opposing groups Republicans and Democrats. Both political
parties have subdivisions of thought and belief. One division of the Democratic party, Liberals,
believe the government should work to attain equal opportunities and equality for all (Student

HEALTH LAW, REGULATION, AND POLICY
5
News Daily, 2009). Liberals believe that without state or federal government involvement
industries would not succeed. On the opposite side, the Republican's believe in individual
responsibility, sparse government, free markets, individual liberty, conservative American
values, a robust national defense, and function with fewer limitations and react to supply and
demand (Student News Daily, 2009). Acting on supply and demand caused an increase in the
cost of healthcare. During the enactment of the ACA, liberals held the majority vote at the


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