O'Neill Institute | April 27, 2022Read the Publication
As anyone who has ever been sick or had a sick family member knows, health care in the United States can be exceedingly complex. Our fragmented, decentralized health system relies on a wide array of insurers, providers, and government programs to provide coverage and care to more than 330 million people—often with overlapping federal and state regulatory requirements. Among these federal requirements, Congress has enacted significant health care laws that include the Medicare and Medicaid Act, the Affordable Care Act, and the No Surprises Act.
Given the specialized nature of health care, Congress seldom has the expertise to foresee all circumstances and address every policy complexity or nuance needed for an effective health care system. Instead, Congress has long directed federal agencies to implement its agenda. Congress writes the laws, sets the standards, and instructs federal agencies to implement those laws. Federal agencies can also clarify policies in response to new circumstances, such as emergencies or technological advances. There are many benefits to this system: it promotes efficiency, draws upon agency expertise, and preserves flexibility to effectuate federal health care legislation.