NURS 6050 Week 2 Discussion: Politics and the Patient

Walden University NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

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Whether one passes or fails an academic assignment such as the Walden University NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

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The introduction for the Walden University NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

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After the introduction, move into the main part of the NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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A cost-benefit analysis is a process used to compare the overall benefits, or revenue, of an action minus the cost associated with implementing that decision (Hayes, 2023). An analysis involves financial metrics as well as intangible benefits to explore if a project, or in this case a law, is favorable for legislatures. In 2010, the Affordable Care Act (ACA) was established after President Barack Obama declared a priority for his administration would be healthcare for all (Milstead & Short, p. 11, 2019). This put us on a path to universal insurance which introduces the idea of healthcare being a right versus a privilege. According to Joel Teitelbaum, the ACA passed without any republican signatures, and during implementation, nearly half of the states led by Republicans were actively challenging or ignoring the laws (Walden University, 2018). This leads us to believe that the republican party had a very different outtake on the cost-benefit analysis associated with the Affordable Care Act than the democratic party.

Since the ultimate goal for legislatures is to be reelected, a cost-benefit analysis is an essential tool when it comes to efforts to repeal or replace the policy. In 2014, the Congressional Budget Office (CBO) released an analysis that rebutted claims by Republicans explaining that the ACA is “helping the labor market, laying the foundation for future economic growth, and improving families’ financial security and well-being” (Furman, 2015). According to Willison and Singer, “The Trump presidential campaign leveraged struggling individual and small-group markets, escalating premiums, and tumbling insurer participation in its calls to repeal the ACA” (2017). The bottom line is that the views of voters affect decision-making by legislative leaders. The people want to know how will this policy benefit me and how much will it cost. That makes cost-benefit analysis a game-changing tool when it comes time for reelection. In this case, democrats saw the advantages of the Affordable Care Act during the Obama Administration whereas the republican party sided with noteworthy changes to the ACA under the Trump Administration.

In researching the outcomes of a repeal of the Affordable Care Act, something that concerned me as a future advanced practice registered nurse is that a reduction in federal government spending on healthcare for the nonelderly could result in a “state spending increase by $68.5 billion between 2017 and 2026 as reductions in Medicaid spending would be more than offset by increases in uncompensated care” (Buettgens, Blumberg, Holahan, & Ndwandwe, 2016). As nurses, we have been programmed to advocate for disease prevention to stay ahead of spending more on treatment. Again, all factors that go into an effective cost-benefit analysis.

A Sample Answer For the Assignment: NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act

The Affordable Care Act expands the coverage of insurance in two ways. First, it increases the access of coverage through Medicaid and subsidies to buy private insurance on health care exchanges. Second, enhance the quality and dimensions of coverage by improving benefits, including the Essential Health benefits (EHBs). Essential health benefits contain 10 categories of care which provides access to health care services for individuals and small groups to improve the health and wellbeing of Americans.

Cost and benefit analysis plays a significant role in policy making such as this if legislator would want to repeal the ACA. It helps them identify the consequences, evaluate if policy maximizes financial resources, and measures the total welfare of the population. The benefits of repealing the ACA coverage would save $1.5 trillion 2027 and increase economic growth. The house of representatives introduced 50 bills to repeal ACA in whole or in part. The vote was defeated in the effort of repealing it in the summer of 2017. Repealing the Affordable Care Act would cause disadvantages to the Americans. The government would reduce their expend budget on healthcare insurance for non-elderly which is the aim of those who advocate for it. The following below are the effects if ACA will be repealed:

There will be an increase of 81% of uninsured Americans.
There will be 14.5 million people who will get less Medicaid coverage.
There will be no assistance support for those who have received tax credits for private health coverage.
State expend will increase by $68.5 billion between 2017 and 2026 since Medicaid spending is reduced by uncompensated care.
Various states reported that there will be shortage of budget if Medicaid is expanded and repeal the ACA.
Health care services will be limited to modest-and-low-income families.

Legislators are dealing with intricacy and the risks that could come if ACA is completely repealed and many states are against repeal the efforts.

Voters’ view is significant in making policies as it has an influence on legislators in making decisions. Legislators represent the community, and they seek and receive information from sources. The need to replace the ACA was mainly taken by the Republicans leaders view as for them it deeply hurts the Americans while the Democratic leaders wants to maintain the law as it helps the American citizens. However, the debate on repealing it most people’s view is based on their belief and values about the responsibility of the federal government to provide insurance for those who are uninsured. Majority of the public opinions believed that the government should be involved in improving the health care system, 87% from the Democrats and only 28% of Republicans. They preferred lawmakers to make changes so the more people would get the benefit of health insurance whereas Republicans chose to reduce the government spending. This is what makes the legislators had a difficulty in approving the single-repeal-replace plan.

NURS 6050 Week 2 Discussion: Politics and the Patient Protection and Affordable Care Act

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.

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

Discussion: Politics and the Patient Protection and Affordable Care Act

The five social determinants of health include: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context (U.S. Department of Health and Human Services, 2021).

Out of the 5 social determinants of health, healthcare quality and access to health care appears to be one of the domains the nation struggles with the most. The social determinates of health have such a major impact on individuals’ lives that Healthy People 2030 created one of their goals specifically based on these concepts.

Their goal related to SDOH is as follows: “Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all (U.S. Department of Health and Human Services, 2021).”

In regard to repealing and replacing the ACA with the AHCA, this would be counterproductive in overcoming the social determinants of health. These determinates are linked to a lack of resources and a lack of opportunity (CDC, 2019). If the AHCA was passed, millions of people would have lost their insurance and lost access to quality healthcare.

This is a prime example of a lack of resources and a lack of opportunity. These determinates are all linked to each other. For example, if someone with no insurance has a medical emergency and must pay for medical services out of pocket, that now affects the determinate of economic stability (U.S. Department of Health and Human Services, 2021).”

References:

U.S. Department of Health and Human Services. (2021). Social determinants of health. Social Determinants of Health – Healthy People 2030. Retrieved September 16, 2021, from https://health.gov/healthypeople/objectives-and-data/social-determinants-health.
Center for Disease Control and Prevention. (2019). NCHHSTP Social Determinants of Health. Center for Disease Control and Prevention. Retrieved September 16, 2021, from Social Determinants of Health | NCHHSTP | CDC.

I couldn’t agree with you more, and I appreciate Dr. A.E.’s intentions in prompting this question and

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mentioning social determinants of health. Healthcare quality and access to health care is a major obstacle in healthcare reform. The ACA and AHCA not only strategize to increase access to health care by providing Americans affordable insurance options, but also include interventions to force the improvement of healthcare quality, which becomes a major source of contentions for economic healthcare stakeholders.

An example of this can be explored by discussing the AHCA element of transitioning care from a fee-for-service reimbursement model to a value based reimbursement model. This AHCA enforced change resulted in a major shift for many health care organizations. Fee-for-service reimbursement rewarded providers for the volume of services they provide, while the value-based approach payments are rendered based off of meeting agreed-upon quality and performance measures directly tied to patient outcomes.

According to McHugh, M. D., et al, (2013), the AHCA’s Hospital Readmissions Reduction Program (HRRP) highly invests and highlights the value of quality measures and services offered by health care professionals outside of the provider, specifically nurses. HHRP penalizes hospitals with excessive readmission rates of Medicare beneficiaries; the primary objective of the HRRP is to reduce the rate of readmissions in accordance with the hospitals’ financial incentives with payers’ and patients’ quality goals (McHugh, M. D., et al, 2013).

According to McHugh, M.D., et al, (2013), hospitals with higher nursing staff had 25 percent lower odds of being penalized compared to other similar hospitals with lower staffing. One can see why penalties like these would create resistance and motivation for repeal of the AHCA in primary healthcare economic stakeholders and highly influence their political affiliation despite social determinants of health.

