NURS 6050 Politics and the Patient Protection and Affordable Care Act

Main Post:

The Affordable Care Act (ACA)

The introduction of the Affordable Care Act by President Obama had the target of ensuring that all American residents could afford quality and safe healthcare services. Healthcare is a vital sector that contributes to providing the best healthcare services (Dawes, 2020). Politics is crucial in determining the healthcare outcome and the type of healthcare services the community is entitled to. President Obama’s administration availed the Patient Protection and Affordable Care Act of 2020, a progressive strategy for improving care delivery by addressing the existing social injustices in the American healthcare system (Willison, 2017). The policy was met with hostility from Republican lawmakers. The lawmakers prioritize repealing the Affordable Care Act. After the election of President Trump, lawmakers wanted to have some changes to the legislation. After analysis, the lawmakers understood that repealing the Affordable Care Act would significantly affect medium- and low-income earning voters. The legislators thought their chances of being reelected back to the government would be slim if they pushed for the repeal and replacement of the ACA.

Repeal/ Replace ACA

There have been numerous attempts to repeal and replace the Affordable Care Act. The first attempt was in May 2017, after the House of Representatives passed the American Health Care Act (AHCA). Rice et al. (2018) illustrate that trump’s government and the Republicans invented the American Health Care Act (AHCA) as a tool for repealing and replacing the Affordable Care Act (Manchikanti & Hirsch, 2018). All the health insurance initiatives were good, but it was evident that the ACA was the best solution for the American government. After further analysis, it is evident that repealing the ACA and replacing it with it will have enormous consequences for healthcare consumers. The new policy could contribute to approximately 24 million people losing their health insurance coverage. The AHCA suggested that tax credits be based on age rather than income levels (Walensky et al., 2017). Therefore, the policy will entail the increased cost of healthcare services for many people. Another effort was the introduction of the Patient and State Stabilization Fund, which aimed at reducing the premiums by 20% after 2026. The effects of the policy will include increasing the cost of premiums, especially for individuals having pre-existing conditions. The replacement of the ACA could provide states with more powers that ACA limited. For example, health insurance coverage could ensure increased high premiums, especially for Americans with chronic conditions.

Impact of Re-election Prospects on ACA

Lawmakers, including the Republicans, ensure a cost-benefit analysis. Cost-benefit analysis entails the evaluation of both the positive and negative outcomes of a decision. The negative outcomes entail making decisions that may risk their chances of being reelected in the next elections. Therefore, repealing and replacing the act entails many Americans losing their ability to access healthcare services. The initial objective of the introduction of Obamacare was to ensure that as many Americans access quality healthcare services as possible.   For instance, AHCA was opposed by the American Academy of Family physicians because it increases health insecurities. The insecurities will be attributed to the increases in health premiums and limit the ability of individuals to access quality healthcare services due to age.

 Conclusion

The lawmakers prioritize repealing the Affordable Care Act. After the election of President Trump, lawmakers wanted to have some changes to the legislation. After analysis, the lawmakers understood that repealing the Affordable Care Act would significantly affect medium- and low-income earning voters. Lawmakers, including the Republicans, ensure a cost-benefit analysis. Cost-benefit analysis entails the evaluation of both the positive and negative outcomes of a decision. The negative outcomes entail making decisions that may risk their chances of being reelected in the next elections.

References

Dawes, D. E. (2020). The Political Determinants of Health. Johns Hopkins University Press. https://books.google.co.ke/books?hl=en&lr=&id=XijNDwAAQBAJ&oi=fnd&pg=PR7&dq=politics+in+healthcare&ots=cam6gmBa3e&sig=4M3rej49dZ-Zw7CvKIv-nt1uJBg&redir_esc=y#v=onepage&q=politics%20in%20healthcare&f=falseLinks to an external site.

Manchikanti, L., & Hirsch, J. A. (2018). Repeal and Replace of Affordable Care: A Complex, but Not an Impossible Task. Pain Physician, 19(8), E1109–E1113. https://pubmed.ncbi.nlm.nih.gov/27906931/Links to an external site.

