PLEASE RE-EDIT THIS so that the similarity report shows less than 10%
Washington D.C. Indian Health Improvement Act is a current health policy in the state. This Act is related to the establishment of the governor’s Indian health advisory council as well as the Indian health improvement reinvestment account. This will be done by amending and reenacting RCW 43.84.092 and making an addition to Title 43 RCW. This Act should be enacted by the Washington state legislature. This article discusses the pros and cons of the Washington Indian health improvement Act from the perspective of patient, family, or community, its roles in lowering the cost of health care insurers, the government impact on the cost of health care, regulatory authority implemented in this policy, and the different responsibilities of the federal, state, and local health care with respect to this policy.
Explain the pros and cons of the proposed health policy from the perspective of the patient, family, or community and its role in reducing the cost for health care insurers.
Pros  
The Washington Indian health care improvement Act will ensure the American Indians and the Alaska natives can attain access to high healthcare status. This will be done by provision of the needed resources in order to meet the health needs. This is a good move to raise the health of the American Indians and Alaska natives to be within the thresholds of the Healthy People 2020 initiative. It will ensure that the target community is able to maximumly participate in the provision of health care services. It holds healthcare practitioners more accountable to the needs of this population in meeting their healthcare needs and desires (Empey, Garcia, & Bell, 2021). Statistics from the northwest tribal epidemiology centre and the health department show there is high health disparities and excess rate comparing the American Indians and Alaska natives to the rest of the American population.
This exposes these communities to cases of suicide, premature mortality, chronic diseases, injuries, and poor mental health among others. The introduction of this Act will fight the existing healthcare disparities and do away with the existing historical trauma and increase the health status of this population. Patients and families will be able to access funds from the federal government to support their Medicaid programs if they meet the regulatory requirements (Empey, Garcia, & Bell, 2021). This will ensure that the American Indians and Alaska natives can access quality health care as well as allied health care services.
Cons  
The enactment of this policy can fail to meet the needs of all the American Indian and Alaska natives because of the regulatory requirements (Kruse, et.al. 2022). There are members of this population in need of these services but cannot meet the threshold regulatory requirement meaning they will be sidelined in accessing quality health care services.
Explain the government’s impact on the cost of health care.
The government plays a significant role in ensuring the implementation of the Washington Indian health care improvement Act. In 2016, an update in payment policy from all the Medicare and Medicaid services centres was done. This move made it possible for the state to shift more cost of care for the vulnerable community from the state general fund to the federal government. The access to federal funds makes it possible to have the administrative burden of this policy from the state government and increase the general effectiveness of the policy. The federal payments help the state to deliver improved health care services to the American Indians and Alaska natives (Kruse, et.al. 2022). Through this fund, it is possible to strengthen the continuity of quality care and result in the general improvement of the health of the population.  
Explain what regulatory authority will implement or enforce this health care policy.
The legislature through this Act intends to have a national policy of Indian self-determination and attain quality health status for the target community implemented. The legislature will establish the governor’s Indian health advisory council. The Indian health advisory council will consist of voting members including; a representative from each tribe, a CEO from each urban Indian organization, a member from the largest house caucuses, a member from the two largest caucuses in the senate, a representative from the governor’s office (Kruse, et.al. 2022). The other members are non-voting and are all representatives of state agencies, Indian health services, the commission, and the board.  
This council will have the following responsibilities; do an assessment of the tribal implication which are not able to resolve at the agency level, oversight the implementation of the Act, develop a biennial advisory plan, and establish a reinvestment account for Indian health improvement. The council will have the responsibility to appropriate and deposit in the reinvestment account new states’ savings and maintain fiscal neutrality to the state general fund (Willging, et.al., 2021). Ensure that the funds in the account are only spent on issues pertaining to the improvement of Indian health with respect to the advisory plan.    
The advisory committee can choose to appoint technical advisory committees to meet specific issues and concerns. The advisory council will also meet, and give reports and recommendations which aim at improving the health status of the American Indians and Alaska natives.
Describe the differences between federal, state, and local health care regulatory responsibilities in the chosen health policy. 
The federal government has a key responsibility of funding the implementation of the Washington Indian health improvement Act. This will be done depending on the amount which the state shifts from its general funds to the federation.
The state government has a responsibility to carry out the activities needed for the implementation of the act. A key duty is a creation of an advisory council that will oversee the implementation of the act. The state has the responsibility to ensure the advisory council created meets the threshold requirements as proposed in the policy. The state will develop a reinvestment account for Indian health improvement. All the money appropriated funds set for the implementation of the Act will be deposited here (Willging, et.al., 2021). The state has the responsibility to ensure revenue control and effective expenditure of the funds in the reinvestment account.
The local governments have the responsibility to provide health statistics and records from the target population. Through local government agencies the following services should be provided; control of communicable diseases, home health care, school health services, sanitation services, public health nursing, and epidemiology (Willging, et.al., 2021). The combination of the services from the federal, state, and local government will ensure the implementation of the Washington Indian Health Improvement Act.  
Regulatory And Policy Impact  
References
Empey, A., Garcia, A., & Bell, S. (2021). American Indian/Alaska Native child health and poverty. Academic pediatrics, 21(8), S134-S139.
https://doi.org/10.1016/j.acap.2021.07.026.  
Kruse, G., Lopez-Carmen, V. A., Jensen, A., Hardie, L., & Sequist, T. D. (2022). The Indian Health Service and American Indian/Alaska Native Health Outcomes. Annual Review of Public Health, 43. 
Wilensky, S. E., & Tietelbaum, J. B., (2020). Essentials of health policy and law (4th ed.). Burlington, MA: Jones & Bartlett Learning. 
Willging, C. E., Jaramillo, E. T., Haozous, E., Sommerfeld, D. H., & Verney, S. P. (2021). Macro-and meso-level contextual influences on health care inequities among American Indian elders. BMC public health, 21(1), 1-14.  
DOI https://doi.org/10.1186/s12889-021-10616-z.