References

McHugh, M. D., Berez, J., & Small, D. S. (2013). Hospitals With Higher Nurse Staffing Had Lower Odds Of Readmissions Penalties Than Hospitals With Lower Staffing. Health Affairs, 32(10), 1740–1747. https://doi-org.ezp.waldenulibrary.org/10.1377/hlthaff.2013.0613

Murphy, L. S., & Warshawsky, N. E. (2015). Nursing Education A Solution to Healthcare’s Gordian Knot?JONA: The Journal of Nursing Administration, 45(6), 302–304. https://doiorg.ezp.waldenulibrary.org/10.1097/NNA.0000000000000203

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.

Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.

To Prepare:

Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
Consider who benefits the most when policy is developed and in the context of policy implementation.

By Day 3 of Week 3

Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA.
Then, explain how analyses of the votes views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).
Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.

Legislators who assume elective positions are always determined to support initiatives that will influence voters to re-elect them. However, due to competing interests of the government, some legislators might get concerned with the potential impacts that some bills, when signed into law, might affect their possibilities of getting re-elected (The Commonwealth Fund, 2017).

Borrowing from the events that surround the efforts to repeal/replace the Affordable Care Act (ACA), conducting a cost-and-benefits analysis, in terms of both dollars and votes, can help legislators to decide whether they should support or oppose government initiatives.

Repealing/replacing the ACA is associated with benefits and costs measured in dollars and votes. According to the Committee for a Responsible Federal Budget. (2017), the cost of repealing or replacing the ACA through 2027 is estimated to be 350 billion United States dollars. However, the United States government will save approximately 1.55 trillion through 2027 when only the coverage provisions of the ACA are replaced.

It is further anticipated that although repealing Medicare cuts would cost about 1.10 trillion United States dollars, it is likely to cause a slight improvement in economic growth, which would translate into additional net savings of about 200 billion United States dollars (Committee for a Responsible Federal Budget, 2017). As for Americans, their concern is whether they will still benefit from increased health coverage, enabling them to continue receiving affordable prescription drugs and accessing other healthcare services (The Commonwealth Fund, 2017; Willison & Singer, 2017).

In this respect, legislators will likely benefit from their political maneuvers and get re-elected only when repealing/replacing ACA increases health coverage for Americans and economic growth. In this respect, legislative leaders must analyze the voters’ views before positioning or recommending national policies.

By Day 6 of Week 3

Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

The Affordable Care Act, called Obamacare, was a significant healthcare reform passed in 2010. Its replacement became a severe issue, with various lawmakers advocating for multiple approaches based on their ideological beliefs and perceived societal benefits.

The cost-benefit analysis regarding legislators reelected significantly impacted efforts to repeal or replace the Affordable Care Act (ACA). The ACA’s new exchanges were successful, depending on where one looks, as states implemented and undercut the ACA during the Obama administration. Different states in the US that tried to create their exchanges failed, while others that appeared hostile on the surface worked with the Obama administration behind the scenes.

Repealing will undermine efforts to reduce the budget deficit, primarily rooted in the cost of health care in the United States. The Congressional Budget Office (CBO) addressed that the ACA will reduce the deficit by $100 billion over the first decade and by more than $1 trillion between 2020 and 2030. ACA would not diminish the rising healthcare costs. The bill incorporates many current ideas about reducing healthcare costs, which is not insufficient. Introducing cost-saving measures, such as payer rates and a public option, has become necessary.

The Democrats continue to control the Senate, and President Obama will veto any bill trying to repeal the ACA. Also, Republicans will be able to dismantle the ACA by refusing to fund it. They evaluated the healthcare system’s impact on insurance markets, healthcare providers, and the economy. The negative consequences of supporting a full repeal or replacement outweighed the benefits. They were concerned about adverse reactions and relied on the ACA for healthcare access, affordability, and protection. The lawmakers are mindful that the reelection was compromised if they supported a policy that resulted in constituents losing coverage or facing higher costs.

The ACA needed to meet the political goal of most voters about the affordability of their coverage. The law’s supporters among the public did not say making affordable care was a reason. Analyses of voter views on healthcare, such as public opinion polls, and surveys, provided insights for legislative leaders.

They allowed lawmakers to understand the concerns and priorities of constituents regarding healthcare, including Medicare and Medicaid policies.(Nahouraii et al., 2021) Legislative leaders understand that their success hinges on voter approval. Aligning their recommendations with the current voter views increases voter support and ultimately being reelected. Voter views on healthcare policies will help legislative leaders to craft effective messaging strategies.

A legislator’s job is to reelect; this does not imply that electoral considerations solely drive their decisions. Lawmakers also consider policy goals, constitutional obligations, and the long-term implications of their choices. However, voter views are critical in shaping legislative leaders’ recommendations on national policies, mainly on essential issues like healthcare that directly impact their constituents’ lives.

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Module 2 Discussion: Politics and the Patient Protection and Affordable Care Act

RE: Discussion – Week 3

The Affordable Care Act was enacted by former President Obama in 2010. The goal of the ACA was to make health insurance more affordable and available to the people, expand the medicaid programs statewide, as well as support innovative medical care delivery methods which would hopefully decrease health care costs (ACA). Health care and repealing/replacing the ACA is a hot topic among the political world. The ultimate goal of the politician or legislator is to gain votes and be reelected.

Whether a legislator truly believes repealing/replacing the ACA with something different will be beneficial to Americans, they are likely to do so anyway to gain the vote from the community. Politicians desire to secure reelection seems to cause legislators to engage in undesirable activities.

Money unfortunately plays a critical role in these election and reelection campaigns, as it costs millions of dollars to win an election even at the local level (Milstead & Short, 2019). Cost benefit analysis plays a huge part in terms of legislators being reelected. Legislators will partner with “527 committees” to gain funds for their campaigns (Milstead & Short, 2019).

This can skew their actual viewpoint and opinion on a topic, but due to the necessity of big money needed to win an election, they will partner with these wealthy individuals and employ and project their opinion on a political topic to gain money and votes (Milstead & Short, 2019).

The republican party is working on, and has been trying hard, to repeal/replace the ACA in order to gain votes of the people who are not in favor Obamacare, which in turn helps them gain votes for reelection. To do this, the republican party has tried to implement the Better Care Reconciliation Act, which has cut funding in certain areas, and cost the American people more money in ways (Amadeo, 2018).

References

ACA. (n.d.) Affordable Care Act- Healthcare.gov Glossary. Retrieved March 11, 2020, from https://www.healthcare.gov/glossary/affordable-care-act/
Amadeo, K. (2018, October 17). What a Congressional Plan to Repeal Obamacare Would Look Like. Retrieved March 11, 2020, from https://www.thebalance.com/congressional-plans-to-repeal-and-replace-obamacare-4160599
Milstead, J.A., Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed). Burlington, MA: Jones & Bartlett Learning.

Health Policy and Politics: The Affordable Care Act

The Affordable Care Act (ACA), famously known as Obamacare, sought to enhance universal healthcare access by making health insurance to be inexpensive for all Americans. ACA targeted individual market, employer-provided benefits, and non-Medicare-eligible population to ensure they accessed affordable and comprehensive insurance coverage without any discrimination on the basis of their health status (Nadash, Miller, Jones, Gusmano, & Rosenbaum, 2018).

The Republican Party seeks to stop government interference in the insurance market. It has spearheaded efforts to repeal and replace the ACA through the courts terming it as unconstitutional. Additionally, several states have shown open hostility to the law since it expanded the Medicaid coverage. Besides, House and Senate Republicans have sponsored several repeal initiatives such as Better Care Reconciliation Act (BCRA) and Graham-Cassidy bills (Nadash et al., 2018).

