NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE

NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE

NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE

The Affordable Care Act (ACA) was enacted in 2010, and it considerably changed the U.S. health care landscape. The goals of the ACA were to make insurance coverage more affordable, reduce the number of uninsured, and expand access to care. To attain these goals, the ACA expanded eligibility for Medicaid and established new marketplaces where Americans without employer coverage could purchase policies directly from insurers (Oberlander, 2017). The ACA faced strong opposition from Republicans, who described it as unrealistic because it required every American to have medical insurance (Oberlander, 2017). When the Trump administration took power in 2017, the president and Congress members of the Republican Party vowed to replace the ACA. However, one year after taking office, Republicans could not agree on whether to repeal the ACA immediately, repeal right away and replace it later, or repeal it later after establishing a replacement strategy (Oberlander, 2017).  Although the Republicans repealed parts of the ACA, including the budgetary and fiscal provisions, they did not replace it.

The Senate Republicans’ failure to honor their promise of passing a bill to replace ACA, can be attributed to the unpopularity of this bill to the public. The legislators had to assess the political impact of repealing the ACA with no replacement on their chances of being reelected (McCarthy, 2017). They had to perform a cost-benefit analysis on the cost of repealing the ACA on the future chance of being reelected and the benefits of repealing it. For instance, if the Senate replaced the ACA right away, with no replacement, the number of uninsured Americans would increase drastically, which would be opposed by their voters (McCarthy, 2017). This would negatively affect the public view of the lawmakers on their constituents, and lower their odds of being reelected if they did not have a better plan to replace the ACA.  Besides, the cost-benefit analysis can explain why the Republicans had two canceled votes in March 2017 and had to introduce a new amendment to the American Health Care Act to unite the party behind the bill (McCarthy, 2017). The failure to replace the ACA as promised shows that lawmakers can be unwilling to support bills that are a potential threat to their election results in upcoming elections.

Legislative leaders’ decisions regarding recommending or positioning national policies are often influenced by their voters’ views. Voters are known to influence legislators’ policy choices and are at times forced to compromise their choices including partisan politicians (Pacheco & Maltby, 2017). Lawmakers have to consider their voters’ views before making a policy decision that affects their constituents to maintain a positive public image (Pacheco & Maltby, 2017). In the case the voters’ views contradict a legislator’s decision regarding a policy, the lawmaker is forced to compromise their position on the policy and move to the center.

Failing to take the voters’ views can have negative consequences on the law maker’s future elections. Furthermore, to continue supporting and voting for a legislator in future elections constituents must remain convinced that their lawmaker is listening to them and consider their views (Pacheco & Maltby, 2017). For instance, members of congress had to assess the voters’ view on repealing the ACA provisions that would cut funding for Medicaid or change Medicaid to a block grant program. Since many Americans benefited from the expansion of Medicaid, it affected Congress’ decision to pass bills that would hinder their voters’ access to the program and ultimately affect their public image.

NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE References

McCarthy, M. (2017). U.S Republican attempt to repeal and replace Affordable Care Act collapses. https://doi.org/10.1136/bmj.j3508

Oberlander, J. (2017). Repeal, replace, repair, retreat—Republicans’ health care quagmire. New England Journal of Medicine, 377(11), 1001-1003.

Pacheco, J., & Maltby, E. (2017). The role of public opinion—does it influence the diffusion of ACA decisions?. Journal of Health Politics, Policy and Law, 42(2), 309-340.https://doi.org/10.1215/03616878-3766737

The U.S. Federal Government is made up of three branches: legislative, executive, and judicial. To ensure the government is effective and citizen’s rights are protected, each branch has its powers and responsibilities, including working with the other branches. The legislative branch is made up of the House and Senate, known collectively as the Congress. Among other powers, the legislative branch makes all laws, declares war, regulates interstate and foreign commerce, and controls taxing and spending policies. (United States House of Representatives, n.d.).

