Politics and The Patient Protection Discussion

Politics and The Patient Protection Discussion

Politics and The Patient Protection Discussion

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.

Politics and The Patient Protection Discussion 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

Healthcare is at the forefront of all presidential candidacy and agendas. It is no wonder that when an administration changes so does the legislations and bills that comes along in support of their constituents. When President Trump took office, he was elected on his platform of “Repeal, replace, repair or starve” the Affordable Care Act, (Milstead & Short 2019). This powerful stance allowed for much debate and anxiety about the fate of Medicaid and Medicare in the political arena. Private insurances, without the option to refuse people with preexisting conditions business model would fail (Milstead & Short 2019). These pressing issues placed legislators in a very difficult position, as with any political decision a Cost-Benefit Analysis (CBA) needs to occur before any big decision can be voted on. “A CBA is supposed to be a neutral decision tool that helps government decision makers focus resources to maximize the social returns of public investment…. In reality, CBA inevitably requires value judgments that are inherently subjective, rendering the analyses potentially manipulable for political ends” (Cole, 2012).  To make another dramatic change to our healthcare system once again, legislators need to carefully consider the outcomes of the bills that they supported.  The decision to support a bill that resends the progress made in the Affordable Care Act, could mean millions of people uninsured again, denied due to preexisting conditions. Supporting the ACA could potentially lead to a collapse in the private healthcare insurance business. A lot of variable to consider when a bill is presented to vote on by a legislator. 

As mentioned before the subjective nature of a CBA could lead to manipulation of a legislator’s political agenda. If a legislator’s job is ultimately to get reelected and maintain their position, then they are ultimately working for constituents and special interest groups. If they were voted into office on a position that is not supported by evidence-based practice, then an angle or manipulation typically occurs to sell the views of their lobbyist. According to Taylor & et. al, politicians across the country are pushing for laws and regulations that restrict ethical standards of care and impose politics and ideology on evidence-based clinical care (2017). Depending on the motive behind a piece of legislation, sometimes the people who benefit the most are the legislators themselves. If the outcome is not considered for the population as a whole, with a true ethical CBA, then it can be a self-serving move. Understanding how legislation is passed, the importance on having a voice as a special interest group and lobbyist can help nurses and all healthcare disciplines drive the political system to advocate for better healthcare laws and patient outcomes.

Politics and The Patient Protection Discussion References   

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

 Jones & Bartlett Learning. 

Cole, D. (2012) Law, Politics, and Cost-Benefit Analysis. Alabama Law Review Vol, 64:1:55 p55-89. 

Eds-a-ebscohost-com.ezp.waldenlibrary.org  

Fugate-Wood, N., Hagan, T., Johnson-Mallard, Olshansky, E., V., Safriet, B., & Taylor, D.,(2017)  

Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook 65 (2), p346-350. http://dx.doi.org/10.1016/j.outlook.2017.05.003. 

Discussion: Politics and the Patient Protection and Affordable Care Act

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.

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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.

The Affordable Care Act (ACA) is a healthcare reform law that was passed in 2010. This law was implemented to increase access to affordable medical insurance for Americans. It allowed access to Medicaid managed care plans by those low-income individuals or those without access to healthcare.

Cost-Benefit Analysis

In terms of legislators being re-elected, their efforts to repeal/replace the ACA are at the forefront of minds of the Americans. The main goal of a legislator, is to be re-elected. There are some that would like to maintain the ACA just the way it is with some possible improvements and there are others that would like to repeal or replace it, or repair it (Milstead & Short, 2019). If there ACA were repealed, millions of people could lose free preventative care, others with pre-existing conditions could lose access to care, and millions of people could lose some of the benefits of their prescription drug coverage (United States Government, 2023)

This could potentially be catastrophic for many Americans. Without insurance, and oftentimes, without the ability to pay medical bills, the cost of medical care for those that are insured, will increase in order to compensate for those bills that are unpaid.  Those individuals without insurance, are less likely to seek medical care, with the potential to decrease quality of life and an increase in mortality rates.