Rice, T., Unruh, L. Y., van Ginneken, E., Rosenau, P., & Barnes, A. J. (2018). Universal coverage reforms in the USA: from Obamacare through Trump. Health Policy, 122(7), 698-702. https://www.sciencedirect.com/science/article/pii/S0168851018301544Links to an external site.

Wilensky G. (2017). The Economics and Politics of the American Health Care Act. The Milbank Quarterly, 95(3), 462–465. https://doi.org/10.1111/1468-0009.12268Links to an external site.

Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act Essential Health Benefits: Threats and Obstacles. American Journal of Public Health, 107(8), 1225–1226. https://doi.org/10.2105/AJPH.2017.303888Links to an external site.

The affordable care act (ACA) has been a crucial healthcare policy in the United States and has helped most people access care through health insurance (Buntin, 2020). The law provides consumers with subsidies that lower costs for households with incomes between 100% and 400% of the poverty level. (HHS, 2022).

Republican legislators have tried, without success, to repeal the ACA since it was signed into law on March 10, 2010. The 2016 election of President Trump prompted renewed attempts to abolish the ACA through 2017. Congress and federal agencies have chipped away at several ACA requirements and restricted enforcement of others, but healthcare and insurance systems continue to operate under its framework and the law remains largely intact. With the political promises of decreased spending leading to a decreased tax burden on the American people, legislators can attempt to swing voted their way by bartering more cash in your pocket, for a ballot in the box.

The Tax Cuts and Jobs Act (TCJA) was the most concrete threat to the ACA. It reduced the dollar amount of the tax from $5000 to zero, eliminating any financial penalty for failure to enroll in a health benefits program beginning January 1, 2019. While the tax penalty is gone for not enrolling in an employer or marketplace-sponsored healthcare plan, this still leaves the uninsured exposed to escalating medical costs and potential financial ruin in the event of illness and/or injury. At least the politicians who wanted to “Save A Buck” were re-elected.

References:

Buntin MB. (2020). The Affordable Care Act at 10 Years. JAMA Health Forum; 1(7):e200896. doi:10.1001/jamahealthforum.2020.0896

U.S. Department of health and human services. (2022, March 17). About the affordable care act. HHS.gov. Retrieved December 13, 2022, from www.hhs.gov

Week 3 Discussion

The purpose of the ACA was to make possible universal healthcare coverage needed to prevent Americans from facing financial difficulties due to illness or accident without insurance coverage (Gaffney & McCormick, 2017). The Affordable Care Act (ACA) was the answer to address healthcare inequalities and make possible medical care equality for all Americans. The ACA also expanded Medicaid, a combined state and federal insurance program, by making it more accessible to poor individuals (Gaffney & McCormick, 2017). In 2010 the ACA was passed into law, and it was in 2014 that it became fully implicated. From the birth of the ACA, republicans were utterly against it and vowed to repeal or replace it. The ACA passed without one republic vote for it (Nadash et al., 2018).

Cost-benefit analysis (CBA) is the federal government’s process of examine, estimating, or comparing a new rule or law’s potential cost or benefits. In the case of Republicans, after the 2016 election results of a republican President and the republican party controlling both the house and senate. The Republican party saw their chance to repeal and replace the ACA. According to Gaffney & McCormick (2017), in March of 2017, the Republican House speaker introduced the bill American Health Care Act (AHCA) which mimicked the ACA, except that it would have displaced older and lower-income Americans providing inadequate coverage. The AHCA would create healthcare inequalities which was the opposite of the ACA. Although wealth still plays a significant role in health and care access. In 2017 the republican legislators were still faced with the issue of how passing the AHCA would affect their re-election by causing both poor and elderly Americans who can already receive affordable coverage under ACA from not being able to receive affordable healthcare coverage with the new AHCA bill (Gaffney & McCormick, 2017). It would be a loss of political support for re-election amongst the poor and elderly voters of our nation (Milstead & Short, 2019). They were especially considering that these two groups of citizens rely on Medicare and Medicaid programs for their healthcare needs, and both are government-funded programs

Medicare and Medicaid are popular government programs that provide insurance for Americans who otherwise could not afford it. According to Nadash et al. (2018), the ACA made health insurance more accessible and affordable to protect Americans against high healthcare costs and focused on the poorer and elderly classes of people. The ACA made improvements to both government programs Medicare and Medicaid. In this situation, the intelligent choice or best CBA of a legislator looking at the chance to be re-elected must focus on the majority needs of the voters that elect them.