The constant onslaught of the ACA from President Trump and Republicans has led to an increase in premiums and several insurers withdrawing from selling the insurance plans in the recent past. The early success of the ACA, whereby millions of Americans secured insurance coverage through the individual markets, subsidies for low-income individuals, and Medicaid, have been eroded.

The Impact of Cost-Benefit Analysis

Milstead and Short (2019) argued that the supporters and critics of ACA include the members of Congress whose main objective is to be re-elected during the election cycles. The opponent’s debates and efforts to repeal and replacement of ACA in both President Obama’s and Trump’s administrations are deliberate for political expediency as opposed to promoting public health and well-being.

Furthermore, the political elites do not perform a cost-benefit analysis of the effectiveness of the ACA to enable them to compromise on a bipartisan basis about the contentious issues contained in the law, such as the insurance mandates, Medicaid, insurance plans, and tax credits.

Analysis of Votes

Notably, the ACA resulted in a progressive American tax system whereby the wealthy individuals were obligated to pay higher federal taxes, 3.8% more on taxes on unearned income and a 0.9% increase in Medicare payroll taxes. The new tax revenue was earmarked to fund the expansions proposed by the ACA (Grogan, 2017).

Additionally, the law delimited the out-of-pocket costs for marketplace insurance coverage, specifically $13,200 and $6,600 for family and individual plans (Grogan, 2017). The subsidies and financing options of ACA ensured equitable access to healthcare and lowered the financial burden of healthcare costs for the majority of low-income Americans.

According to Congressional Budget Office, The Joint Committee on Taxation, and The Center on Budget and Policy Priorities (as cited in Grogan, 2017), repealing and replacing the ACA will increase Medicaid costs by over $370 billion over the next decade, which would be covered by the states. Besides, eliminating tax directives will benefit the wealthiest people since they will be able to save almost $600 billion through 2026 (Grogan, 2017).

Despite such cost-benefit analysis being conducted to determine the effect of repealing and replacing ACA, the legislators focus on their re-election prospects while discussing the merits and demerits of Obamacare. The lawmakers’ support for ACA must be consistent with the views of their electorates and donors. For instance, voting against the Act would have been contrary to the desires of most Republicans, and they risked losing their elective seats in the House or Senate.

Conclusion

It is evident that ACA not only resulted in national Medicaid expansions and subsidized Marketplace coverage, but it also reduced the cost of medical care and improved access to health services for patients in various age groups. These results would be what any leader would like to experience in their country, that is easy access to affordable and quality care for all people. Nevertheless, legislators would be willing to disregard these benefits to the society if all their chances of re-election would not be increased by them supporting the ACA.

It is on the same basis that members of Congress will make decisions on whether to reject or recommend national policies concerning Medicaid/Medicare. Politicians rely on donors and lobbyists for financial support to win their elections. In healthcare, these funders could be medical organizations that are negatively affected by the particular policy under deliberation. As such, to ensure that they continue to receive support from these agencies, legislators have to cater to the interest of their donor and vote to reject a policy that could otherwise, benefit the society.

However, this does not mean that they do not believe passing such a proposal into law would be in the best interest of the public. The members of the U.S. Congress usually align with their left- or right-wing political affiliation and support legislations to appease their electorates, lobbyists, and sponsors purposely to ensure they retain their Senate or House seats as opposed to promoting public good in a bipartisan manner.

References

Grogan, C. M. (2017). How the ACA addressed health equity and what repeal would mean. Journal of Health Politics, Policy and Law, 42(5), 985-993.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6^th 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.

RE: Discussion – Week 3- Initial Post

Ever since The Patient Protection and Affordable Care Act (PPACA, Affordable Care Act, ACA, or Obamacare) was signed into law in 2010, Americans have always been on the divide. The ACA was passed without any Republicans’ signature. After its passage and implementation, half of the states, mostly led by Republicans, challenged the law (Walden University n.d.).

The ACA is an example of a significant federal policy that aimed to improve people’s access to health care.

Health care access means having the ability to receive the right type of care when needed at an affordable price (Mason et al., 2020). Americans were skeptical initially because of the number of regulations, taxes, mandates, and subsidies. Opinions changed when the number of uninsured Americans went down.

With the Trump administration and Congress continue to show interest in repealing the ACA, more people said the ACA had a mostly positive effect on the country. More Americans have access to health care without the fear of being denied because of a pre-existing condition. Several ACA provisions make it easier for individuals to get and keep insurance (Patient Protection and Affordable Care Act, 2020).

With the global pandemic, it is essential to have insurance. With millions of Americans who lost their jobs, millions of them become uninsured. But with ACA, the newly unemployed were able to get health coverage through the ACA marketplace with financial assistance to make their coverage affordable or through Medicaid expansion.

The COVID pandemic has influenced public opinion regarding health insurance coverage. The public influence will then affect their legislator’s view as the legislator needs votes to get reelected. If they represent an area with high unemployment, they will most likely be on the side to keep the ACA or replace it with another program that offers even more health insurance exchanges.

References

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2020). Policy & politics in nursing and health care – E-book. Elsevier Health Sciences.
Patient protection and affordable care Act. (2020, March 26). Brain Injury Association of America. https://www.biausa.org/public-affairs/public-policy/patient-protection-and-affordable-care-act
Walden University. (n.d.). An Introduction to Health Policy and Law Program Transcript. https://class.content.laureate.net/9e8e1f08ee35476e91f0bca97ae86ae1.html#section_container_20

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Cost-Benefit Analysis

The cost-benefit analysis in terms of legislators being reelected played a significant role in efforts to repeal/replace the Affordable Care Act (ACA). Affordable Care Act, commonly referred to as the ACA and signed into law on March 23, 2010, was the most significant reform of the American health- care system since the passage of Medicare and Medicaid a half-century earlier.

According to Manchikanti and Hirsch (2019), President Obama noted in his assessment the law was intended to “improve the accessibility, affordability, and quality of health care”. Legislators are essentially charged with the critical task of making prudent choices. Such decisions, therefore, rely greatly on their ability to conduct an in-depth and accurate cost-benefit analysis with the intention of evaluating the suitability of any proposed change (Selker, 2013,p.5).

Legislators who were in favor of repealing the ACA believed that doing so would be popular with their constituents and that this could help them win reelection. On the other hand, legislators who were opposed to repealing the ACA believed that doing so could be politically risky, especially if their constituents rely on the ACA for healthcare coverage.

The cost-benefit calculation may, therefore a priority for legislation when confronted with demands from the electorates (Job,2018,p 150). Legislators who supported repealing the ACA failed to do despite numerous attempts. The main reason being the potential cost of repealing the ACA outweighed the benefits.

Analyses of the Voters

Analyses of voter views can significantly impact legislative leaders’ decisions about national policies. For example, if a particular policy is popular with voters, legislators may be more likely to support it, to improve their chances of winning reelection. Conversely, if a policy is unpopular, legislators may be more hesitant to support it to avoid angering their constituents.

In the case of Medicare or Medicaid, analyses of voter views could be particularly important, given that these programs are designed to provide healthcare coverage to vulnerable populations. The number one job of a legislator is to be reelected, and voter views are a critical factor in shaping legislative decision-making. However, it is also important for legislators to consider the broader impact of their decisions on their constituents’ well-being and the overall functioning of government.

Are strongly supportive of these programs, legislators may be more likely to protect and expand them in order to demonstrate their commitment to providing healthcare for all Americans. Conversely, if voters are less supportive of these programs, legislators may be more likely to propose cuts or reforms in order to demonstrate their commitment to fiscal responsibility.

