LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT NURS 6050
Sample Answer for LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT NURS 6050 Included After Question
By Day 7 of Week 4
Submit your completed legislation grid and testimony/advocacy statement.
Politics and the Affordable Care Act
According to the U.S Department of Health and Human Servies (2022) the Affordable Care Act (ACA) has 3 primary goals-
- 1. Make affordable health insurance available to more people.
- 2. Expand the Medicaid program to cover all adults with income below 138% of the FPL. Not all states have expanded their Medicaid programs.
- 3. Support innovative medical care delivery methods designed to lower the costs of health care generally.
A Sample Answer For the Assignment: LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT NURS 6050
Title: LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT NURS 6050
LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT NURS 6050
LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT NURS 6050
Legislation Grid Template
Nurses are patient advocates and interact with different individuals who suffer from existing health disparities that reduce their access to health care services and quality care outcomes. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity by the National Academies of Sciences, Engineering, and Medicine emphasizes the critical role that nurses will play in the next decade to achieve health equity (Bode, 2022). The purpose of this legislation grid LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT NURS 6050 is to analyze a bill to reduce health disparities and the role of nurses in advocating its enactment to attain health equity by reducing the current health disparities.
| Health-related Bill Name | Health Equity and Accountability Act of 2022 |
| Bill Number | H. R. 7585 |
| Description | Introduced by Representative Kelly Robin (Democrat for Illinois’s second Congressional district), the bill requires the Health and Human Service Department and other agencies to implement different interventions aimed at reducing health disparities (Congress.GOV, 2022). The bill aims at making the U.S. health care system not only equitable but also accessible for everyone, irrespective of their diversity and legal status in the country. |
| Federal or State? | Federal |
| Legislative Intent | The legislative intent of the bill is to ensure that Congress creates policies aimed at addressing the link between health inequities and demographic factors like race and ethnicity, immigration status, age, disability and sex, gender, sexual orientation and expression as well as language and socioeconomic status. The bill has over 80 cosponsors and support from 60 stakeholder groups and organizations (Congress.GOV, 2022). The bill implores the Health and Human Services Department to focus on ten areas associated with health equity to reduce disparities. The bill requires the department to support health workforce diversity and increase access to culturally and linguistically appropriate care. It also proposes changes to eligibility and requirements for Medicare and Medicaid as well as private health insurance and nutritional assistance. These programs among others aim at reducing health disparities. |
| Proponents/ Opponents | Proponents: The bill has diverse proponents that include over 80 Congressional members and close to 60 stakeholder groups in healthcare and related sectors. The bill emphasizes the need to improve quality care delivery for all people across the health and age continuum. It has certain provisions for noncitizens and ethnic minority groups. |
| Opponents: Currently, there has been no documented opposition to the bill, both in and outside Congress. | |
| Target Population | The bill targets the general population because of its components. The bill has wide provisions for different demographics, from support to health workforce to improving accessibility by even noncitizens to illustrate its wide scope and target. |
| Status of the bill (Is it in hearings or committees?) | The bill has had eighteen actions and been to 13 committees. Currently, the bill is in the House and been reviewed or tabled and debated in different committees that include Energy and Commerce, Ways and Means, Education and Labor, Agriculture and Budget, Judiciary and Homeland Security as well as Financial Services and Transportation and Infrastructure. |
| General Notes/Comments | The bill is critical to addressing the current disparities in health care to ensure health equity for all people in the country. With over 80 cosponsors, the bill is poised to be passed and will have significant transformation of the health care industry, especially efforts to reduce health disparities and achieve equity. |
Part 2: Legislation Testimony/Advocacy Statement
Advocacy is an essential role for nurses, especially in efforts to reduce existing disparities and attain health equity for different populations, especially low-income individuals and families. The Health Equity and Accountability Act (HEAA) of 2022 is a critical legislative piece that requires enactment because it addresses critical issues that impact the delivery of health equity for different populations. Consequently, Congress should pass this bill for effective enactment to attain its benefits. Keeping demographics about individuals and families as well as groups experiencing disparities and inequities in health care provision is essential to improving the health of the population (Bode, 2022). The bill also considers the position of nurses and the need to enhance their ability to offer quality care as it proposes increased support from the HHS to health workforce diversity and enhancing access to culturally and linguistically-sensitive care for patients and health populations.
The bill has provisions that respect noncitizens, maternal health, infant health and child health. It also
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proposes interventions to health individuals access support and changes eligibility requirements for Medicare, Medicaid and private health insurance. Therefore, this bill captures all aspects recommended in the report by the National Academies of Sciences, Engineering and Medicines (Bode, 2022). Today, millions of Americans and noncitizens cannot access equitable and quality care due to disparities caused by different aspects of their demographics. As such, this bill will be critical in improving the current conditions and increasing access to healthcare services. Currently, there is no opposition to the bill. However, in case it arises, it is essential to remind opponents that developing a healthy nation reduces expenditure on care and the burden of costs associated with health disparities, especially health inequities and inequalities.