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The members of the house are elected every two years. In general, the elected officials usually have much passion and want to make good policy during their terms. Many come to their respective legislative bodies because they want to make a difference and be part of good government (National Council for the Social Studies, n.d.). NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE

One of the most essential policies enacted by the legislators is the ACA (Affordable Care Act), famously known as Obamacare, a comprehensive care reform law enacted in March 2010. The three main goals of the ACA (Affordable Care Act) are: to make affordable health insurance available to more people, enhance Medicaid programs, and support innovative medical care delivery methods designed to lower the costs of health care (Health Care, n.d.). However, some conservatives objected to the policy. It is because of the increase and high insurance premiums that we need to pay for Obamacare. They also think that it may have adverse effects on the quality of care. According to Laureate (2018), the ACA (Affordable Care Act) passed without Republicans’ signatures. After it was passed and implemented, half of the states, led by either Republican governors or legislatures, are actively challenging or ignoring the law. So it is clear that obviously, politics is playing a significant role in both the design at the outset and now the implementation of the ACA (Affordable Care Act). During Trump’s administration, the republicans tried to replace the ACA (Affordable Care Act) with AHCA (American Health Care Act). The AHCA (American Health Care Act) ensures more affordable health by not requiring everyone to buy the insurance and not paying penalties if they decide to buy later. However, the AHCA (American Health Care Act) has not to get the majority of the vote and has not become a law. According to a national poll done by Quinnipiac University, 56% of American voters disapproved of the AHCA, and 46% of voters said they would be less likely to vote for their representative if they supported the AHCA. If doing the right thing wasn’t enough to get Republican representatives to oppose the bill, knowing that they could lose their seats in the next election sure was (Iyamah J., 2017). NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE

The number one job of a legislator is to be re-elected. Legislators want to remain in office or at least leave on their terms. In order to find the support to be re-elected continually, legislators must be aware of not only the political climate but also how specific votes will affect their ability to stay in office. They must consider the will of their constituents, the needs of their state, and the desire of their party (National Council for the Social Studies, n.d.). Once legislators win a seat, they are expected to make good decisions on whom they support and what advocacy they champion. In a cost-benefit analysis, the making of policy and law should pass a stringent process. They need to influence other legislators with their arguments. Sufficient data and research should support a bill to pass a debate and move to the Senate. The bill needs the majority of the votes in order for it to be a policy. If a legislator did not re-elect, the policy they make or amends could be dismantled. In order for a bill to be a policy, a legislator needs support from the officials. The policy should cover the greater good of the population. The re-election of a legislator means continuity of the policy they started or a chance to repeal a current policy.

NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE References

Health Care.gov (n.d.). Affordable Care Act (ACA). Retrieved from https://healthcare.gov/glossary/affordable-care-act/

Imayah, J. (2017). Why did the American Health Care Act Fail?. Friends Committee on National Legislation. Retrieved from https://fcnl.org/updates/2017-04/why-did-american-health-care-act-fail

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum (Video file). Baltimore, MD: Author.

National Council for the Social Studies. (n.d.). How Legislators Make Decisions. Retrieved from https://socialstudies.org/advocacy/how-legislators-make-decisions

The White House. (n.d.). The Legislative Branch. Retrieved from https://whitehouse.gov/about-the-white-house/our-government/thr-legislative-branch/

United States House of Representative. (n.d.). Retrieved September 20, 2018, from https://www.house.gov/

Unites States Senate. (n.d.). Senate organization chart for the 115^th Congress. Retrieved September 20, 2018, from https://www.senate.gov/reference/org_chart.htm

The concept of cost benefit analysis plays a major role in helping leaders and policymakers, especially in Congress, to make better decisions on distribution of resources at the federal level. The technique is effective at evaluating if a program, like the Patient Protection and Affordable Care Act (PPACA), is cost-effective in attaining its expected goals (Bussing et al., 2020). The use of the concept depends on the legislators running for office and their personal views as well as political position on healthcare system in general. For instance, if a legislator or candidate believes that resources used for the ACA could be utilized or allocated somewhere else for better use, then this could have an effect on their idea to repeal and replace the Affordable Care Act (ACA).