References

Gaffney, A. & McCormick, D. (2017, April 18). The Affordable Care Act: Implications for

health-care equity. The Lancet, 8:389, 1442-1452.

https://pubmed.ncbi.nlm.nih.gov/28402826/Links to an external site.

Milstead, J. A. & Short, N. M. (2019). Health policy and politics: A nurse’s guide. Jones and

Barlett Learning LLC.

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 and Social Policy, 30:3-4, 259-281.

           https://doi.org/10.1080/08959420.2018.1462683Links to an external site.

Initial Post

The Affordable Care Act helps support and help Americans with health insurance coverage. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL) (HHS, 2022). Expand the Medicaid program to cover all adults with income below 138% of the FPL (HHS, 2022). Policy makers are not necessarily focused on how real people will be affected by the changes but rather on how the changes will affect their own re-election chances (Milstead, 2019). The cost-benefit analysis plays an important role with the government leaders and legislation. The government decides how the tax dollars will be used and where the money will be utilized at. When new or reevaluated policies are being considered the cost is monitored closely. The government wants to know if the cost will benefit the American people or if it’ll cause a hardship.

Several attempts have been made to repeal and even replace the ACA policy. An attempt could help a person’s reelection process in the future. The decision to repeal or replace can also become costly. For so many negatives’ outcomes legislators have become hesitant in the decision. Legislators aren’t ready to make the final decision for the proposal of losing elections and political stance. Change in Presidents can result in citizens wondering if they will still have healthcare coverage and any out-of-pocket expenses.

In 2017, President Trump wanted to repeal and replace Obamacare. The easier road for repeal led Republicans to consider doing that first and then dealing with a replacement, which could take several years. But that strategy has been challenged as health-insurance experts and others have warned that large numbers of people could lose coverage and prices could rise sharply if a replacement is delayed by years, as some Republicans have suggested (Mangan, 2017). That in turn has raised fears that Republicans could suffer politically if they repealed Obamacare without replacing it (Mangan, 2017).  In return the legislators will support the cost benefit legislation if they can benefit from it being cost effective.

On May 2019, the CBO released its score showing that 23 million more Americans will be without coverage in a decade than under the ACA (PSCA, 2019).  The bill overall saves $119 billion over a decade – this number comes from $1.1 trillion in cuts to Medicaid and premium subsidies offset by repealing $874 billion in ACA taxes and fees and spending $117 billion on premium-reduction payments (PSCA, 2019). When policies are created and implemented in regard to healthcare, I believe nurses and the patients will be impacted the most. The ones who benefit the most would be ones who are in charge of the legislation. After all, the President is behind all decisions that will be made, and I believe they also will impact on how the decision will affect future votes.

References

Affordable Care Act (“ACA”) Repeal and Replace. (2019, December 19). Plan Sponsor Council of America. https://www.psca.org/affordable-care-act-aca-repeal-and-replace

Assistant Secretary for Public Affairs (ASPA). (2022, March 16). About the Affordable Care Act. HHS.gov. https://www.hhs.gov/healthcare/about-the-aca/index.htmlLinks to an external site.

Mangan, D. (2017, January 10). Donald Trump says he wants Obamacare repealed and replaced “very quickly or simultaneously.” CNBC. https://www.cnbc.com/2017/01/10/donald-trump-says-he-wants-obamacare-repealed-and-replaced-very-quickly-or-simultaneously.htmlLinks to an external site.

