NURS 6050 Discussion: Politics and the Patient Protection Act -

NURS 6050 Discussion: Politics and the Patient Protection Act

Sample Answer for NURS 6050 Discussion: Politics and the Patient Protection Act Included After Question

Given the high and rising expense of healthcare, it appears that the postelection efforts to repeal, replace, or reform the Affordable Care Act (ACA) will not end the acrimonious discussion over healthcare coverage. Approaches that are feasible and have the potential to be bipartisan should prioritize health care reform to attain greater quality at a reduced cost (MarkJapingaLinks to an external site.,2018). Combining high-risk pools, reinsurance, and risk adjustment could expand coverage alternatives and promote innovative approaches to treating the highest-risk patients in the individual market, where many consumers are faced with limited options and increasing prices (Mark McClellanLinks to an external site.,2018 ).Federal reforms that offer greater flexibility for state Medicaid programs, which are becoming more and more significant sources of coverage but are crowding out other crucial budget priorities that affect population health, could improve outcomes.

If Medicare were expanded to cover all age groups, a national program known as Medicare for All, many of the issues with the Affordable Care Act would be resolved. All Americans would have lifetime automatic coverage. Medicare taxes would take the place of premiums. There would be no cost sharing with the patient. People would be able to choose whatever doctor they wanted. Medicare’s ability to negotiate as a single payer would limit price rises and lower the share of GDP that is spent on healthcare. For economically developed countries, taxes as a proportion of GDP would increase from below average to average. Age-based phases would apply to Medicare for All.

Medicare for All, ideally implemented, could offer powerful advantages over our current health care financial system. Unfortunately, the political obstacles to such a system are formidable and are likely to remain so for decades. More to the point, a politically viable single-payer system would not replace our currently dysfunctional health care politics. It would be a product of that same legislative process and political economy and thus be disfigured by the same interest group politics, path dependence, and fragmentation that Laurence Seidman rightly laments.

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.

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.

A Sample Answer For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

Citizens of the United States were presented with a new healthcare reform act known as the Patient Protection and Affordable Care Act in 2010. The Patient Protection and Affordable Care Act also known as Obamacare was intended to develop healthcare and health insurance businesses in America. The main aim of Obamacare is to increase new benefits for healthcare, more patient rights, more patient protection, and making healthcare more affordable and accessible to the citizens in the United States. Attempts to repeal and replace Obamacare has been a subject matter constitutionally contested and have the subtle meaning of egotism by politicians to capitalize on voter support. From a cost-benefit approach, for a system to be cost-effective, the benefits must be higher in comparison to the amount acquired during the enactment of the program (Milstead & Short, 2019). When the Patient Protection and Affordable Care Act was developed, it made access to healthcare available to most of the American citizens, and thus, repealing and replacing the act will make political lawmakers lose voter support.

Despite reported accomplishments by the Affordable Care Act, there is still political deliberation to repeal and replace. Many political leaders are concerned that if the Act is repealed many Americans will lose coverage by insurance companies (Taylor, et al., 2017). Consequently, many low-income or middle-class families insured under the Act by the Medicaid program will lose their coverage. A study by DaVanzo (2016), projected that if the Affordable Care Act is repealed, by 2026 the number of uninsured persons would have increased by 22 million persons which can lead to an unparalleled heath crisis as persons would no longer be covered and able to receive the care they need.

Since the Act has been enacted, it has encountered many disputes amongst politicians. Since in office, the Trump administration has attempted to repeal and replace Obamacare but has since not succeeded. During his elections, many legislators supported this idea but at present time, considers this decision a liability as they are up for re-elections (Hawryluk, 2020). Legislators are more likely to support agendas that are favorable to them based on a cost-benefit analysis. As such, repealing The Affordable Care Act will not be of benefit to them and the American people. Therefore, they are unlikely to reverse the act.

The Affordable Care Act allows for many Americans to have access to services in healthcare and repealing the Act will only make legislators lose the voter support they want. Most political decisions and policies are driven by and appeal to the expectations of their voters.

NURS 6003 Discussion Politics and the Patient Protection Act

References

DaVanzo, D. (2016, December 6). Estimating the Impact of Repealing the Affordable Care Act on Hospitals. Retrieved from AHA.org: https://www.aha.org/system/files/2018-02/impact-repeal-aca-report_0.pdf

Hawryluk, M. (2020, August 28). Opposition to Obamacare Becomes Political Liability for GOP Incumbents. Retrieved from 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 (6 ed.). Burlington, MA: Jones & Bartlett Learning.