The case of ACA and efforts to repeal and replace demonstrate how legislators and Congress can apply the cost-benefit approach to save a program that has a fundamental effect on the health of millions of Americans. The ACA was enacted to reduce the cost of care, increase access to care, and improve quality of care for millions of Americans, especially those from low-income households. The Trump administration was determined to repeal and replace the ACA; implying that over 25 million Americans could have lost their health and medical insurance. These include the aged and individuals with preexisting conditions who benefit from expanded Medicare and Medicaid programs (Nadash et al., 2018). Therefore, after conducting a comprehensive cost-benefit analysis, many legislators, especially leaning towards Trump and the Republican Party, withdrew their support and realized the proposal to repeal and replace ACA would hurt the American voters. Therefore, this would cost them by hindering their re-election to Congress.

The cost-benefit analysis allowed the legislators to determine if actions or opinions would impact their re-election to office in a negative or positive way. Therefore, many who supported the need to repeal and replace ACA lost their re-election while others withdrew their support for the same to enhance their re-election based on public opinions as many Americans hailed Obamacare, especially those with preexisting conditions (Milstead & Short, 2019). The legislators’ views and support to repeal and replace the ACA impacted voters’ decisions concerning their re-election and this means that a cost-benefit approach is essential in healthcare reforms.

NURS 6050 Discussion Politics and the Patient Protection and Affordable Care Act SAMPLE References

Bussing, A., Patton, W., Roberts, J. M., & Treul, S. A. (2020). The electoral consequences of roll

            call voting: Health care and the 2018 election. Political Behavior, 1-

21. https://link.springer.com/article/10.1007/s11109-020-09615-4

Milstead, J. A., & Short, N. M. (2019). Health Policy and Politics: A Nurse’s Guide (6 ed.).

            Burlington, MA: Jones & Bartlett Learning

Nadash, P., Miller, E. A., Jones, D. K., Gusmano, M. K., & Rosenbaum, S. (2018). A series of

unfortunate events: Implications of Republican efforts to repeal and replace the Affordable Care Act for older adults. Journal of aging & social policy, 30(3-4), 259-

281. DOI: 10.1080/08959420.2018.1462683.

Affordable Health Care Act

Every time a policy is developed and implemented, certain people benefit. This was evident in the case of the 2020 Affordable Care Act (ACA). The Obama government launched the ACA to improve healthcare accessibility by lowering the number of US citizens without medical insurance (Zhao et al., 2020). Hence, to achieve this aim, the legislation came with different provisions, for instance, affordable insurance exchanges, premium credits to qualified families and people, employer requirements, health insurance reforms, and individual mandates. However, after Trump was elected, his administration wanted some ACA provisions to be repealed, for instance, the individual mandate. Nonetheless, these efforts were undermined since there were not enough legislators.

Repeal and Replace the Affordable Care Act

After doing a cost-benefit analysis, many legislators denounced their support of the new repeal because they felt they would make the ordinary voter suffer. Several Republican legislators began seeing minimal chances of being re-elected if they supported repealing and replacing Obamacare. Hence, the cost-benefit analysis made the legislators understand their political reputation concerning how voters viewed them (Woolhandler et al., 2021). This was because of the severe negative impacts of repealing and replacing Obamacare. For instance, the new policy would deny many Americans affordable healthcare accessibility, which the ACA addressed.

In conclusion, The American Academy of Family Physicians opposed the newly proposed AHCA as they noted it would increase health insecurity among people. Specifically, the vulnerable population would feel the financial burden, which would not afford the insurance costs. The new policy increased costs and denied sick people coverage based on their socioeconomic status, health status, or age. In addition to making healthcare expensive, the new legislation aimed to remove employer and individual mandates.

Indeed, the recent global experience can be used to summarize the current crisis in access to mental health services and other healthcare issues; “During the past 2 years, exacerbated by the COVID-19 pandemic, there are more individuals suffering from depression, anxiety, substance abuse, social isolatio