Agenda Comparison Grid and Fact Sheet
Agenda Comparison Grid and Fact Sheet Sample 1
Healthcare Insurance Access for Underserved Adults
I selected healthcare insurance access for underserved adults because many adults with low incomes depend on Medicaid or ACA Marketplace plans for basic and long-term care. Policy changes can alter coverage quickly, which affects health outcomes and access to needed treatment. This paper compares two presidential agendas, analyzes agency roles, and presents a fact sheet for legislative communication.
Part 1: Agenda Comparison Grid
| Identify the Population Health concern you selected. | Healthcare insurance access for underserved adults is a serious population concern, Many adults have low incomes, limited employer insurance, and rely on Medicaid or ACA Marketplace subsidies. | |
| Describe the Population Health concern you selected. | Underserved adults, who often rely on Medicaid or Marketplace plans for routine care and treatment of chronic illness are strongly affected by policy changes in Medicaid, and by changes in the ACA subsidies, which can increase or reduce their access to healthcare with life or death repercussions. That is why this issue is so important for national and state leaders. | |
| Administration (President Name) | Biden administration | Trump administration |
| Explain how each of the two presidential administrations approached the issue. | The Biden administration approached this issue by increasing federal support for ACA enrollment and expanding subsidies. The administration restored full Navigator funding, reopened enrollment periods, and removed barriers created by the previous administration (White House, 2025). It also enhanced premium tax credits through the American Rescue Plan Act and later extended them. These actions made insurance more affordable and easier to access. Medicaid work requirements were withdrawn or blocked, and enrollment systems were improved. The administration also increased outreach to underserved communities. These steps supported record ACA enrollment in 2025 and improved access for adults who have low incomes (White House, 2025). | The Trump administration approached this issue by reducing federal support for ACA enrollment and by adding new rules that made enrollment harder for adults with low incomes. The administration cut Navigator funding by ninety percent, shortened the enrollment period, and removed automatic re-enrollment (Pifer, 2025). The administration also supported Medicaid work requirements and encouraged states to increase eligibility checks. These policies reduced outreach, increased confusion, and raised the risk of coverage loss for underserved adults. The House Republican bill, the One Big Beautiful Bill Act, continued this direction (McIntyre et al., 2025). It included large cuts to Medicaid and ACA subsidies. It created new work requirements, new income verification rules, and shorter enrollment periods. It also raised out-of-pocket costs for many families. The intent of the bill was to reduce federal health spending, but the effect was a sharp reduction in coverage. |
| Identify the allocations of resources that the current and previous presidents dedicated to this issue. | Increased Navigator funding. Expanded subsidy funding through ARPA and IRA (White House, 2025). Strengthened CMS staffing. Increased federal investment in outreach and enrollment support. | Navigator funding reduced from $98 million to $10 million (Pifer, 2025). Reduced federal spending for outreach. Supported legislation cutting $800 billion from Medicaid and ACA subsidies over ten years. The Congressional Budget Office estimates that proposed legislation would reduce Medicaid enrollment by approximately 10 million people and increase the uninsured population by 7.6 million (McIntyre et al., 2025). Federal Medicaid expenditure reductions under consideration range from $625 billion to $880 billion over ten years, with significant impacts on coverage for underserved adults (Gaffney et al., 2025). |
| General Notes/Comments | As a result of this administration’s policies, people had improved access and lower premiums (White House, 2025). This resulted in stronger protection for adults with low incomes and chronic conditions. | The policy changes instituted by the Trump administration resulted in an increased risk of coverage and higher costs for those who remain insured. Research suggests that proposed Medicaid funding reductions could lead to substantial coverage losses among low-income adults, with an estimated 10.3 million people losing Medicaid enrollment and large increases in preventable mortality (Gaffney et al., 2025). |
Part 2: Agenda Comparison Grid Analysis
| Administration | |
| Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected? Why is this agency the most helpful? | Healthcare insurance access for underserved adults is shaped by federal agencies that create rules, guide the states, and manage these huge programs. The agency that would help me address this issue is the Department of Health and Human Services (HHS), especially the Centers for Medicare & Medicaid Services (CMS). HHS and CMS manage Medicaid and the ACA Marketplace, so they have the authority to create enrollment rules, guide outreach work, and monitor state actions. CMS also gives states technical support when they try to improve enrollment systems. This makes CMS the most helpful agency for my issue, because the agency already manages the programs that underserved adults depend on. |