Overall, the number one job of a legislator is indeed to be reelected, and voter views are a critical factor in shaping legislative decision-making. However, it is also important for legislators to consider the broader impact of their decisions on their constituents’ well-being and the overall functioning of government. According to Winston Churchill, Cost-benefit analysis may be the worst tool for policymaking (Dudley, 2018).

RE: Discussion – response 2

I enjoyed reading your post and you offered a lot of information regarding the ACA. While I agree that the purpose of passing the Affordable Care Act was in the best nature of the Americans it was meant to serve, it was met with opposition from the conservative party. Gardner (2013) wrote that creating a new health care structure that involves fundamental change in how providers are paid, how consumers are insured, and how medical care and public health are integrated to safeguard the nation’s health at a sustainable cost, will not happen without difficulties along the way.

Although the ACA offers progress on getting more Americans insured it did not transition smoothly with many Americans and legislators alike.

When President Trump took office, his main goal was to repeal the ACA, however without another plan to implement millions of Americans would lose healthcare. Those that opposed the ACA described it as a policy that allows for big government intrusion into individual freedom (Gardner, 2013) which has been the basis for several Supreme Court cases that challenge the validity of the ACA and President Trumps stand on taking away the rights of American freedom to choose.

As congress prepares for their re-election they have been faced with the pressure of repealing/replacing or fixing a broken ACA health care plan. According to Fontenot (2014) it undoubtedly becomes harder to push for repeal as Americans get used to benefits offered through the ACA, but it would also appear the country is simply tired of arguments about the law. The American people want progress and legislation on both sides, but to this day there is still question on the security of our nation’s health care system.

According to an article in the Washington Post “some conservative advocates still push legal challenges to the ACA. But overall, Republicans lawmakers, faced with the pandemic’s health-care crisis, have slowed or stopped their efforts to terminate benefits that votes have come to expect (2020). Officials are faced with tough decisions to protect the American people they were elected to serve and balance the opposition to secure a job in the next election.

With the expansion of Medicaid those people that have lost their jobs due to the global pandemic can still obtain health insurance coverage in the event they are impacted medically by the pandemic. Many lawmakers have done a cost-benefit analysis based on the goal of securing a their job in the next election and attempting to repeal a law that has provided health care coverage to so many impacted by the pandemic would be political suicide.

Resources

Fontenot, S. F. (2014). Politics And A Broken Promise: The ACA Faces Another Election Cycle. Physician Leadership Journal, 1(2), 48-50. POLITICS AND A BROKEN PROMISE: THE ACA FACES ANOTHER ELECTION CYCLE.: @ Walden University Library (waldenulibrary.org)
Gardner, D. (2013). Health Policy and Politics. ACA Implementation: A Vulnerable and Misunderstood Endeavor. Nursing Economics, 31(6), 307-306. Health Policy and Politics. ACA Implementation: A Vulnerable and Misunderst…: @ Walden University Library (waldenulibrary.org)
Jacobs, L. R., Mettler, S., & Zhu, L. (2020, April 27). Republicans are relying on the Affordable Care Act to respond to the pandemic. The Washington Post. Facing the coronavirus, Republicans now support the Affordable Car Act – The Washington Post

Read Also:

NURS 6050 Discussion 1: Evidence Base in Design

NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making

NURS 6050 Assignment: Advocating for the Nursing Role in Program Design and Implementation

The Affordable Care Act (ACA) was enacted in March 2010 by President Barack Obama. The goals of the (ACA) were to make reasonably priced health insurance available to all Americans, expand Medicaid Coverage to Americans with low socioeconomic status, and support healthcare delivery at a lower cost (Affordable Care Act). One of the most controversial aspects of the ACA was the requirement for individuals to carry healthcare insurance or face a penalty- known as the individual mandate.

Congressmen and Senators receive campaign funds mainly from wealthy individuals and special interest groups. The wealthy individuals and special interest groups who are providing funds to the candidates must receive a benefit for providing said funds. Otherwise, there is no benefit to them (Milstead & Short, 2019).

The individual or groups that supported repealing/replacing the ACA, provided funds to the candidates that were also in favor of repealing or replacing the ACA. The cost-benefit was beneficial to both the individual/groups and the candidates in favor of repealing/replacing the ACA. Though it was not completely repealed, the individual mandate was repealed by the Tax Cut and Job Act of 2017 (Glied, 2018).

The primary goal of a legislator is to get reelected. This means legislators are driven by voter interaction as well as endorsement funds. Candidates learn what the voters want through means such as polling and interactions with voters. They then choose their platforms and seek endorsements. Candidates value endorsements because it increases the voters’ confidence in the candidate’s abilities. Special interest groups also value the endorsement of a candidate because it spotlights their agenda (Milstead & Short, 2019).

References

Affordable Care Act (ACA). Retrieved March 11, 2020 from https://www.healthcare.gov/glossary/affordable-care-act/
Glied, S. (2018). Implications of the 2017 tax cuts and jobs act for public health. American Journal of Public Health, 108(6), 734-736. doi: 10.2105/AJPH.2018.304388
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Since President Barack Obama signed the Affordable Care Act on March 23, 2010, there are many discussions on the pros and cons of this bill. The ACA’s primary purpose was to extend health insurance to millions of people in the country, reducing the number of uninsured people, expand their care, and make insurance coverage affordable.

This bill had many clauses that secure that children would remain on their parent’s insurance plan until the age of 26, expansion of Medicaid, preventing insurance companies from denying people with pre-existing condition health coverage.

After the passing of this law, the country saw an increase in the number of insured people to an estimated 20 million people (Eibner, 2019). President Trump and his administration have been focusing on the repeal or replace the ACA since his election in 2016 (Milstead & Short, 2019), creating many discussion sessions in Congress and the House about this issue.

The main goal for legislators and politicians is to be reelected and continue in the positions they are. Repeal and replacing the Affordable Care Act is a sensitive topic for many politicians, placing them in a dilemma to where to position when it comes to discussing it. Many factors will contribute to the disliking of voters if the repeal of the ACA happens.

Studies done showed that changes to the ACA would cause millions of people to become uninsured (Urban, 2019), approximately 24 million people by 2021, a higher number of uninsured people than before the ACA was passed. Since ACA turned into law, the spending in the health care setting reduced significantly to a total of $2.3 trillion (Emanuel, 2019). For legislators to keep their seats and seek reelection, they have to know what voters want when it comes to how they want to be covered and how they want to pay for their health.

References

Eibner, C. (2019). The Future of U.S. Health Care: Replace or Revise the Affordable Care Act. Retrieved from https://www.rand.org/health-care/key-topics/health-policy/in-depth.html on March 11, 2020
Emanuel, E. J. (2019). The Affordable Care Act has saved billions in health care costs. Retrieved on March 11, 2020, from https://www.statnews.com/2019/03/22/affordable-care-act controls-costs/
Milstead, J.A., & Short, N. M. (2019). Health policy and politics: A Nurse’s Guide (6^th ed.). Burlington, MA: Jones & Bartlett Learning.

You did a great job outlining the ACA and what it provided for individuals in this country. I agree with you that repealing the ACA is a sensitive topic among politicians right now and has been since Trump’s election in 2016. Every legislator strives to be reelected, which makes it hard for one to truly know how they feel about this topic. In addition to the politician doing whatever it takes to win votes, money plays a huge role in running a campaign to be reelected.

Politicians partner with wealthy individuals and special interest groups who will provide them with large funds to run a campaign (Milstead & Short, 2019). It is likely that the legislator will take a standpoint on political views based on who is giving them money.

Sadly, their determination to win the votes impacts our healthcare system immensely. When there is political interference in healthcare, there can be problems with the provider-patient relationship as well as a decline in ethical and evidence- based practice standards (Taylor et. Al, 2017).