Politicians encourage laws and regulations that impose politics and ideology on evidence-based care and restrict ethical standards of care (Taylor, et al., 2017). Legislators make decisions based on the ideals of their political party, while these sometimes do not align with what’s best for the American people.

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.

Politics and the Patient Protection and Affordable Care Act

Main Post

Healthcare is a multi-million-dollar industry that gains priority to be on the presidential agendas for each election. Many bills are presented and debated with opposing parties. Still, the legislator ultimately decides to enact a law or reject to address the most pressing population health concerns, which is also influenced by monies received from supporters and critical component of election/re-election (Milstead & Short, 2019).

The Affordable Care Act (ACA), better known as Obamacare, was first introduced in 2009 and became public law in 2010 (Congress.gov, n.d.). It had been debated and amended several times and continues to be the topic of interest to address healthcare reform for U.S. citizens’ betterment. There have been discussions regarding repealing or replacing the ACA. For example, liberals wish to keep the ACA while making improvements; on the other hand, conservatives have made efforts to repeal and replace the ACA (but with changing times, they want to repair (Milstead & Short, 2019). Hawryluk (2020) reports polling findings of political groups, which are as follows, in July 2014, 55% of voters opposed the law, and 36% were in favor. By 2020, this changed to 51% in favor while 38% opposed it. Since the ACA’s introduction, it has cost democratic officials to lose 64 seats in the house of representatives (Cohn, 2020). In the political system, the number of votes for parties fluctuates due to new bills being introduced and new issues taking priority.

As I researched this week’s discussion topic further, I have realized that political processes are continually changing. For instance, looking at the statics regarding those in favor of the law and those who opposed it, the statistics changed as new issues emerged over time. It would not be fair to say that ACA is perfect. If it is repealed or replaced, there are consequences that the government should be ready to face. At least, right now, Americans are insured, and if ACA is repealed, there will be a rise in uninsured individuals and potentially unaffordable. As per Buettgens et al. (2016), if the ACA is repealed, it would lead to 24 million Americans being uninsured by 2021, and state spending revenue would increase by $68.5 billion between the years 2017-2026. While discussing bills, it is also the legislator’s responsibility to balance the budget. For instance, monies mobilized to support the COVID-19 pandemic relief have pushed many governments’ budgets into deficits.

Politics and The Patient Protection Discussion References

Buettgens, M., Blumberg, J. L., Holahan, J., and Ndwandwe, S. (2016). The cost of ACA repeal.http://www.urban.org/sites/default/files/publication/81296/2000806-The-Cost-of-the-ACA-Repeal.pdf

Cohn, J. (2020, March 6). The ACA, repeal, and the politics of backlash. Health Affairs.https://www.healthaffairs.org/do/10.1377/hblog20200305.771008/full/

Congress.gov. (n.d.). H.R. 3590 – Patient protection and affordable care act. https://www.congress.gov/bill/111th-congress/house-bill/3590/related-bills#

Hawryluk, M. (2020, August 28). Opposition to Obamacare becomes political liability for GOP incumbents. KHN. https://khn.org/news/opposition-to-obamacare-becomes-political-liability-for-gop-incumbents/

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

*Note: Throughout this program, your fellow students are referred to as colleagues.

Politics and The Patient Protection Discussion SUBMISSION AND GRADING INFORMATION

Grading Criteria
To access your rubric:
Week 3 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 3
To participate in this Discussion:
Week 3 Discussion

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Politics and The Patient Protection Discussion Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6050_Module02_Week03_Discussion_Rubric

Grid View
List View

Excellent
Good
Fair
Poor

Main Posting

45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness

10 (10%) – 10 (10%)

Posts main post by day 3.

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)
Does not post by day 3.
First Response

17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Second Response

16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.
Participation

5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6050_Module02_Week03_Discussion_Rubric