| How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there? | This issue would get on the presidential agenda when national leaders see large coverage losses, rising costs for families, and major changes in political support for their party. A president usually pays attention when many people lose access to care or when advocacy groups and professional groups share strong evidence of harm. When I see the steady rise in the number of adults who need help paying for insurance, I understand why leaders continue to focus on this topic. Strong media coverage and moving stories from people who lose insurance also help keep the issue in the public eye and affect public opinion and voting behavior. |
| Who would you choose to be the entrepreneur/champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected? An example is Michael J. Fox a champion for Parkinson’s disease. | A policy issue like this one needs a champion who understands health equity and who can speak directly to lawmakers. My choice for champion is Ernest Grant, PhD, RN, FAAN, the former president of the American Nurses Association. Dr. Grant has a long history of advocating for improved access to care and supporting underserved communities. He understands the daily challenges faced by adults who cannot pay for insurance and often miss care for chronic illness. He also knows how federal policy affects the practice environment for nurses. Dr. Grant meets often with federal leaders, and he uses evidence and strong communication skills to work for health equity. These qualities make him an effective champion for expanding insurance access and reducing barriers that keep many people from getting care. |
| Analysis | Research demonstrates that nurse-led care models can advance whole-person health and health equity within Medicaid programs serving underserved populations (Johnson et al., 2024). The ACA Medicaid expansion reduced racial and ethnic disparities in healthcare access, though significant inequities persist in non-expansion states (Osmani, 2025). Long-term studies show that adults who gained coverage through ACA expansions experienced improved health outcomes and reduced costs when entering Medicare (Tipirneni et al., 2025). |
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Part 3: Fact Sheet
HEALTHCARE INSURANCE ACCESS FOR UNDERSERVED ADULTS
THE ISSUE
- Millions of low-income adults depend on Medicaid and ACA Marketplace subsidies for essential healthcare coverage
- Policy changes can rapidly alter coverage access, directly impacting health outcomes and survival
- Gaining coverage is linked to improved long-term health outcomes and reduced costs upon entering Medicare, making this a fiscally responsible long-term investment (Tipirneni et al., 2025).
KEY FACTS FROM PRESIDENTIAL ADMINISTRATIONS
Biden Administration:
- Restored Navigator funding and expanded premium subsidies through ARPA and IRA (White House, 2025)
- Achieved record ACA enrollment in 2025 with improved access and lower premiums (White House, 2025)
- Strengthened CMS staffing and increased federal investment in enrollment support (White House, 2025)
Trump Administration
- Reduced Navigator funding from $98 million to $10 million (90% cut) (Pifer, 2025)
- Congressional Budget Office projections indicate that recent legislative proposals would reduce Medicaid spending by hundreds of billions of dollars and result in 7.6 million additional uninsured Americans (McIntyre et al., 2025).
- Created administrative barriers including work requirements and shortened enrollment periods (McIntyre et al., 2025)
FEDERAL AGENCY RESPONSIBILITY
- The Centers for Medicare & Medicaid Services (CMS) within HHS manages Medicaid and ACA Marketplace programs
- CMS creates enrollment rules, guides states, and provides technical support for enrollment systems
WHY NURSES MUST BE INVOLVED
- Nurses are the largest healthcare workforce and witness firsthand how insurance gaps affect patient outcomes
- Nurses possess clinical evidence and patient stories that can inform effective policy decisions
- Professional nursing organizations have direct access to federal policymakers and can champion health equity
- Nurses must actively counter political interference in health policy decisions to protect evidence-based care for vulnerable populations (Taylor et al., 2017)
CALL TO ACTION
- Maintain and expand Navigator funding to ensure enrollment support
- Protect premium subsidies and Medicaid eligibility for underserved adults
- Engage nurses in policy discussions to bring clinical evidence to legislative decisions
Conclusion
Access to affordable healthcare insurance is essential to protect people’s lives and improve health outcomes for underserved adults. The comparison of presidential agendas shows large differences in support and funding priorities. CMS is a key player in this issue, but it is dependent upon funding at the congressional level, and nurse leaders must keep this issue active in the political arena in order to support health equity.