Conclusion
Nurses need advocacy to help improve access to healthcare for patients and health populations. The bill aims at addressing these issues and nurses should take a forefront position to advocate its enactment. Through this bill, the workforce will also be enhanced to meet expected demands.
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References
Bode, H. (2022). A new bill to address health disparities: The Health Equity and
Accountability Act. https://www.kidneyfund.org/article/new-bill-address-health-disparities-health-equity-and-accountability-act
Congress.GOV (2022). H.R.7585 – Health Equity and Accountability Act of 2022.
https://www.congress.gov/bill/117th-congress/house-bill/7585
Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-
2030: Charting a path to achieve health equity. National Academy of Sciences.
Maternal healthcare is one of the determinants of the quality, safety and efficiency of health in a state. The US is one of the most developed countries in the world. It is therefore expected to have the lowest maternal mortality and morbidity rates in the world. However, statistics show that the rates of maternal mortality and morbidity in the US are significantly high. Consequently, this paper explores a proposed policy that aims at reducing the current rates and trends in maternal mortality and morbidity in the USA.
| Health-related Bill Name | Recognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers |
| Bill Number | H.Res.539 |
| Description | Maternal mortality and morbidity is a critical issue affecting the United States of America. The statistics presented in the bill shows that despite being a developed nation, America has the highest rate of maternal mortality and morbidity. The statistics also show that the risk for maternal mortality and morbidity is significantly elevated among women from ethnic minority groups when compared to the American natives. Women also experience challenges in their maternal care such as mistreatment that degrade their self-identity and autonomy. Based on the above maternal health-related issues, the Recognizing The Maternal Health Crisis In The United States And The Importance Of Reducing Mortality And Morbidity Among All Women And Honoring Mothers Act was proposed for implementation. The act seeks to address the issue by focusing on a number of aspects related to maternal health. Firstly, it seeks to raise the awareness of the public about maternal morbidity, mortality and the existence of disparities in maternal health-related outcomes. The bill also seeks to encourage states, Federal Government, territories, local communications and healthcare organizations among other stakeholders to take interventions that reduce the risk and rate of adverse maternal health outcomes as well as improve maternal safety. The other aims of the act include addressing and eliminating disparities in maternal health outcomes, ensuring the provision of equitable and respectively maternal care, honoring mothers who have died due to pregnancy-related complications, and supporting the collection of data on maternal morbidity and mortality. It also supports the need for further investment efforts to enhance maternal health and health outcomes as well as eliminate disparities in maternal healthcare. |
| Federal or State? | Federal |
| Legislative Intent | The legislative intent of the act is to recognize the seriousness of maternal morbidity and mortality issues in the US. The act also seeks to raise the awareness of the public and other stakeholders on the need to prevent maternal morbidity and mortality. Further, the act aims at ensuring the disparities in outcomes of maternal health are eliminated. Lastly, it aims at ensuring that mothers and pregnant women receive respectful care that meets their health needs. |
| Proponents/ Opponents | Proponents: They include Reps. Underwood Lauren, Kelly Robin, Spanberger Abigail Davis, Wexton Jennifer, and Adams Alma. |
| Opponents: none | |
| Target Population | The primary beneficiaries of the proposed bill are pregnant women and mothers. It also includes women from ethnic minorities. The secondary target population includes healthcare providers, policymakers, and communities. |
| Status of the bill (Is it in hearings or committees?) | The bill has been referred to the House Committee on Energy and Commerce. |
| General Notes/Comments | The proposed bill is a crucial bill that should be adopted in the US. The need for the bill is attributed to the high rate of maternal mortality and morbidity rates in the USA. Its implementation would therefore support the provision of care that addresses the needs of pregnant women and mothers from diverse ethnic backgrounds. |
Advocacy Statement
Maternal mortality and morbidity is a critical issue in the US despite it being a developed nation (Collier & Molina, 2019; Joseph et al., 2021). For example, statistics show that 60% of the maternal mortalities reported in the US are preventable. In addition, the risk of women of ethnic minority groups such as African American and American Indians dying from pregnancy related complications is three times that of the White women. Women also experience different forms of mistreatment, as they receive their needed maternal healthcare (Morton et al., 2019). Therefore, the proposed bill should be adopted in the USA to address the identified issues.
The bill will increase the maternal health outcomes as well as the quality of care mothers and pregnant women receive (Congress.gov, 2021). Through the bill, the USA will rank among the world’s leading nations with lowest maternal mortality and morbidity rates. I will address the opponents in my position by presenting facts above the severity of the issue of maternal mortalities and morbidities in the US. I will also provide the socioeconomic implications of maternal mortalities and morbidities to the state. For example, I will explore the cost implications of the issue to the American economy and families.
Conclusion
The US currently has a high rate of maternal mortality and morbidity. Significant disparities exist in maternal health outcomes due to ethnicity of the mothers and pregnant women. The proposed bill is important in ensuring equity in maternal healthcare and adoption of best practices to reduce and prevent maternal mortalities and morbidities. Therefore, it should be implemented to promote public health.