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

Low income citizens unfortunately are finding that the cost of care is becoming more difficult to afford quality healthcare. Unfortunately , politics plays a huge role in making these decisions. Since March 23 2010 the Affordable Care Act (ACA) also known as Obamacare. Obamacare is a law that was created to address the concerns of the high healthcare cost throughout the United States including preventative care and prescription medications. The law was amended by the Health Care and Education Act that helped millions of Americans who unfortunately suffered without the proper healthcare insurance and coverage in order to cover the cost of their expensive treatments. Unfortunately, when the republican party took over they made it their mission to get rid of the ACA. Once the republican party took over the House of Representative in 2016 the republican party tried to abolish what was passed of the ACA (Milstead & Short, 2019). The initial efforts to repeat and replace the ACA were in 2017 after the AHCA was made into law by the House of Representatives (Buntin 2020). President Trump and is party wanted to abolish Obamacare stating that it was costing too much to the American people. Yet, what the Trump administration fails to see is that these individuals were in fact benefiting from Obamacare because they were able to now seek medical attention without fearing how they will pay for it. They failed to realize that this would leave 24 million people out of access to healthcare coverage. Voters were starting become concerned about the extent of their healthcare coverage because the proposed policy would further raise care cost (Courtemacnhe et al., 2021). This would be a huge hit and cause those individuals who have chronic illnesses that require for them to constantly have various treatments and medications now force them to have to pay at a higher rate compared to others. A greater population of Americans were relying on Obamacare as their primary source of healthcare coverage. Regardless of thoughts on the Obamacare Act. The act was created in order to cut cost while also providing those who could not afford healthcare with healthcare benefits. Cost-benefit analysis is what it simply boils down to. What is going to be the most affordable for the individuals who are seeking this care. In the end the goal is to minimize the cost but also be able to provide those individuals with the resources that they need in order to receive the medical help that they need. Unfortunately, those who are opposed to the ACA believe that the conception of this act is not necessary. America is one of the very few countries who have complex checks and balances that we do on the federal, state, and local level (Jarman & Greer, 2020). Unfortunately we as Americans are watching our own healthcare system fall to the ground and the people in the Office do not seem to care since they have money at their leisure.

References:  

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

Buntin MD. (2020). The Affordable Care Act at 10 Years. JAMA Health Forum: 1(7):e200896. Doi:10.1001/jamahealthforum.2020.0896

Courtemanche, C., Fazlul, I., Marton, J., Eckert, B., Yelowitz, A., & Zapata, D. (2021). The   Affordable Care Act’s Coverage Impacts in the Trump Era. Inquiry: a journal of medical Care organization , provision, and financing, 58. 469580211042973. http://doi.org/10.1177/004695801211042973

Jarman, H., & Greer, S.L. (2020). What is the affordable care act a case of? Understanding the  ACA through the comparative method. Journal of Health Politics, Policy and Law, 45(4).  677-691

The Affordable Care Act or “ACA” is the comprehensive health care reform law enacted in March 2010. The goal of this healthcare system was to make health insurance affordable and available to more people. It also allows low-income citizens to obtain health insurance. (U.S. Department of Health & Human Services, 2018) The supporters of the ACA allege it has helped many people to obtain affordable health care and discontinuing it would cause low-income families to suffer financially. (Economic Policy Institute, 2016) There has been much controversy surrounding the legalities of this act and analysis related to cost benefits.

As we approach legislative elections, the number one goal of any legislator is to be re-elected. With that said the politician must appeal to his voters. The larger number of votes currently in America is in the hand of a population that is low-income. (State Laws and Actions Challenging Certain Health Reforms, 2018) The decision to remove or continue ACA is in the hands of the voters. Each politician has their own agenda. Therefore, their platforms are not exactly what they seem.

The cost of medical care even with the ACA is skyrocketing. People still cannot get healthcare. The underserved don’t contribute financially to our country, so the middle and upper-class float the bill for them. It’s an abuse of the system, it encourages people to not work and it dips into the pockets of those that do. I am not in support of this act.  The politicians in support of ACA argue the act is cost-effective, but how much has the ACA cost the taxpayers? How much has the ACA cost taxpayers? 73 million taxpayers earn approximately or under a little under $200,000. This class, the ones that work, will see their taxes rise. The initial estimation of the cost of ACA was much lower than what we have spent. The current cost is now $1.683 trillion a year. (Explaining Health Care Reform: Questions about Health Insurance Subsidies, 2020) This is absurd and working citizens should not have to pay for medical care for those who do not work.