References
Gaffney, A., Himmelstein, D. U., & Woolhandler, S. (2025). Projected effects of proposed cuts in federal Medicaid expenditures on Medicaid enrollment, uninsurance, health care, and health. Annals of Internal Medicine, 178(9). https://doi.org/10.7326/ANNALS-25-00716
Johnson, C., Ingraham, M. K., Stafford, S. R., & Guilamo-Ramos, V. (2024). Adopting a nurse-led model of care to advance whole-person health and health equity within Medicaid. Nursing Outlook, 72(4), https://doi.org/10.1016/j.outlook.2024.102191
McIntyre, A., Kim, J., & Sommers, B. D. (2025). New Medicaid enrollment barriers and lessons from unwinding. JAMA Health Forum, 6(9), e254849. https://doi.org/10.1001/jamahealthforum.2025.4849
Osmani, A. R. (2025). Unequal gains? A literature review on the Affordable Care Act’s effects on healthcare utilization across racial and ethnic groups. International Journal of Environmental Research and Public Health, 22(7), 1059. https://doi.org/10.3390/ijerph22071059
Pifer, R. (2025, February 18). Trump administration slashes funding for ACA navigators. Healthcare Dive. https://www.healthcaredive.com/news/trump-slashes-aca-navigator-funding-cms/740180/
Taylor, D., Olshansky, E. F., Woods, N. F., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to: Political interference in sexual and reproductive health research and health professional education. [Nursing Outlook, 65(2), 242–245]. Nursing Outlook, 65(3), 346–350. https://www.nursingoutlook.org/action/showPdf?pii=S0029-6554(17)30262-2
The White House. (2025, January 8). Fact sheet: Biden-Harris administration announces record-breaking 2025 open enrollment period under the Affordable Care Act. https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2025/01/08/fact-sheet-biden-harris-administration-announces-record-breaking-2025-open-enrollment-period-under-the-affordable-care-act/
Tipirneni, R., Roberts, E. T., Levy, H. G., et al. (2025). Health care utilization and costs for older adults aging into Medicare after the Affordable Care Act. JAMA Health Forum, 6(1), e245025. https://doi.org/10.1001/jamahealthforum.2024.5025
Agenda Comparison Grid and Fact Sheet Sample 2
Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2: Assignment
Introduction
One ongoing public health crises affecting countries across the globe is opioid. It is characterized by a high incidence of opioid addiction, fatal overdoses, and skyrocketing costs in terms of health care and social implications. It is even worse in rural and low-income areas to the point where health care and police services are overstretched. Several presidential terms have developed measures to resolve the crisis, and each has its strategies. This paper contrasts the Biden and Trump administrations and underscores the necessity for representing and eradicating this issue through legislation and public health campaigns.
Part 1: Agenda Comparison Grid
| Identify the Population Health concern you selected. | Opioid Crisis | |||
| Describe the Population Health concern you selected. | Opioid refers prescription of heroin and other synthetic opioids, for example, fentanyl. It has resulted in alcoholism, instances of deaths through substance overdose, and high expenses on health as well as other social services. It has tremendously affected health care, especially in rural areas, and is still a burden to medical and the police (Centers for Disease Control and Prevention, 2022).
GET ASSIGNMENT HELP HERE |
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| Administration (President Name) | Biden Administration | Trump Administration | ||
| Explain how each of the two presidential administrations approached the issue. | The administration of Biden has put more focus on the pro-health aspect of the opioid epidemic treatment rather than increasing access to services for addiction treatment, as well as making naloxone more available. President Biden has advocated for funding in the American Rescue Plan and other statutes to address substance use and overdose and has especially emphasized race and socioeconomic justice in treatment. | Prevention and treatment measures were in the balance, but primarily, the Trump administration opted for a law enforcement approach concerning Illegal drug trafficking. In 2017, Trump as the President by then called the opioid crisis a public health emergency and worked for legislative approaches. The approaches were meant Support for Patients and Communities Act aimed at strengthening opioid treatment programs and increasing access to addiction services Agenda Comparison Grid and Fact Sheet. | ||
| Identify the allocations of resources dedicated to this issue by the current and previous presidents. |
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During the administration of Trump s $6 billion were set aside for two years to fight the opioid crisis, with the intended funding for states and communities for treatment and recovery and other programs. In the past, the Support Act gave healthcare professionals and law enforcement tools to deal with substance use disorders Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2: Assignment | ||
Part 2: Agenda Comparison Grid Analysis
| Administration | |
| Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected? Why is this agency the most helpful?
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The agencies that would most respond to the opioid problem are the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention. HHS has main regulatory authority over public health activities, health insurance accessibility, and substance use treatment programs through sister agencies such as the SAMHSA. The CDC has to track data and monitor the success or otherwise of its interventions concerning opioid overdoses.
These agencies are the most helpful because they address both the public health and medical sides of the disaster. The U.S. Department of Health & Human Services (HHS) facilitates the expansion of medication-assisted treatments (MAT), while the CDC is important for research and monitoring of overdoses to inform policy changes. |
| How might your selected healthcare issue get on the presidential agenda? How does it stay there? | The opioid crisis can thus get to the presidential agenda through public pressure, the media and statistics. The opioid overdose death rate, which has crossed a hundred thousand in the U. S, remains an area of interest in the current social trends as it continues to attract the attention of the citizens as well as the policymakers.