References
Collier, A. Y., & Molina, R. L. (2019). Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. NeoReviews, 20(10), e561–e574. https://doi.org/10.1542/neo.20-10-e561
Morton, C. H., VanOtterloo, L. R., Seacrist, M. J., & Main, E. K. (2019). Translating Maternal Mortality Review Into Quality Improvement Opportunities in Response to Pregnancy-Related Deaths in California. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), 252–262. https://doi.org/10.1016/j.jogn.2019.03.003
Joseph, K. S., Boutin, A., Lisonkova, S., Muraca, G. M., Razaz, N., John, S., … & Schisterman, E. (2021). Maternal Mortality in the United States: Recent Trends, Current Status, and Future Considerations. Obstetrics and Gynecology, 137(5), 763. doi: 10.1097/AOG.0000000000004361
Congress.gov. (2021, July 19). Text – H.Res.539 – 117th Congress (2021-2022): Recognizing the maternal health crisis in the United States and the importance of reducing mortality and morbidity among all women, and honoring mothers. (2021/2022) [Legislation]. https://www.congress.gov/bill/117th-congress/house-resolution/539/text
Assignment: Legislation Grid and Testimony/Advocacy Statement
As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.
Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.
To Prepare:
- Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)
Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.
Part 1: Legislation Grid
Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:
- Determine the legislative intent of the bill you have reviewed.
- Identify the proponents/opponents of the bill.
- Identify the target populations addressed by the bill.
- Where in the process is the bill currently? Is it in hearings or committees?
Part 2: Legislation Testimony/Advocacy Statement
Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:
- Advocate a position for the bill you selected and write testimony in support of your position.
- Explain how the social determinants of income, age, education, or gender affect this legislation.
- Describe how you would address the opponent to your position. Be specific and provide examples.
- At least 2 outside resources and 2-3 course specific resources are used.
You give a good explanation for this. I like your example that a politician could do a survey on how his or her constituent feel about the ACA. According to one of the studies, nearly nine in ten Democrats (87%) along with six in ten independents (58%) view the law favorably, while eight in ten Republicans (79%) hold unfavorable views. They also mention that the law has increased the costs of health care or health insurance. Increasing the cost has a big impact for the public. And with the politician’s side, they should consider the impact and the expense to the family and individual, and not their personal interest.
According to analysis, If the Democrats have control of both Congress and the presidency, they will continue implementation of the ACA and try to expand the number of currently uninsured people covered by the program. They will also probably try to fix many of its insurance actuarial problems. In addition, Democrats are likely to seriously consider pursuing the addition of a public option, a government-sponsored health insurance program that would compete with private health insurance plans and would be available only for those eligible for subsidized health insurance through the ACA. If the Republicans win, they are not likely to see their mission as making the ACA work.
They are not likely to replace the ACA in total but would be likely to attempt to reduce the scale and scope of the law, reduce or eliminate mandates of all types, and decrease federal subsidies. In addition, Republicans are likely to attempt to give much more authority to states to develop or oversee their own health insurance and Medicaid programs, even if this leads to less insurance coverage. With their different policies, I hope their very interest is for the greater of all. As you mention, they should listen to the voter’s views before they take decisions and recommend national policies.
The ACA has been challenged in federal and state courts nearly 2,000 times since it was first put into place in 2010 (Pitsor, 2021). In 2017 if the Affordable Care Act was repealed long-term, it would cost approximately $350 billion under conventional scoring and $150 billion using dynamic scoring through 2027 (Daniel, 2017). If ACA was repealed it would save $1.55 trillion but also end health coverage for more than 20 million Americans which makes the ACA a central topic during elections. Politicians’ goal is to be re-elected and that guides their stance on current legislative topics. The ACA has been heavily criticized, argued, discussed, and has created further divisions in politics. To a large population in the United States, it is not a matter of how much will this cost the government but a true concern for losing healthcare coverage for themselves and their family.
Conservatives have been against the ACA since day 1 due to the increase it causes in insurance premiums and costs to the government. Since 2010 when the ACA was introduced, the republican party has focused on how much it cost and centered their argument for replace/repeal around that. Instead of acknowledging the coverage and the lessened health care gaps that the ACA provides. For republican politicians who are looking at the issue from a monetary viewpoint, repealing the ACA is the best choice due to the high amount of savings. From a democratic perspective, the number of uninsured individuals outweighs the savings, and the cost of the ACA is worth it. Public opinion on the ACA has shifted as well- 55% of the public has a favorable opinion (Montero, 2022) which has already influenced how many politicians stand for the ACA and increased the number of republicans who are no longer fighting to repeal the ACA. Healthcare is a complex and highly politicized topic; it will be on agendas and discussed for the foreseeable future. If politicians are going to continue being involved and influential in healthcare, they also need to take the time to be better informed instead of holding whichever stance will gain them more votes. Decisions in healthcare that affect millions of people should not be made with the intention of gaining votes.