Explaining Health Care Reform: Questions About Health Insurance Subsidies. (2020, October 30). KFF. https://www.kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health-insurance-subsidies/

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State Laws and Actions Challenging Certain Health Reforms. (2018). Ncsl.org. https://www.ncsl.org/research/health/state-laws-and-actions-challenging-ppaca.aspx

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Economic Policy Institute. (2016). How would repealing the Affordable Care Act affect health care and jobs in your state? Economic Policy Institute. https://www.epi.org/aca-obamacare-repeal-impact/Links to an external site.

U.S. Department of Health & Human Services. (2018, December 7). About the ACA. HHS.gov. https://www.hhs.gov/healthcare/about-the-aca/index.html

Discussion of ACA Repeal/Replacement

Healthcare challenges in the United States continue to affect millions of patients. The care costs are increasing and becoming difficult for low-income citizens to afford quality healthcare. Important healthcare decisions are made through the political setting such as using the legislators. For instance, the affordable care act (ACA) has been a crucial healthcare policy in the United States and has helped most people access to care through health insurance (Buntin, 2020). The ACA addressed in a big manner the social justice issues across the country and brought a revolution to healthcare. However, the legislators politicized this policy with the coming of Trump’s administration. Attempt to repeal or replace the ACA policy have been in many times affected and the cost-benefit analysis. For instance, legislators realized that their efforts to repeal or replace the ACA policy would end up negatively affecting the common citizen and their reelection. This would mean that when citizens are hurt then the reelection of members into the political seats would be hindered (Schatman, 2020). Thus, after making the cost-benefit analysis it is clear that the legislators are not ready to make the said proposals for fear of losing their political positions during the election.

The voters’ views regarding the ACA appeal or replacement affect the decisions of the legislators and their positioning of national policies such as Medicare and Medicaid. This is because the voters and their families are concerned only about whether they will still have access to health coverage after the elections. The common voters largely determine the legislators to send to congress and only when their campaign ideas and manifesto resonate with those of the common citizens. The repeal and replacement of the affordable care act emerged as a threat to many legislators who risked being voted out for altering this policy. Thus, the ultimate motive of the politicians is first to get reelected into office hence they fear losing their seats by pushing for such policy changes. The voters aim to have the policy improved to ensure it covers every person in the country in terms of health. For example, the repeal introduced by President Trump’s administration aims at ending the Medicaid expansion to low-income persons and also by reducing federal funding to the beneficiaries. Such motives are seen by voters as a way of eliminating health coverage that has been beneficial to their well-being (Schatman, 2020). Such views by voters greatly affect the legislators’ abilities to make and change policies because they fear being punished through the ballot.

The initial efforts to repeal and replace the ACA were in 2017 after the American health care act (AHCA) was made into law by the House of Representatives (Buntin, 2020). President Trump’s administration’s main ambition was to use the AHCA to eliminate Obamacare. It was however realized that fully adopting the AHCA would remove about 24 million people from health coverage. The voters were getting concerned about the extent of their health coverage because even the proposed policy would further raise care costs (Courtemanche et al., 2021).  Also, Americans suffering from chronic illnesses would be forced to pay higher rates compared to others. The repeal and replacement policy under the AHCA would be more costly and would eliminate most low-income earners from health insurance coverage (Schatman, 2020). Considering such moves the voters were determined to remove most of the legislators and even the entire Trump administration. This has caused the current legislators to be less determined to change health policies that harm the voters because of fear of getting punished like the past regime.

References

Buntin MB. (2020). The Affordable Care Act at 10 Years. JAMA Health Forum; 1(7):e200896. doi:10.1001/jamahealthforum.2020.0896

Courtemanche, C., Fazlul, I., Marton, J., Eckert, B., Yelowitz, A., & Zapata, D. (2021). The Affordable Care Act’s Coverage Impacts in the Trump Era. Inquiry: a journal of medical care organization, provision, and financing, 58, 469580211042973. https://doi.org/10.1177/00469580211042973Links to an external site.

