With the vast improvements in health care the quality and life expectancy has increased. Because of this we have seen an increase in our population both young and old. The increase of the elderly population has caused the government to increase the amount of money is spent on Medicare. Health care expenditure has grown substantially; in 1960 it was $26.9 billion versus in 1990 it was $1,035.1 billion (Acker, 2010). Even with the increase in health care funding, health care has still been limited due to the costs. There have been an increase in insurances; large research grants have driven up costs, and the increase use of prescription drugs have driven pharmaceutical costs up. All of these developments have made the American government raise funding for programs such as Medicaid and other health care programs that aid the lower social classes. Programs like these are necessary because other wise many Americans wouldnt be able to afford to see doctors, get medications, or even afford to get simple health care preventives like vaccines. With the passing of the affordable health care act Alabama had the option to expand Medicaid but choose not to. This choice has lead to many Alabamians uninsured. I would amend this policy by accepting the expansion of Medicaid. This would make it to wear everyone would be able to be insured whether they are able to pay for insurance and receive a tax credit or be able to receive Medicaid free of charge. There are many stakeholders involved with Medicare and Medicaid in the state of Alabama. There are many hospitals, doctors, and even patients who all have differing positions and opinions on health care policies. I believe that the creation on comprehensive programs is a critical step in advancing our current health care policies.One health care policy in Indiana that can be revised would be Medicaids Hoosier Health Care Plan. Historically speaking, Medicaid has come a long way, and has is now providing health care and other amenities to low income families all over Indiana. The Hoosier Health Care Plan is offered to low income families who virtually have no income. The reason why I feel this policy needs to be changed, is because it doesnt allow people to use their services while trying to become self sufficient while also lack cultural competence to the reasons that contribute to low income families. One of those contributions is addiction and substance abuse, and this health care plan does not allow for people to use substances or alcohol. However with stakeholders oppose to funding those that are under substances thus programs that are supposed to help the needy, enable the needy.