References
Assistant Secretary for Public Affairs (ASPA). (2022, March 15). About the ACA. HHS.gov. Retrieved September 15, 2022, from https://www.hhs.gov/healthcare/about-the-aca/index.html
Daniel, M. (2017). The cost of full repeal of the Affordable Care Act. Committee for a Responsible Federal Budget. Retrieved September 13, 2022, from https://www.crfb.org/papers/cost-full-repeal-affordable-care-act
Jack Pitsor, A. G. (n.d.). Legal cases and state legislative actions related to the ACA. Retrieved September 15, 2022, from https://www.ncsl.org/research/health/state-
laws-and-actions-challenging-ppaca.aspx
Montero,A. (2022, April 14). 5 charts about public opinion on the Affordable Care Act. KFF. Retrieved September 13, 2022,
Regardless of geographical location, race, culture, and other factors, all populations deserve quality, timely, and affordable health. Besides, health care providers and stakeholders should devise interventions for health promotion and the protection of vulnerable communities. Health care policies are instrumental in health promotion since they outline guidelines for benefitting patients, communities, and health care providers (Wolstenholme & McKelvie, 2019). As a result, Congress and other law-making bodies formulate health promotion bills to advance health in the United States. The purpose of this paper is to evaluate a recently-proposed health-related bill and an advocacy statement supporting its legislation
Part 1: Legislation Grid
| Health-related Bill Name | End Tuberculosis Now Act of 2022 |
| Bill Number | H.R. 8654 (Congress.gov, 2022). |
| Description | End Tuberculosis Now Act of 2022 underlines that the United States foreign assistance program has an obligation to end global tuberculosis (TB) pandemic through multifaceted interventions, including actions that support TB diagnosis and treatment among all adults and children and prevent new infections (Congress.gov, 2022; Kaiser Family Foundation, 2022). The bill also outlines the objectives and goals of TB-related policy, such as appropriate funding of comprehensive person-centered programs, capacity building among populations where the TB burden is high, and direct support to at-risk and impoverished populations. |
| Federal or State? | Federal |
| Legislative Intent | The bill’s intent is to prevent, cure, and treat tuberculosis globally. Besides, the bill ensures that at-risk populations are identified and get appropriate support. |
| Proponents/ Opponents | Proponents: Representative Ami Bera (Congress.gov, 2022). |
| Opponents: no opponent has been noted | |
| Target Population | All adults and children with all forms of Tuberculosis and at-risk populations in the United States (Congress.gov, 2022; Kaiser Family Foundation, 2022). |
| Status of the bill (Is it in hearings or committees?) | The bill is in the committees stage (House- Foreign Affairs) |
| General Notes/Comments | The bill focuses on a critical population health matter that deserves maximum attention from individuals, communities, health care providers, and governments. Generally, optimal health outcomes can only be achieved by protecting populations from infections, supporting health promotion programs, and identifying vulnerable populations. Since the bill will be instrumental in ending the TB pandemic and reducing health care costs, quick implementation is crucial. The federal government should also ensure that the United States foreign assistance program has adequate funding to achieve the health care goals outlined in the bill. |
Part 2: Legislative Testimony/Advocacy Statement
Healthy populations are critical for a nation’s productivity and progressive economic well-being. The End Tuberculosis Now Act of 2022 will be instrumental to people’s health and well-being and should be quickly implemented. It will be crucial to health and well-being since it promotes preventive health, which helps to reduce deaths, disability, and health inequities (Franklin & Sleet, 2018). Besides, the bill applies a global approach to achieve internal health outcomes since it will advance measures for protecting Americans from foreign TB infections. Such an approach will further help the nation to achieve Healthy People 2030 goals.
TB rates vary with populations’ characteristics. Social determinants of income affect the legislation of the End Tuberculosis Now Act of 2022 since the variance in TB rates necessitates intervention programs specific to a population’s needs. Health research demonstrates a close link between TB and poverty since TB infections are high in low-income areas (Abou Jaoude et al., 2022). People living in low-income areas are likely to live in poorly ventilated and overcrowded conditions that are ideal for the spreading of TB bacteria. The rates of malnutrition and diseases such as HIV/AIDS are also high in low-income areas and increase TB resistance (Balinda et al., 2019). Such income-related outcomes necessitate adjustments in intervention measures since a universal approach cannot be used to promote health in populations with varying needs, vulnerabilities, and cultural practices.
Opponents should understand the implications of TB on populations, health care spending, and the progressive economic well-being of the nation. The best way to address them is through research and health statistics demonstrating the link between TB and adverse health outcomes. For instance, the Centers for Disease Control and Prevention (2020) reported that TB is the leading infectious disease in the world and claims approximately 1.5 million lives annually. As a result, multifaceted health promotion programs are vital. Abou Jaoude et al. (2022) stated that Stop TB Partnerships and health promotion programs have helped to reduce TB spending. Similar measures underlined in the End Tuberculosis Now Act of 2022 should be intensified to protect general and vulnerable populations.