Schatman, M. E., Shapiro, H., & Fudin, J. (2020). The Repeal of the Affordable Care Act and Its Likely Impact on Chronic Pain Patients: “Have You No Shame?”. Journal of pain research, 13, 2757–2761. https://doi.org/10.2147/JPR.S289114Links to an external site.

The first thing that stuck out to me for this week’s discussion prompt was the statement in the prompt, “the number one job of a legislator is to be re-elected”. It is such an obvious statement but helps one understand much about the frustrating nature of politics.  Currently we have a system that relies on incentives, “in the incentives embodied in the system, leaving the task of deciding how to configure the production of care in response to these incentives up to the actors in the market (Pauly, 2011). The goal of the Affordable Care Act (ACA) was to increase the amount of insured individuals in the United States as a way to increase healthcare outcomes. Due to political polarization, the final Act that was passed was viewed as too little action by those left of the aisle, and too much of an overreach by Republicans in congress and the Senate. As a matter of fact, we never got to see the final product as originally conceived due to the changes that were made when the Republican Party took control of the Senate and the House of Representatives in 2016. Shortly after they tried to dismantle what was passed of the ACA (Milstead & Short, 2019). Broadly speaking, the argument over this topic should be one aimed at getting the best insurance for the most amount of people, with one side asking for more government control over insurance, and one asking for less. Ideally, it comes down to a question of cost-benefit analysis and what would be most affordable for the population and the individuals involved. However, the structure of the current political debate regarding healthcare reform seems more like one side is trying to improve things while the other is content with the way things are. The arguments aren’t being made in good faith either. As I mentioned earlier, the ideal conversation regarding healthcare policy would be the most intelligent people in the room debating their two plans at maximizing benefits while minimizing costs. Unfortunately, the ACA has been framed as radical healthcare reform since its conception by those who appose it and thus it has been deemed a luxury and not a necessity. The reality is that in comparison to the healthcare systems of other civilized countries, the ACA, while it extends coverage and promotes equity in a variety of ways, is still only a partial coverage extension by the standards of other rich countries, and it came with a furious and racialized backlash (Jarman & Greer, 2020).

It seems like the United States is far more complex demographically and governmentally than your typical country. Most countries have smaller, more autonomous populations and don’t face the segmentalism that we face in the United States. Most countries don’t have the complex checks and balances that we do on the federal, state, and local level (Jarman & Greer, 2020). In many cases, this system is beneficial. Still, in an instance like this, where the truth of the story is getting lost behind a political narrative, the marginalized members of our society are suffering. Sadly, the reality is that we could get a completely effective government option, or Medicare, for all at not too large of a cost, but we collectively buy into the narrative that we can’t while our healthcare system slowly crumbles and costs escalate.

Jarman, H., & Greer, S. L. (2020). What is the affordable care act a case of? understanding the ACA through the comparative method. Journal of Health Politics, Policy and Law, 45(4), 677–691. https://doi.org/10.1215/03616878-8255589Links to an external site.

Milstead, J. A., & Short, N. M. (2019). Government Response:Legislation. In Health policy and politics (pp. 37–56). Jones & Bartlett learning

Pauly, M. V. (2011). Patient protection and affordable care act cost-containment choices: The case for incentive-based approaches. Journal of Health Politics, Policy and Law, 36(3), 591–596. https://doi.org/10.1215/03616878-1271315

The Affordable Care Act (ACA), also known as “Obamacare,” is the comprehensive health care reform law and its amendments. The law addresses health insurance coverage, health care costs, and preventive care. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010, and was amended by the Health Care and Education Reconciliation Act on March 30, 2010 (Health and Human Services, n.d.). The ACA has helped millions of Americans who have lived years without healthcare afford coverage and seek treatment for acute and chronic illnesses.