Resources

Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones & Bartlett Learning.
Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B.J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346-350. doi:10.1016/j.outlook.2017.05.003

In 2010 President Obama passed the Affordable Care Act (ACA). The primary objective of the ACA was to decelerate the increasing cost of health care and promote a more cost efficient and high value health care program in the United States (Bowling et al, 2018). The advantage of ACA was to help more American who did not have health care benefits attain them.

During President Trumps campaign he voiced his plan to repeal and replace the ACA, but the Trump administration was unsuccessful twice with their replacement plan; the American Health Care Act. For the incumbent president advancing their agenda relies heavily on having the appropriate staff at the department and agency level (Weinstock, 2017), as well as having the support of the American voters.

Healthcare agenda is always a hot topic of debate in the political sector and in the homes of Americans. When we as Americans are listening to politician’s campaign speeches what goes through our minds is a quick cost-benefit analysis of how this leader’s agenda will affect our family, community, income, and future. If the political leader’s agenda aligns well with your personal agenda he or she will win your vote.

Unfortunately, policymaker’s agendas have not always focus on how Obamacare, Medicare or Medicaid will actually have an effect on the American population. Rather their agenda focuses more on how it will affect their own re-election (Milstead & Short, 2019). The two sides of the of the ACA cost-benefit analysis for the American people was that it would require insures to cover preventative care without deductible, copayment or other out of pocket expenses, coverage for children with preexisting conditions, cover college age student to age 26 under their parents plan, premiums to go to the individuals benefit verses the administrator cost, and provide explanation for rate increases (Mandel, 2021).

All of these were benefits to the American people, but the money needs to come from somewhere to fund this. On the cost side of the ACA new tax fees were instituted, health insurance premium increased up to 40%, individuals who earned more that $200,000/year and couples who filed joint earing $250, 000/year were tax to help pay for Medicare, fees were applied to medical device and brand name prescription companies, and finally medical tax deduction increased from 7.5% to 10% (Auerbach, 2019).

Regrettable there is no perfect plan in place that benefits every American equally and is a cost-effective plan for the individuals and the economy. Political leaders have their own agenda and sometimes it benefits the American population and other times it is only to their reelection benefit.

References

Auerbach, M.P, (2019). Patient Protection and Affordable Care Act: Overview. Salem Press Encyclopedia.
Bowling, B., Newman, D., White, C., Wood, A., & Coustasse, A. (2018). Provider Reimbursement Following the Affordable Care Act. Health Care Manager, 37(2), 129–135.
Mandel, I. (2021). Access to Health Care in the U.S. Research Starters: Sociology. https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=9&sid=c0e7ff24-32e0-4832-aa16f292b0a05f5d%40sessionmgr4006&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=89185280&db=ers
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Weinstock, M. (2017). Trumps first 100 days marred by failed ACA repeal effort. Modern Healthcare, 47 (18), 7. https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=1&sid=c0e7ff24-32e0-4832-aa16-f292b0a05f5d%40sessionmgr4006&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=30476392&db=mnh

NURS 6050 Discussion: The Role of the RN/APRN in Policy Evaluation

NURS 6050 Assignment: Assessing a Healthcare Program/Policy Evaluation

NURS 6050 Assignment: Global Healthcare Comparison Matrix and Narrative Statement

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.

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.

RE: Discussion – Week 3

As it pertains to our discussion this week, the cost for a legislator to support repealing or replacing the Affordable Care Act (ACA) could be an actual monetary value or a vote. There are supporters on both sides of the proverbial fence when it comes to the ACA. In the current divided political atmosphere, there is a clear delineation of support split into democrat and republican. A legislator typically takes a stance on the issue and thereby attains support which equals votes.

The legislator then must decide how to vote, or which acts or reforms to support or refute. If a legislator who gained their position by supporting democratic issues, then supports republican views they would likely stand to lose the support of their democratic voters. When considering this they must ask themselves which views their supporters’ advocate.

There is another consideration; the legislator’s financial supporters, which often have conflicting interests, must also be taken into consideration. Deciding one way or the other could cost votes or financial support. Considering the above mentioned, it stands to reason the agendas of those who vote for or financially support the legislator are influential in legislation.

The voter’s views and an analysis thereof would reasonably influence the decisions being made. After all it is the job of the legislator to “make decisions regarding bills and resolutions pending before the legislative body to which they have been elected” (Milstead & Short, 2019, p 38). Legislators also must be aware of their political health. In an effort to retain their position “legislators must be aware of not only the political climate but also be aware of how certain votes will affect their ability to stay in office” (National Council for the Social Studies., n.d.).

References

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

National Council for the Social Studies. (n.d.). https://www.socialstudies.org/advocacy/how-legislators-make-decisions

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003.

Thank you for your post. It is very detailed, but I want to add that it is indeed very accurate that people usually develop concerns when evaluating perceived competing interests of government and their influence on topics of interest to them regardless of their political associations. The same case also appears to have been present in the health care domain courtesy of the controversial Patient Protection and Affordable Care Act, which on March 2010 became law but received formal protest seven years later when leaders from The Republican Party introduced a bill to repeal the Affordable Care Act (Wilensky, 2019).

When legislatures develop policies and implement them, we expect the primary beneficiaries of such policies to be the electorate. Although it is said that the act was done for citizens with little or no insurance to be provided with affordable healthcare coverage, critics have argued that the bill was indeed forced through the legislative process by the Democratic party, which boasted of a majority. After facing numerous attacks in the form of legislative efforts to repeal it about its validity, given the conflict between Republicans and Democrats, the demand to repeal the Affordable Care Act progressed thanks to a Republican nominee in the 2016 elections (Campbell & Shore-Sheppard, 2020).

The House of Representatives, in fulfillment of their campaign promise, passed the American Healthcare Act bill in May the following year. This new bill would reform how healthcare is financed for individuals without insurance and phase out the decree that required all Americans to have insurance.

In its frequent attempts, last January of 2016, for the first time, congress passed a bill repealing the Affordable Care Act (ACA) to reduce federal government spending on health care by $927 billion between 2017 and 2026. During Trump’s administration, republican candidates planned to propose health policies to put in place after repeal; although, they made no broad agreement. Former President Trump wanted to revoke ACA provisions such as individual mandates, health insurance reforms, affordable insurance exchanges, employer requirements, and premium credits to eligible individuals and families (Nadesh et al., 2018).

However, this impacts coverage and welfare for most uninsured individuals with preexisting health conditions and disabilities. It was predicted that if this reform succeeds and continues, by 2021, the number of uninsured individuals will rise by 24 million, 81% will lose coverage in working families, and 14.5 million fewer people with Medicaid coverage in 2021.

Moreover, approximately 9.4 million people who received tax credits for private coverage will no longer receive assistance, and State spending will increase by $68.5 billion between 2017 and 2026. As reductions in Medicaid spending would be more than offset by increases in uncompensated care, and less health care treatment would be provided to modest-and low-income families (Buettgens et al., 2016).

Republicans campaigned attacking “Obamacare” during the 2010 midterm elections dishonoring and disapproving his U.S. health care system plans. Eight years later, republicans lost dozens of house seats, which was believed to have something to do with the repeal effort. In contrast, the democrats focused on health care, which involves the preservation of the revenue streams for health institutions, e.g., medical hospitals, insurance coverage, and drug industries. Between 2010-2016 House Republicans passed repeal bills more than 50 times.

Elements of this campaign were arguably actions by GOP state officials who refused to expand Medicaid programs as several republican governors embraced its expansion, with the federal government picking up nearly all cost. However, GOP officials held out in states like Georgia, Florida, and Texas, and millions of low-income people remained uninsured. Trump’s 2016 victory made the repeal inevitable, yet the former president and his allies could not keep their vows.