Facing Addiction and MAPDA are other important players who constantly push for the realization that the opioid crisis exists through engaging Congress as well as the public. These approaches seem to be likely to remain on the presidential agenda as long as the rates of addiction and overdoses are relatively high and there is a new increasing bipartisan interest in the development of integrated drug policies. As a result, public health and safety may remain a concern in the future, which will sustain the issue focused on in the discussion of the nation (White House 2019). |
| Who would you choose to be the entrepreneur/ champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected? An example is Michael J. Fox, a champion for Parkinson’s disease. | One more vigorous supporter of the opioid crisis is Senator Rob Portman. As argued by White House. (2019) Senator Rob Portman has supported more affordable holistic opioid addiction treatment programs; he has also pushed for and worked on both sides of the CARA or Comprehensive Addiction and Recovery Act Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2: Assignment
In addition, Macklemore musician, who has talked about his opioid use disorder, can become an advocate. That is why his participation in programs dedicated to addiction recovery and campaigns for young people will be effective and helpful in removing the stigma of seeking assistance. |
Part 3: Fact Sheet
Title: Addressing the Opioid Crisis: A National Priority
Overview:
The opioid crisis is one of the unprecedented incidents which developed into a significant threat to the public health system of the U. S., claiming at least one hundred thousand overdose fatalities per year. It has affected the health care delivery systems especially in the rural regions and has put much pressure in the public health and law enforcement organs. Infection continued to rise during both the Biden and Trump administrations; efforts have been made to address the lack of treatment, further the prevention, and maintain the nation’s health infrastructure.
Why it Matters:
- Opioid affects a large population of people in the United States and has suppressed their lives by raising the number of deaths, healthcare costs, and social services expenditures.
- If left unaddressed, the crisis will persistently worsen and stretched public health care and Sunday families and communities.
- Agenda Comparison Grid and Fact Sheet – Walden University NURS-6050 Week 2: Assignment
- It is crucial to act in order to make addiction treatment, overdose prevention as well as care for affected individuals accessible to everyone.
Nurse’s Role in Policy Setting:
- Nurses have a particular duty of promoting health reforms in the population and supporting the patients diagnosed with SUDs.
- Thus, there is nothing as strategic as empowering nurses as they turn out to have the right outlook that is required in making policies concerning the treatment of opioid addition and the prevention of opioid overdose.
- Advocacy can be done by the nurses through educating other people, working with policymakers, and see to it that these policies reflect patient’s needs.
Summary/Conclusion
Opioid crisis is involving numerous overdose deaths per year and continues to strain healthcare facilities. Both the Biden as well as Trump governments have previously taken the measures. The Biden administration has been active in increasing access to addiction treatment and access to naloxone coupled with the promotion of health care equity. On the other hand, the current Trump’s administration prefers the law enforcement approach by enacting the Support Act needed for further expansion of treatment and recovery initiatives. Major governmental entities including HHS and CDC are involved in the identification of emerging overdose patterns and the coordination of treatment interventions. Both Democratic and Republic politicians and advocates have been able to keep the crisis as one of the main priorities in the country. This profession play a very important role in formulation of the healthcare policies based on their experience and observations of different programs and patients needs in order to come up with the correct policies that are workable and respected by patients.
References
White House. (2019). Trump administration’s efforts to combat the opioid crisis. Office of National Drug Control Policy. https://www.whitehouse.gov/ondcp/presidential-efforts
Centers for Disease Control and Prevention. (2022, March). Understanding the epidemic. CDC. https://www.cdc.gov/drugoverdose/epidemic/index.html
To Prepare:
- Review the agenda priorities of the current/sitting U.S. president and at least one previous presidential administration.
Tip: You can locate presidential agenda information by searching Google for your health topic and the president. For example, mental health Obama presidential agenda. - Select an issue related to healthcare that was addressed by two U.S. presidential administrations (current and previous).
- Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda.
- Use your Week 1 Discussion post to help with this assignment.
The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page. This is an APA paper. Use 2-3 course resources and at least 2 outside resources.
Part 1: Agenda Comparison Grid
Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the previous president, and their agendas related to the population health concern you selected. Be sure to address the following:
- Identify and provide a brief description of the population health concern you selected.
- Explain how each of the presidential administrations approached the issue.
- Identify the allocation of resources that the presidents dedicated to this issue.
Part 2: Agenda Comparison Grid Analysis
Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:
- Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected and why is this agency the most helpful for the issue?
- How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there?
- An entrepreneur/champion/sponsor helps to move the issue forward. Who would you choose to be the entrepreneur/champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected and why would this person be a good entrepreneur/ champion/sponsor? An example is Michael J. Fox is champion for Parkinson’s disease.
Part 3: Fact Sheet
Using the information recorded on the template in Parts 1 and 2, develop a 1-page fact sheet that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following:
- Summarize why this healthcare issue is important and should be included in the agenda for legislation.
- Justify the role of the nurse in agenda setting for healthcare issues.
Assignment document should include:
- Title page
- Introductory paragraph
- Agenda comparison grid and analysis
- Fact sheet
- Summary/conclusions
- References