Conclusion
Health care bills advance health through more funding, advocacy, and the protection of special populations, among other strategies. Implementing the End Tuberculosis Now Act of 2022 will be instrumental in attaining healthy and productive populations. As a result, quick implementation of the bill is essential and more support from legislators is needed as well. The government should also supplement such interventions with other health promotion programs, particularly in vulnerable communities where TB rates are high.
References
Abou Jaoude, G. J., Baena, I. G., Nguhiu, P., Siroka, A., Palmer, T., Goscé, L., … & Haghparast-Bidgoli, H. (2022). National tuberculosis spending efficiency and its associated factors in 121 low-income and middle-income countries, 2010–19: a data envelopment and stochastic frontier analysis. The Lancet Global Health, 10(5), e649-e660. https://doi.org/10.1016/S2214-109X(22)00085-7
Balinda, I. G., Sugrue, D. D., & Ivers, L. C. (2019). More than malnutrition: a review of the relationship between food insecurity and tuberculosis. Open forum infectious diseases, 6(4), ofz102. https://doi.org/10.1093/ofid/ofz102
Centers for Disease Control and Prevention. (2020). Tuberculosis. https://www.cdc.gov/globalhealth/newsroom/topics/tb/index.html
Congress.gov. (2022). H.R. 8654– End Tuberculosis Now Act of 2022. https://www.congress.gov/bill/117th-congress/house-bill/8654
Franklin, R. C., & Sleet, D. A. (2018). Injury prevention and health promotion: A global perspective. Health Promotion Journal of Australia: Official journal of Australian Association of Health Promotion Professionals, 29(2), 113–116. https://doi.org/10.1002/hpja.191
Kaiser Family Foundation. (2022). U.S. global health legislation tracker. https://www.kff.org/coronavirus-covid-19/fact-sheet/u-s-global-health-legislation-tracker/
Wolstenholme, E., & McKelvie, D. (2019).The dynamics of care: Understanding people flows in health and social care. Springer.
The cost-benefit analysis made quite the impact on legislatures and their reelection. This has been a political debate for years, and it’s now being used selfishly to win votes. The law and healthcare tie into each other and can significantly impact votes for representatives. For many years republicans used the ACA repeal for votes and attention. The ACA was part of their success, and it was the star of their campaigns at times. People voted specifically on the promise of the ACA being repealed. This didn’t just affect republicans either; this affected all legislation. According to Johnathan Cohn (2020), “Democrats lost 64 seats in the House of Representatives, relinquishing a majority they had won just four years before. And although the results reflected a variety of factors, they had a lot to do with anger over the Affordable Care Act (ACA)”.
For years republicans struck the ACA and tried tearing it apart piece by piece. A lot of people thought that it would ruin the entirety of the healthcare system and make insurance pricier. A cost-benefit analysis by the legislators, Republicans included, soon showed them that they risked not getting re-elected because of the far-reaching negative aspects of ‘repeal and replace. The new policy would deprive many Americans of access to affordable healthcare (Daniel, 2017). Everyone quickly realized that The AHCA would be a financial disaster for millions.
The cost-benefit analysis put all the tiny puzzle pieces together, showing everyone the bigger picture that would change millions of lives. Repealing the ACA would cost roughly $350 billion through 2027 under conventional scoring and $150 billion using dynamic scoring. Repealing ACA would increase the number of uninsured people by 23 million (Daniel, 2017). Figuring out the numbers changed the legislature’s minds and forced them to change how they would win the public votes. The CBA showed the nitty gritty details that people weren’t considering. It showed the actual cost, the time it would take, and the advantages and the disadvantages.
A video from Walden University (2018) featuring Joel Teitelbaum shares, “It is clear that politics is playing a vital role in the design at the outset and now the implementation of the ACA.” I think the cost-benefit analysis greatly impacted whether specific people would earn votes. The most recent KFF Tracking Poll conducted in March 2022 found slightly more than half of the public (55%) hold a favorable opinion of the ACA, while about four in ten (42%) hold a negative view of the law (Montero,2022). The ACA has brought division to the political parties and in several communities.
Legislators’ goals are to remain in office, so at this point, they would do anything for support to be re-elected. As their agendas changed, so did their views. Now they had to change the message to attract different people. The public view changed, and legislatures soon realized they must be careful about what policies they allow to represent them and what procedures they chose to support. Many opinions on government involvement in the health care system impact voters’ choice of the presidential candidate. Blendon and Benson (2014) state, “Polling results have highlighted that voters do not see health care as a single issue. In one poll, 73% of respondents said health care was an important issue in their voting decision. When asked from a list what they meant by this statement, the ACA or Obamacare was the dominant health care issue (48%). Medicare was mentioned by 25%, and Medicaid by 14%”
As Americans, we want to keep moving forward, working towards coverage that suits everyone. The debates over healthcare and the ACA, in general, will not cease, as we will continually have to work to come to the same solution. Though the answer seems far away, hopefully, one day, we can find a middle ground that suits everyone, even if it looks a little different through political representation. The representation of the specific legislators and what they support/represent will always be what sways votes. Taking each aspect into consideration and looking at the targeted population is what will keep legislators in office.