As he promised that in his term, there would be health insurance for everyone, but health care coverage is so expensive, and the government spent much money in the form of subsidies. As a result, this does not favor the public. The lack of success in repealing legislation did not end well with the Republican Party’s ultimate plan of eliminating the Affordable Care Act program. The Trump administration canceled funding for outreach, and an essential set of subsidies for insurers was already unfunded, eventually changing the policies on how states could design their Medicaid program.

In 2017, congress passed a tax bill zeroing the ACA’s penalty for people who did not carry insurance, and Trump agreed to sign the provision (Cohn, 2020). In the middle of the Pandemic during Trump’s administration, with the death of Justice Ruth Bader Ginsburg days before the Supreme Court will hear oral arguments regarding the health care repeal lawsuit, the chance of the Affordable Care Act (ACA) remaining active is entirely uncertain.

Totally revoking the ACA would have been disastrous to millions of Americans and wreaked havoc on the insurance markets and the U.S economy in general. As the pandemic continued, Medicaid expansion as an alternative was vital to the nation, especially for curative and preventive care during the outbreak. Finally, economic research highlighted that Medicaid expansion had enhanced public safety, especially for low-income adults, saving communities tens of billions of dollars (Rapfogel et al., 2020).

In my view, cost-benefit is vital for legislators in determining their opinions and actions regarding a specific policy that impacts every voter’s decision whether they will be re-elected or not. It is crucial for the safety of the people and our nation’s economy. The ACA has proved a stumbling block for several Republicans who want to abolish it. Every policy passed or repealed is based on the legislators’ decisions, and the probability of its consequences is inevitable.

In this case, the dubious cycle of repealing the Affordable Care Act causes different opinions from democrats and republican parties; however, popularity votes regarding a specific national concern that caters more to the people’s welfare prevails and wins in the end. For example, Republican Sen. Martha McSally was one of the more vocal advocates of repealing the ACA. She publicly acknowledged that this would negatively impact her senate bid, and she indeed lost, and the seat was filled instead by Sen. Jon Kyl. Dr. Daniel Derksen, a professor of public health at the University of Arizona, said, “

The fall election will significantly revolve around people’s belief about what candidates will do for their health coverage.” According to Ashley Kirzinger, associate director of public opinion and survey research for the foundation, since Trump won the election in 2016, a larger share of the public holds’ favorable views of the health law. This was evident in 2017 after the failed repeal in the senate.

ACA policies became much more prevalent in some other States, and it is believed that the people bringing up this Act are the Democrats. The foundation’s polling found that in 2014, 55% of voters opposed the ACA law, while only 36% favored it; last 2020, it shifted to 51% favoring it and 38% opposing it. A shift was seen in political groups, with only 74% of Republicans still viewing it unfavorably in the latest poll (Hawyluk, 2020).

The Affordable Care Act 2010 is a landmark legislation aimed at expanding access to quality and cost-effective care for millions of Americans who lacked a medical cover or insurance. With its enactment, over 20 million Americans, especially from low-income and ethnic minority groups got health insurance coverage through insurance exchange markets focusing on their incomes (Campbell et al., 2020).

However, political opposition to the policy from Republicans and other stakeholders affects the support of the legislation with attempts by the Trump administration that was keen on repealing and replacing the ACA 2010 when he came into office.

The initial attempt to repeal and replace ACA occurred in 2017 when House of Representatives passed the American Health Care Act (AHCA). However, the Congressional Budget Office (CBO) was categorical that implementing the AHCA would lead to a rise in the cost burden for the federal government while over 24 million individuals would lose their health coverage.

The AHCA proposed having tax credits based on age and not income. The AHCA also wanted a patient and state stability fund to be established to reduce premiums from 2026 by 20% percent. The implication is that these measures were going to lead to a rise in the cost of healthcare (Li et al., 2020). Americans with chronic conditions were going to pay higher rates of premiums while states would be at liberty to suspend several components of the ACA.

Re-election Prospects impacted attempts to repeal and replace the ACA based on the cost-benefit analysis by legislators, especially Republicans. Public opinion showed that a majority who were supporting the AHCA would lose their re-elections due to the negative effects of repealing and replacing the ACA. The proposed policy would lead to a rise in the number of uninsured Americans.

Many health care professional associations like the American Academy of Family Physicians (2020) were against these proposals. Due to re-election fears and possible losing of their seats, the Republicans led by the then Senate Majority Leader could not vote for the AHCA. Their interests to be re-elected would be impacted negatively had they voted to repeal and replace the ACA. They instead had their proposed approach under the Better Care Reconciliation Act.

Voters’ views impacted the decisions by legislative leaders in positioning national policies as they realized that repealing and replacing the ACA would make millions to lose health insurance. Legislative leaders are elected by voters and any decision they make to affect them can have serious consequences, especially on their re-election (Rapfogel et al., 2020). Consequently, they did not support the repeal and replacement of the ACA based on cost-benefit analysis as they realized that doing that would cost them their seats and chances of getting re-elected by voters.

Politics and the Patient Protection and Affordable Care Act

Politicians’ main interest is to be re-elected to continue maintaining their political positions. The interest of being reelected every campaign has greatly impacted the policymaking process. Politicians would rather support what looks good in the eyes of people to ensure they do not lose quorum (Milstead & Short, 2019). Since President Trump became the president of the United States of America, he has been against the Affordable Care Act. As a result, he has tried to repeal the policy but the efforts have failed. President Trump’s administration has not given up since many trials to repeal the Affordable Care Act are expected. Most probably, the repeal trials have failed so that politicians can safeguard their likelihood of being re-elected. This paper explains how the cost-benefit analysis in terms of legislators being re-elected affected efforts to repeal/replace the ACA. It also explains how analysis of the voter views may impact politicians’ recommendations about the Medicare Prescription Drug Savings and Choice Act of 2019

. How The Cost-Benefit Analysis in Terms of Legislators Being Re-Elected Affected Efforts to Repeal/Replace The ACA

The ‘Obamacare’ commonly known as the Affordable Care Act was launched by President Barack Obama. The policy has enabled most Americans to receive health insurance. However, the repeal process has failed perhaps because election matters a lot to politicians. Just within a year of Trump’s inauguration, Republicans began the debate to repeal ‘Obamacare’ and revise the long-standing Medicare and Medicaid programs (Obama, 2017). Because replacing the ACA would result in many people losing their insurance and this would limit medical care, it would impact negatively the 2018 election. Many leaders who supported the repeal would lose their seats. The leaders could not support the repeal upon realizing that it would negatively impact their reelection. A clear picture here is that political leaders do not care about how repealing the Affordable Care Act would affect Americans but how it would affect their reelection chances (Taylor et al., 2017). Therefore, it is clear that not just election results matters to politicians but also the threat of upcoming elections.

The Medicare Prescription Drug Savings and Choice Act of 2019

Politicians’ interest in being reelected also impacted the Medicare Prescription Drug Savings and Choice Act of 2019. This bill was introduced by the representative for Illinois’s 9th congressional district who is a Democrat (Congress.Gov, 2020). The bill is still in the first stage of the legislative process. It was introduced to Congress on 21st October 2019. It must be first considered by the committee before it is send to the House or Senate as a whole. Politicians will have to examine this bill to identify whether or not it will impact the upcoming election. This bill touches part D of Medicare, which is a voluntary program that helps pay for outpatient prescription drugs (Congress.Gov, 2020). This section, therefore, might affect many Americans. How this bill will influence the next election will determine whether or not it will be passed as a part of the law that governs Medicare operations in the United States. The cost-benefit analysis in terms of politicians being reelected therefore has a significant influence on their recommendations and positioning of legislative policies (Dickinson & Reinmuth, 2017, October).

