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The Patient Protection and Affordable Care Act

Introduction
States have a duty under the constitution to make reforms to improve on their programs. The tenth Amendment of the Constitution of the United States provides for federalism whereby states have powers to make laws and create policies which enhance their wellbeing. The Tenth Amendment empoweres states to exercise their sovereignty and independence. There are many programs which in the past have been fostered by states. The tenth Amendment has overtime been subject to massive controversy with some seeking express limitation on the powers granted on distinct States. Such controversies have affected the programs that states have established. In one bracket they have been termed as the social welfare programs while on the other hand the social welfare is an umbrella name which encompasses many programs (Ashford, 2012).
The paper seeks to unveil the health care program in the State of New York. The duty of providing effective health services in New York solely rests in the hands of the California Department of Health Care. This essential means that the department protects and finances all health delivery services in the State of New York. The success of the New York department is widespread and it has been linked with funding the California Medical Assistance Programs. Its mission is to increase accountability in the public health to reach every New York (Federal Health Care Reform, 2012).
States have an increasing important role to play in health reforms. For instance under the Tenth Amendment as aforementioned, states have the right to establish their own health care programs. The federal health reform has been appraised for the continued to play a critical role in reaching where the national government would not have possibly reached. The health care program has taken a greater turn in the health care insurance. Greater protections under the health reform have been greatly strengthened than already established under the federal law. In New York stronger laws on consumer protection have been established so as to increase the coverage to health insurance.
The program has helped people in New York in funding and providing assistance to individuals in high risk places. The health insurance law creates polls whereby less privileged individual get to benefit from the entire health care insurance program. Currently New York does permit insurers to deny coverage to people. However, they are under the law allowed to impose a condition on the people with the pre existing conditions (Community Health Care, 2010).
The main advantage of federal programs is that they provide a source of revenue to the national government while at same time responding to the needs of the people with the confines of the State. Certain restrictions on these programs by the central government are disadvantageous since the national government resources are not effective enough to cater for the said needs. In addition, the national government also loses revenue in the said restrictions (Community Health Care, 2010).
The central source of tensions created between the federal government and the federal government are classified two main categories. First, the tension created by lack of uniformity in the legislations drafted by the states provided they do so under the constitutional threshold. The Social programs have been regulated by federal law controversy has always surrounded those bills. Secondly, the effectiveness of the said programs in the delivery of their services has largely been under the scrutiny of central government (Community Health Care, 2010)
Conclusion
There are numerous tensions generated under the different social programs engineered by different States. Though the programs have had tremendous achievements the tensions can not be ignored while the effectiveness of the programs is put into test. The limit of the States programs has been detrimental to the national government.

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