Legislation Grid
| Health-related Bill Name | H.R.5 – Equality Act |
| Bill Number | H.R.5 |
| Description | The H.R.5 – Equality Act is a bill that was introduced in the House of Representatives on February 18, 2021. The purpose of this bill is to amend the Civil Rights Act of 1964 and other existing federal laws to prohibit discrimination based on sexual orientation and gender identity in various areas of life, such as employment, housing, education, and public accommodations (U.S. Congress, 2021). The bill aims to ensure that all individuals, regardless of their sexual orientation or gender identity, are protected from discrimination under federal law. The bill also includes provisions to protect religious freedom and exempts certain religious organizations from the non-discrimination requirements in certain circumstances (U.S. Congress, 2021). |
| Federal or State? | Federal |
| Legislative Intent | The legislative intent behind the H.R.5 – Equality Act is to extend federal protections against discrimination to individuals who are LGBTQ+ and ensure that they are afforded the same rights and opportunities as everyone else (Hussain, Rizvi, & Sheikh, 2022). The bill aims to provide explicit protections against discrimination based on sexual orientation and gender identity in various areas of life, such as employment, housing, education, and public accommodations, and close existing gaps in federal law that leave LGBTQ+ individuals vulnerable to discrimination (Hämäläinen, 2021). The bill also aims to provide clarity and consistency across federal law to ensure that individuals are not subject to different standards of protection based on where they live or work. Overall, the legislative intent behind the Equality Act is to promote equal treatment and dignity for all individuals, regardless of their sexual orientation or gender identity (U.S. Congress, 2021). |
| Proponents/ Opponents | Proponents:The bill argue that it is necessary to provide explicit federal protections against discrimination based on sexual orientation and gender identity (Hussain, Rizvi, & Sheikh, 2022). They argue that LGBTQ+ individuals face significant barriers to full and equal participation in society, including in areas such as employment, housing, and public accommodations. They also argue that existing federal laws do not go far enough in protecting these individuals from discrimination and that the Equality Act would fill in these gaps and ensure that all individuals are treated fairly and equally under the law. |
| Opponents:The bill argue that it could infringe on religious freedom and lead to conflicts with existing federal laws, particularly with respect to gender identity. They argue that the bill could require religious organizations to violate their beliefs by requiring them to hire or accommodate individuals whose beliefs or behaviors conflict with the organization’s religious tenets. They also argue that the bill could have unintended consequences, such as allowing biological males to compete in female sports, which could disadvantage biological females and threaten women’s rights. | |
| Target Population | Individuals who are LGBTQ+ and who may face discrimination based on their sexual orientation or gender identity (Haik et al., 2022). The bill seeks to extend federal protections against discrimination in various areas of life, such as employment, housing, education, and public accommodations, to ensure that LGBTQ+ individuals are afforded the same rights and opportunities as everyone else (Hämäläinen, 2021). The bill also includes provisions to protect religious freedom and exempts certain religious organizations from the non-discrimination requirements in certain circumstances. The overall goal of the bill is to promote equal treatment and dignity for all individuals, regardless of their sexual orientation or gender identity (U.S. Congress, 2021). |
| Status of the bill (Is it in hearings or committees?) | As of March 18, 2023, the H.R.5 – Equality Act is listed as “Held at the desk” in the Senate. This means that the bill is not currently being considered by the Senate and is being held for further action. The bill was passed by the House of Representatives on February 25, 2021, and was received in the Senate and referred to the Committee on the Judiciary (U.S. Congress, 2021). However, the bill has not yet been reported out of committee or brought to the Senate floor for a vote. It is possible that the bill may be considered in the future, but its current status indicates that it is not actively being considered by the Senate at this time. |
| General Notes/Comments
| The H.R.5 – Equality Act is a highly debated and contentious bill that has been the subject of significant discussion and controversy in both the House of Representatives and the Senate. The bill seeks to provide explicit protections against discrimination based on sexual orientation and gender identity in various areas of life, and it has been supported by LGBTQ+ advocates and civil rights groups as an important step towards ensuring equality for all individuals. However, opponents of the bill argue that it could infringe on religious freedom and have unintended consequences, and the bill has faced significant opposition from some conservative and religious groups.The bill’s status as of March 2023 is that it is held at the desk in the Senate, meaning that it is not currently being actively considered. However, the bill could be brought up for consideration at a later time, and its status may change. Regardless of the bill’s ultimate fate, it is clear that the issue of LGBTQ+ rights and discrimination will continue to be a significant topic of debate in the United States, and the outcome of this bill could have significant implications for the LGBTQ+ community and for the broader fight for civil rights and equality. |
| Excellent | Good | Fair | Poor | |
|---|---|---|---|---|
