NURS 6050 Politics and the Patient Protection and Affordable Care Act
Politics and the Patient Protection and Affordable Care Act
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.
References
American Academy of Family Physicians [AAFP] (2020). ACA repeal and replace.
https://www.aafp.org/media-center/kits/aca-repeal-replace.html
Campbell, A. L., & Shore-Sheppard, L. (2020). The social, political, and economic effects of the
Affordable Care Act: introduction to the issue. RSF: The Russell Sage Foundation Journal of the Social Sciences, 6(2), 1-40. https://doi.org/10.7758/rsf.2020.6.2.01
Li, X., & Stith, S. S. (2020). Health insurance and self‐assessed health: New evidence from
Affordable Care Act repeal fear. Health Economics, 29(9), 1078-1085.
Rapfogel, N., Calsyn, M. & Seeberger, C. (2020). The Chaos of Repealing the Affordable Care
Act During the Coronavirus Pandemic. https://www.americanprogress.org/article/chaos-repealing-affordable-care-act-coronavirus-pandemic/
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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.
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.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
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 voters 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.
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.
*Note: Throughout this program, your fellow students are referred to as colleagues.
NURS_6050_Module02_Week03_Discussion_Rubric
| Criteria | Ratings | Pts | ||||
|---|---|---|---|---|---|---|
| This criterion is linked to a Learning Outcome Main Posting |
|
50 pts | ||||
| This criterion is linked to a Learning Outcome Main Post: Timeliness |
|
10 pts | ||||
| This criterion is linked to a Learning Outcome First Response |
|
18 pts | ||||
| This criterion is linked to a Learning Outcome Second Response |
|
17 pts | ||||
| This criterion is linked to a Learning Outcome Participation |
|
5 pts | ||||
| Total Points: 100 | ||||||