“Cost-benefit analysis is a way to compare the costs and benefits of an intervention, where both are expressed in monetary units” (CDC, n.d.). Cost-benefit analysis plays an important role when government leaders decide how tax dollars are distributed. When elected officials examine a specific policy, they consider the amount it will cost and the benefit it will have for the American people. The Senate passed the ACA with a 60-39 vote, with zero Republican party votes (Ballotpedia, n.d.). This vote reflected the voters’ views because they voted along party lines to please their voters in exchange for re-election. Attempts have been made to repeal and replace the Affordable Care Act. The Republican Party has prioritized repealing and replacing the Affordable Care Act. In 2016, the Republican Party took control of the Senate and the House of Representatives, and they began to advocate for repealing and replacing the Affordable Care Act (Milstead & Short, 2019).  In May 2017, the Trump administration passed The American Health Care Act (AHCA) through the House of Representatives (Amadeo, 2019). This was to replace the ACA with AHCA, but this would have left 24 million Americans uninsured and would have also given states the power to suspend many rules that the ACA has and would result in Americans paying more for pre-existing or chronic conditions (Amadeo,2019). The Trump administration failed to do that because not many supported the idea of replacing the ACA NURS 6050 Politics and the Patient Protection and Affordable Care Act.

The primary goal of the legislator is to be re-elected. Legislators must increase their chances of re-election, which necessitates political backing. When presented with legislative demands, legislators are believed to be reasonable and undertake cost-benefit evaluations and their political support. Legislators will support the legislation if the benefit (positive political support) outweighs the cost (negative political support).

                                                                     References

Amadeo (2018). Obamacare repeal and replacement plans: What a congressional

plan to repeal Obamacare would look like. The Balance. Retrieved December 11, 2022, from https://www.thebalance.com/congressional-plans-to-repeal-and-replace-obamacare-4160599Links to an external site.

Ballotpedia. (n.d.). Timeline of ACA repeal and replace efforts. Retrieved December 11, 2022, from https://www.ballotpedia.org/Timeline_of_ACA_repeal_and_replace_effortsLinks to an external site.

Centers for Disease Control and Prevention. (n.d.). Cost-benefit analysis. Retrieved December 12, 2022, from https://www.cdc.gov/policy/polaris/economic/cost-benefit/Links to an external site.

Health and Human Services. (n.d.). Health Care: About the affordable care act. Retrieved December 12, 2022, from https://www.hhs.gov/healthcare/about-the-aca/index.htmlLinks to an external site.

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

The Affordable Care Act’s benefit is to make health insurance more affordable to people. The law provides consumers with subsidies that lower costs for households with incomes between 100% and 400% of the poverty level. (HHS, 2022). It has been reported that the ACA repeal would reduce federal government spending on health care for the nonelderly, which appears to be  on the goals of those advocating repeal. According to the CDC, cost-benefit analysis is a way to compare the costs and benefits of an intervention, where both are expressed in monetary units.(Centers for Disease Control and Prevention, 2020) I do not think legislators being reelected will affect efforts to repeal or replace the ACA seeing as how the benefits of the ACA are  so impactful. On another hand, the re election of legislatures was seldom challenged, and voters became convinced that policy making would be better served by changing the lawmakers on a more regular basis. (Milstead & Short, 2019)

Voter views most certainly affect decisions being made by legislatures. For example, the desire to win reelection makes legislators work harder in key legislative areas that are visible to constituents. Voters who are relying on government-backed insurance such as Medicare and Medicaid provide the data that legislatures need to support voters. I would like to believe that legislatures believe that they are doing the right thing and that during difficult decisions, will use their own beliefs and morals. I am also 100% sure this is not always the case.

References

Centers for Disease Control and Prevention. (2020, May 12). The Affordable care act:policy and law. CDC.gov. Retrieved December 13, 2022, from www.cdc.gov

Milstead, J. A., & Short, N. M. (2019). Government Response:Legislation. In Health policy and politics (pp. 37–56). Jones & Bartlett learning .

U.S. Department of health and human services. (2022, March 17). About the affordable care act. HHS.gov. Retrieved December 13, 2022, from www.hhs.gov  NURS 6050 Politics and the Patient Protection and Affordable Care Act