References

Congress.Gov. (2020). H.R. 4769: Medicare Prescription Drug Savings and Choice Act of 2019. Retrieved from https://www.congress.gov/

Dickinson, M. J., & Reinmuth, K. (2017, October). Trump, Congress, and Health Care: All Politics Is National. In The Forum (Vol. 15, No. 3, pp. 431-450). https://rowman.com/ISBN/9781538105740/The-Trump-Presidency-Outsider-in-the-Oval-Office

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Obama, B. H. (2017). Repealing the ACA without a replacement—the risks to American health care. Obstetrical & Gynecological Survey, 72(5), 263-264. doi: 10.1056/NEJMp1616577

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003

The affordable care act was first established and signed into office on March 23, 2010.  This was the first time that Americans were required to hold and obtain healthcare or be penalized for not carrying it.  This however caused many heated debates over Government mandating healthcare insurance.  Some areas had limited resources and options to insurance companies which allowed the insurance companies to be expensive.  Democrats and Republicans continue to battle over health insurance and argue if it’s a right or a privilege.  Joel Teitelbaum states some concern in his discussion regarding the affordable care act. He says even though Americans hold health insurance it does not guarantee them to adequate health care treatment. 

The cost-benefit analysis of the affordable care act has many parts to it and remains a controversial issues with voting.    “In an average month for each year during that period, between 240 million and 242 million such people are projected to have health insurance, mostly from employment-based plans. But the number of people without health insurance is projected to rise from 30 million in 2019 to 35 million in 2029” (CBO,2019).   Cost of health insurance for people who are unable to get it from an employee is going to continue to rise.  With the rise in health insurance costs, the higher amount of Americans uninsured will continue to rise.  In order for legislative leaders to be re-elected they will need to embrace what there party is asking for with health care needs.  There is a real divide among both parties, each party is wanting something different so in order to speak to the population they will need to communicate among there party and decide what’s best for cost and the health care needs of others.   Legislators main goal is to be re-elected into office for another term which means they will have to figure out what the majority of there party wants and how the most cost effective way there is to obtaining that.

References

Laureate Education (Producer). (2018). Working with Legislators [Video file]. Baltimore, MD:

Author.

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel

Teitelbaum

[Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Peter Beilenson: Population Health [Video file]. Baltimore,

MD: Author.

Congressional Budget Office. (May 2, 2019).  Federal Subsidies for Health Insurance Coverage for

People Under Age 65: 2019 to 2029. Retrieved from

https://www.cbo.gov/publication/55085

The Affordable Care Act (ACA), adopted in 2010, is a significant reform bill that expands coverage for medical insurance for people without health insurance. The act eliminates the expenses incurred out of pocket for patients seeking medical services (Himmelstein et al., 2019). Some lawmakers were working to abolish the ACA Act because doing so would advance their selfish political goals at the cost of patients’ safety. Cost-benefit analysis is based on the idea that lawmakers do not always consider society’s interests when deciding which laws to pass. Politics played a role in the fight to repeal and replace the Affordable Care Act (ACA), with the Republican Party, led by President Trump, aiming to introduce the American Health Care Act as a replacement. Unfortunately, they could not collect enough support to get the measure through the legislature (Congress.gov, 2018). Members of Congress who voted to repeal the ACA belonged to the Republican Party, while those who voted against the measure were Democrats. Political representatives are expected to put healthcare improvement in the nation ahead of their re-election prospects and party allegiance when making decisions.

Feldstein’s speech makes it clear that political forces shown in the development and removal of regulations may impact recommendations and positions taken by legislative leaders. Re-election in elected offices threatens autonomous decision-making for society’s welfare (Congress.gov, 2018). This way, regulations are changed for unintended reasons, putting the majority at risk while gratifying the minority. Such choices may weaken universal health coverage, increasing the number of people who must pay for their healthcare out of pocket and threatening the viability of plans like the Affordable Care Act. Several times, the president has tried to control Congress, which has had a detrimental impact on Congress’s ability to craft policy independently. The Affordable Care Act (ACA) has come to stay for now as numerous publications has shown that the Affordable Care Act is more popular than ever since late 2019 with 50% of the population in support of the Affordable Care act even when political differences have widened rather than shrunk. (Brodie, 2020).

Sample Answer for POLITICS AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT NURS 6050

Sasha Shaheen 

RE: Discussion – Week 3

The Patient Protection and Affordable Care Act of 2010 (ACA) is a revolutionary policy. This Act wanted to address social injustices in the American healthcare system. However, this policy has met stiff opposition from Republican legislators who openly opposed it. When Donald Trump came to power, repealing ACA was one of his number one priorities. They, however, did not get the requisite number to repeal ACA since other legislators felt like many Americans would be affected. Many Republican lawmakers started seeing that they may not get reelected if they continued to support the repeal of ACA.

In May 2017, the House of Representatives passed the American Health Care Act (Jost, 2017). This was the first attempt at repealing ACA. The Trump administration wanted to use this act to repeal ACA.  However, this Act would make millions of Americans lose health insurance coverage. AHCA proposed that tax credit be based on age, which would increase healthcare costs. This Act also created the Patient and State Stability Fund, which would reduce premiums by 25% after 2026 (Jost, 2017). This would increase healthcare costs for Americans with preexisting comorbid conditions.

A cost-benefit analysis by Republican lawmakers revealed that they would not get reelected because of the negative effects of repealing. Repealing ACA would lead to millions of Americans losing insurance coverage (Straw & Aron-Dine, 2020). This was the main reason for implementing ACA. ACA aimed to increase insurance coverage to millions of Americans and reduce healthcare costs (Sommers, 2020). Due to reelection purposes, the Senate Majority Leader McConnell found it hard to garner support for AHCA. To protect their political interest, the US senators came up with another proposal known as the Better Care Reconciliation Act of 2017 (Smith & Gibbs, 2017).

Members of Congress and Senators are elected leaders who must be voted for by the public. Due to this, their positions on policies such as Obamacare are influenced by how their electorates feel. Because of this, their interest is reelection and not ACA.

References

Jost, T. S. (2017). House passes AHCA; HHS acts on regulations. Health Affairs, 36(6), 982-983.  

Smith, K., & Gibbs, T. E. (2017). The APHA PHACT campaign in action in Delaware. Delaware Journal of Public Health, 3(4), 6-11.  

Sommers, B. D. (2020). Health insurance coverage: What comes after the ACA? Health Affairs, 39(3), 502-508.  

Straw, T., & Aron-Dine, A. (2020). Commentary: ACA Repeal Even More Dangerous During Pandemic and Economic Crisis. Center on Budget and Policy Priorities. https://www.cbpp.org/research/health/commentary-aca-repeal-even-more-dangerous-during-pandemic-and-economic-crisis

Sample Response for POLITICS AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT NURS 6050

Sasha,

The last statement of  ”….their interest is re-election and not ACA.” This statement highlights the level of politics within politics. Interest groups spend resources on trying to remove legislators who do not share in their intentions. Americans would be better served by policy-motivated committees that dissect and evaluate the benefit of a bill before allowing it to be considered (Lorenz, 2020). Everything boils down to the dollar. I understand health care and politics are as much of a business as anything else. However, it is unfortunate the system is overly saturated with misguided interests, and how does this benefit me. Personal experiences weigh heavily on attitudes toward the government and health care policies within contemporary societies (Larson, 2020). Lobbyists aid in providing and identifying agendas; these “agenda setters” would be more likely to perform in the public’s best interest if a policy-motivated committee was the influence behind new bills (Lorenz, 2020). 