| Federal and State LegislationPart 1: Legislation GridBased on the health- related bill you selected, complete the Legislation Grid Template. Be sure to address the following:• Determine the legislative intent of the bill you have reviewed.• Identify the proponents/opponents of the bill. • Identify the target populations addressed by the bill. • Where in the process is the bill currently? Is it in hearings or committees? | 32 (32%) – 35 (35%) The response clearly and accurately summarizes in detail the legislative intent of the health- related bill. The response accurately identifies in detail the proponents and opponents of the health-related bill. The response accurately identifies in detail the populations targeted by the health-related bill. The response clearly and thoroughly describes in detail the current status of the health- related bill. | 28 (28%) – 31 (31%) The response accurately summarizes the legislative intent of the health-related bill. The response accurately identifies the proponents and opponents of the health-related bill. The response accurately identifies the populations targeted by the health-related bill. The response accurately describes the current status of the health-related bill. | 25 (25%) – 27 (27%) The response vaguely or inaccurately summarizes the legislative intent of the health-related bill. The response vaguely or inaccurately identifies the proponents and opponents of the health-related bill. The response vaguely or inaccurately identifies the populations targeted by the health-related bill. The response vaguely or inaccurately describes the current status of the health-related bill. | 0 (0%) – 24 (24%) Summary of the legislative intent of the health-related bill is vague and inaccurate or is missing. Identification of the proponents and opponents of the health-related bill are vague and inaccurate or is missing. Identification of the populations targeted by the health-related bill is vague and inaccurate or is missing. The description of the current status of the health- related bill is vague and inaccurate or is missing. |
| Part 2: Legislation Testimony/Advocacy Statement• Advocate a position for the bill you selected and write testimony in support of your position.• Explain how the social determinants of income, age, education, or gender affect this legislation.• Describe how you would address the opponent to your position. Be specific and provide examples. | 36 (36%) – 40 (40%) Testimony clearly, accurately, and thoroughly provides statements that fully justifies a position for a health-related bill. Response provides a detailed, thorough, and logical explanation of the social determinant affecting the topic, and how to address opponents to the position for the health-related bill and includes one or more clear and accurate supporting examples. | 32 (32%) – 35 (35%) Testimony clearly and accurately provides statements that somewhat justifies a position for a health-related bill. Response provides an accurate explanation of the social determinant affecting the topic, and how to address opponents to the position for the health-related bill and may include at least one supporting example. | 28 (28%) – 31 (31%) Testimony used to justify a position for a health-related bill is vague or inaccurate. Explanation of how to address the opponents and social determinant for the position for the health-related bill is vague or inaccurate, lacks logic, and/or the supporting examples are vague or inaccurate. | 0 (0%) – 27 (27%) Testimony used to justify a position for a health-related bill is vague and inaccurate, incomplete, or is missing. Explanation of how to address the opponents and social determinant for the position for the health-related bill is vague and inaccurate or is missing. |
| References | 10 (10%) – 10 (10%) Response includes 3 or more course resources and 2 or more outside sources. | 8 (8%) – 8 (8%) Response includes 2-3 course resources and 2 outside sources. | 7 (7%) – 7 (7%) Response includes fewer than 2 course resources and/or fewer than 2 outside resources. | 0 (0%) – 6 (6%) Response includes 2 or fewer resources. |
| Written Expression and Formatting—Paragraph Development and OrganizationParagraphs make clear points that support well developed ideas, low logically, and demonstrate continuity of ideas.Sentences are carefully focused– neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. | 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. | 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive | 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. | 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. Purpose, introduction, and conclusion of the assignment is incomplete or missing. |
| Written Expression and Formatting: English Writing StandardsCorrect grammar, mechanics, and proper punctuation. | 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. | 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. | 3 (3%) – 3 (3%) Contains several (3-4) grammar, spelling, and punctuation errors. | 0 (0%) – 2 (2%) Contains many (≥5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
| Written Expression and Formatting:The paper follows correct APA format for title page, font, spacing, indentations, parenthetical/in-text citations, and reference list. | 5 (5%) – 5 (5%) Uses correct APA format with no errors. | 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors. | 3 (3%) – 3 (3%) Contains several (3-4) APA format errors. | 0 (0%) – 2 (2%) Contains many (≥5) APA format errors. |
| Total Points: 100 |
|---|
NURS 6051 Week 4 Assignment Legislation Grid and Testimony Advocacy Statement
Legislation Grid Template
Nurses and other healthcare providers encounter situations that motivate them to advocate for patients and ensure that effective policies exist to safeguard them; especially in reducing the cost of healthcare (Milstead & Short, 2019). Prescription drugs remain a concern for many individuals, especially those with chronic and long term conditions like diabetes (Laureate Education, 2018). The purpose of this assignment is to review a proposed bill or law that seeks to address the issue of the cost of prescription drugs.