Larsen, G. (2020. Personal politics? Healthcare policies, personal experiences and government attitudes. Journal of European Social                       Policy. https://doi.10.1177/0958928720904319

Lorenz, G. (2020). Prioritized interests: Diverse lobbying coalitions and congressional committee agenda setting. University of Chicago Press Journals. https://www.journals.uchicago.edu/doi/abs/10.1086/705744

Sample Response for POLITICS AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT NURS 6050

Sasha,

I love that you kept the explanation of the health care acts and attempted repeal short and simple but explained it all perfectly. It is a shame that in recent times, politician’s true colors have shown. They are making it more transparent that some, unfortunately most, do not always have the American people’s best interest in mind. With legislators being driven with the primary goal of being re-elected and not solely for the benefit for its constituents (Milstead & Short, 2019), I am grateful we live in a country that allows us to be a part of a democracy in order to have some control in how our amazing country is ran. According to Dr. Nwogu, “democracy is a system of government with four key elements: a system for choosing and replacing the government through free and fair elections, active participation of the people, as citizens in politics and civic life, protection of the human rights of all citizens and a rule of law in which the laws and procedures apply equally to all citizens” (2015). I genuinely believe, if we allowed these elements to guide our country, the government wouldn’t be viewed as corrupt, and we wouldn’t have to analyze how politicians balance cost vs benefit for their gain instead of the American people like it was originally intended way back when.

References

Milstead, J. A., & Short, N. M. (2019. Informing public policy: An important role for registered nurses. In Health Policy and Polictics: A nurse’s guide (6^th ed., p. 40). Jones and Bartlett Learning.

Nwogu, G. A. I. (2015). Democracy: Its Meaning and Dissenting Opinions of the Political Class in Nigeria: A Philosophical Approach . Journal of Education and Practice, 6(4). Retrieved 2021, from https://files.eric.ed.gov/fulltext/EJ1083739.pdf.

Sample Answer for POLITICS AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT NURS 6050

Amber McCarter 

RE: Discussion – Week 3

Legislators Influence On Health Care

            The Affordable Care Act, also known as ACA or “ObamaCare”, was enacted in March 2010 by the Obama Administration. According to HealthCare.gov, the health care reform law has three primary goals; “make affordable health insurance available to more people, expand the Medicaid program to cover all adults with income below 138% of the federal poverty level, and support innovative medical care delivery methods designed to lower the costs of health care generally” (“Affordable Care Act (ACA)”, n.d.). This health care law was enacted in order to move towards the end goal of universal health care and provided as a right vs a privilege (Teitelbaum, 2018). According to Economic Policy Institute, approximately 29.8 million people would lose their health insurance and approximately 1.2 million would lose their jobs (“Repealing the ACA”, n.d.). With the repeal prospectively affecting that many Americans, you would assume this would play a large role in the legislative leader’s position in congress. We as a democracy, can influence those in the position to place laws and policies that impact our day to day lives. With the impact this repeal would have, I think it would be safe to say, the legislative leaders would have to rebuttal in order to save face and protect their position within congress. Once legislators found how many Americans would be affected by the repeal, the Trump Administration proposed the Better Care Reconciliation Act in 2017. This act would provide more help to cover out-of-pocket costs, health savings accounts, allocating additional resources to combat the opioid epidemic, providing more options for Americans to buy lower premium plans, as well as tax and Medicaid revisions (Senate Budget Committee, 2017). By providing these alterations to the Affordable Care Act, I feel that the legislative leaders were able to secure their position in congress and I can only hope their intentions are to continue to implement laws, policies and acts to better American lives across the nation.

References

Discussion draft – better care reconciliation act (BCRA). U.S. Senate Committee On The Budget. (n.d.). Retrieved December 13, 2021, from https://www.budget.senate.gov/bettercare.

HealthCare.gov. (n.d.). Affordable care act (ACA). Affordable Care Act ACA. Retrieved December 13, 2021, from https://www.healthcare.gov/glossary/affordable-care-act/.

How would repealing the Affordable Care Act Affect Health Care and jobs in your state? Economic Policy Institute. (n.d.). Retrieved December 13, 2021, from https://www.epi.org/aca-obamacare-repeal-impact/.

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

Sample Answer for POLITICS AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT NURS 6050

Tamika Robinson 

RE: Discussion – Week 3

The cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA (Obama Care) is a very interesting topic in healthcare. The impact can either help or hurt some of us. The goal for the legislator is to be reelected, so the decision must be supported throughout society. From my point of view, making ACA affordable, having access to healthcare, and making sure those without insurance are insured. Repealing the ACA keeps health insurance which make it appealing for some of us, while on the other hand, replacing the ACA can make it unappealing. This far, ACA has been very effective, and affordable, so let’s just keep it. On the other hand, if the ACA was replaced, many Americans would pay millions for prescription drugs, like medications that could save lives. According to the NCBI, the public debate focuses not on such important and difficult questions as how to discount future benefits or how to estimate cancer rates but on whether it is proper (or, as some contend, sinful) to “put a price tag on human life (National Research Council (US) Steering Committee on Valuing Health Risks et al., 1990).

The decisions by legislative leaders could affect low-income families currently benefiting from Medicaid expansion would be at grave risk of financial catastrophe and more likely to take out debt in the event of a health emergency if they were to lose their coverage (Cusick Director et al., 2021). Legislatives invests nearly $1 trillion over the 2010–2019 time period aimed at making coverage affordable, the Act more than offsets these expenditures through curbs on Medicare and Medicaid spending, new taxes on high-cost plans, and tax shelters used most heavily by affluent families (Rosenbaum, 2011). Replacing the ACA with (the American Health Care Act – AHCA) can cause significant changes like age of the client, cost, and the lack of coverage. The decision is normally made by voters that have the most votes. The end goal is protecting families and their health.       

References

Cusick Director, J., Cusick, J., Director, Director, S. H. A., Hananel, S., Director, A., Seeberger Director, C., Seeberger, C., Oduyeru Manager, L., Oduyeru, L., Manager, Gordon Director, P., Gordon, P., Shepherd Director, M., Shepherd, M., Director, J. P. D., Parshall, J., Director, D., President, L. R. V., … Simpson, E. (2021, November 7). The chaos of repealing the Affordable Care Act during the coronavirus pandemic. Center for American Progress. Retrieved December 13, 2021, from https://www.americanprogress.org/article/chaos-repealing-affordable-care-act-coronavirus-pandemic/.

National Research Council (US) Steering Committee on Valuing Health Risks, Costs, & Decisions, and B. for E. (1990, January 1). The politics of benefit-cost analysis. Valuing Health Risks, Costs, and Benefits for Environmental Decision Making: Report of a Conference. Retrieved December 13, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK235528/.

Sample Response for POLITICS AND THE PATIENT PROTECTION AND AFFORDABLE CARE ACT NURS 6050

Hi Tamika Robinson 

Legislators must conduct a cost-benefit analysis on repealing Obamacare. The objective of any legislator is to be reelected. The mandate of electing leaders lies with the general public. I agree with your point of view; repealing ACA may negatively affect healthcare costs and access to healthcare services. Since its inception, ACA has increased the number of Americans insured (Silberman, 2020). The decision by legislators can thus affect low-income families who are Medicaid beneficiaries. Legislators will follow what the electorates say to protect their positions to ensure they get reelected.

References

Silberman, P. (2020). The Affordable Care Act: Against the odds, it’s working. North Carolina Medical Journal, 81(6), 364-369. https://doi.org/10.18043/ncm.81.6.364

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Module 2 Discussion: Politics and the Patient Protection and Affordable Care Act

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Health Policy and Politics: The Affordable Care Act

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RE: Discussion – Week 3

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Politics and the Patient Protection and Affordable Care Act

. How The Cost-Benefit Analysis in Terms of Legislators Being Re-Elected Affected Efforts to Repeal/Replace The ACA

The Medicare Prescription Drug Savings and Choice Act of 2019

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