| Health-related Bill Name | End Price Gouging for Medications Act |
| Bill Number | H.R. 2829 |
| Description | The bill was introduced in House by Representative Peter Welch from Vermont on April 22 2021. The bill requires the Department of Health and Human Services (HHS) to set the maximum cost or price of prescription drugs based on different federal programs (Congress.GOV, 2021). The bill seeks to mandate HHS to establish reference prices and ensure that the uninsured individuals and their families and those with private health insurance have access to the drugs at reasonable cost or prices. |
| Federal or State? | Federal |
| Legislative Intent | The legislative intent of the bill is to amend the price gouging for Medications Act, and ensure that individuals who require medications can access them fast and at affordable price. The bill focuses on ensuring that prescription drugs are priced fairly, especially for individuals with chronic and long-term health conditions. The bill advances that retail prices of certain covered medications under known federal health programs like Medicare and Medicaid should not cost beyond established reference prices. The bill will ensure that the HHS sets better prices that allow patients and their families to have lifesaving medicines as prescribed by their physicians and healthcare teams (Congress.GOV, 2021). The proposals of the bill apply to all patients, irrespective of their health insurance status. This implies that creating stabilization would allow Americans to enjoy the same prices of prescribed drugs like their peers in other developed economies like Canada and Germany among other members. |
| Target Population | The bill targets all Americans and individuals using healthcare services. The bill also targets big Pharma’s monopoly power and ensure that reasonable prices exist to allow Americans, especially those with chronic conditions, purchase the much-needed medicines for their conditions. |
| General Notes/Comments | The introduction of the bill is essential to ensuring that more Americans can afford the cost of prescription drugs that remains prohibitive for many that require them. The bill is essential in helping the federal government deal with the current healthcare crises like the COVID-19 pandemic and the Opioid epidemic. The bill will ensure that federal government ends the monopoly enjoyed by Big Pharma who dictate prices, making it hard for many Americans to lack access to critical care despite their conditions. The bill will enhance monitoring of prices to ensure that consumers do not have to pay more for same drugs in different states and counties across the country. The bill will ensure that the cost of drug spending reduces on programs like Medicare (Merkley, 2021). For instance, the Medicare Advisory Payment Commission (MedPAC) notes that drug spending continues to grow in the program as it increased by over 25% between 2013 and 2018 attributed mainly to higher prices and launches of novel drugs and not a rise in the number of filled prescriptions. The implication is that no patient or individual or family of a loved one should be left out or left alone to suffer and even die because of higher prices of prescription drugs. |
Part 2: Legislative Testimony/ Advocacy Statement
The need to regulate and control prescription drugs’ prices is essential given the increased demand for healthcare, especially as the nation battles health crises like the Covid-19 pandemic and the opioid epidemic. Prescription drugs ensure that patients can manage their conditions and ensuring that more Americans can afford the cost of care is important for the nation’s wellbeing. Big pharmaceutical companies continue to manufacture drugs at costly prices which makes it impossible for many to access (Milstead & Short, 2019). Some of these drugs may find their way into the market, albeit used as opiates and not for medical purposes.
As an advanced nurse practitioner, advocating for reduction in the cost of healthcare, including access to medicines, is critical to improving the quality of care and reducing its costs, especially for low-income individuals and households without medical or health insurance coverage (O’Rourke et al., 2018). Having this bill will help many American families that cannot access medications yet they require them to remain alive.
Opposition to this legislative proposal may not be informed by current research and the need to reduce the cost of healthcare in the country. The opioid crisis is partly due to use of prescriptive drugs that are given to individuals, even those who do not have prescriptions. The implication is that this bill will regulate the prices of medicines and help address contributing factors to the opioid crisis.
Conclusion
Improving access to and quality of care is a fundamental part of the nurse advocacy process. As healthcare providers, nurses interact with patients and encounter a host of events that implore them to take actions. The bill to control the prices of prescription drugs is timely and will enhance quality care, particularly to the critically and chronically ill patients.
References
Congress.GOV. (2021). H.R.2829 – End Price Gouging for Medications Act.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide
(6th ed.). Burlington, MA: Jones & Bartlett Learning.
O’Rourke, N. C., Crawford, S. L., Morris, N. S., & Pulcini, J. (2017). Political
efficacy and participation of nurse practitioners. Policy, Politics, and Nursing Practice, 18(3), 135–148. doi:10.1177/1527154417728514
Laureate Education (Producer). (2018). The Policy Process [Video file].
Baltimore, MD: Author.
Laureate Education (Producer). (2018b). Introduction to Health Policy and Law
with Joel Teitelbaum [Video file]. Baltimore, MD: Author.
Merkley, J. (2021). As White House Prepares Health Care Push, Merkley, Welch
Introduce Bill to End Prescription Drugs Price Gouging, Help Ensure Americans Can Get the Medicines They Need. https://www.merkley.senate.gov/news/press-releases/as-white-house-prepares-health-care-push-merkley-welch-introduce-bill-to-end-prescription-drugs-price-gouging-help-ensure-americans-can-get-the-medicines-they-need-2021
Part 2: Legislation Testimony/Advocacy Statement
Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:
- Advocate a position for the bill you selected and write testimony in support of your position.
- Describe how you would address the opponent to your position. Be specific and provide examples.
- At least 2 outside resources and 2-3 course specific resources are used.
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