Taylor, D., Olshansky, E. F., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017, May 1). Corrigendum to position statement: Political interference in sexual and reproductive health research and health. Nursing Outlook, 65(3), 346-350. doi:https://doi.org/10.1016/j.outlook.2017.05.003

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS:NURS 6003 Discussion Politics and the Patient Protection Act

A Sample Answer 2 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

For legislators, supporting legislation or supporting legislation being repealed can come at a great cost and influences their decision greatly. The act of supporting a piece of legislation that is not popular with the constituency that elected them may end up costing them more. This could be in the form of more campaign dollars to gain the favor of the public again or it could just cost them their position entirely. The same could be said for supporting legislation being repealed. When we keep in mind that their number one goal is to be reelected, they will likely opt for what they think makes them most popular with the public that elected them. It would likely benefit the legislator to be consistent with the party that they align themselves with for networking purposes as well. The ACA was a very democratic lead legislation, being passed with no republican votes (Walden University LLC, 2018b). Therefore, if a legislator is aligned with the Republicans, it may be in their best interest to oppose the ACA or look to revise it.

The monetary cost of repealing or replace the ACA according to the Committee for a Responsible budget is as follows: a full repeal of the ACA would cost 350 billion dollars, and money saved from repealing the ACA coverage positions would save 1.55 trillion (2021). One would also have to consider how repealing the ACA would leave many without health insurance. Looking at the problem from a monetary standpoint, a legislator on the Republican side would likely be more in favor of repealing or replacing and editing the ACA due to Republicans tendency towards conservative spending. While a legislator aligned with the Democrats would likely favor keeping the ACA which would aid the numerous people who gained health insurance through the act.

Also, the Lobbyists who contribute to campaigns, likely greatly impact the decision of the legislator. The ACA is a very polarizing topic in politics. That being said, a legislator’s stance on it will greatly shift their public view. According to Milstead and Short, 2019, as a part of the expansion of the risk pool in the ACA, many insurers backed out of the Health Insurance Exchanges (p. 176). Some of these insurance companies could contribute funding to some legislators, thus impacting their decision. Looking at what the ACA could still accomplish if left in place and maybe revised, there are still 25 million uninsured people in the United States. These are potential voters for a legislator that chooses to support the ACA (Walden University LLC, 2018a). Moreover, it is quite concerning how much of a focus on re-election there is in politics, when you would think that the goal of politics would be to have a positive impact on the public.

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

Module 2: Legislation (Weeks 3-4)

Laureate Education (Producer). (2018). Legislation [Video file]. Baltimore, MD: Author.

Learning Objectives
Students will:

Analyze how cost-benefit analysis affects legislative efforts
Analyze legislative intent of bills
Identify proponents and opponents of bills
Analyze legislative process of bills
Advocate policy position for bills

Due By
Assignment
Week 3, Days 1-2
Read/Watch/Listen to the Learning Resources.
Compose your initial Discussion post.
Week 3, Day 3
Post your initial Discussion post.
Begin to compose your Assignment.
Week 3, Days 4-5
Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to compose your Assignment.
Week 3, Day 6
Post at least two peer Discussion responses on two different days (and not the same day as the initial post).
Week 3, Day 7
Wrap up Discussion.
Week 4, Days 1-6
Continue to compose your Assignment.
Week 4, Day 7
Deadline to submit your Assignment.

Learning Resources

Required Readings

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

Chapter 3, “Government Response: Legislation” (pp. 37–56)
Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)

Congress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003.

United States House of Representatives. (n.d.). Retrieved September 20, 2018, from https://www.house.gov/

United States Senate. (n.d.). Retrieved September 20, 2018, from https://www.senate.gov/

United States Senate. (n.d.). Senate organization chart for the 115th Congress. Retrieved September 20, 2018, from https://www.senate.gov/reference/org_chart.htm

Document: Legislation Comparison Grid Template (Word document)

Required Media

Laureate Education (Producer). (2018). Working with Legislators [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author.

Credit: Provided courtesy of the Laureate International Network of Universities.

Laureate Education (Producer). (2018). Contemporary Issues in Public Health Policy with Joel Teitelbaum [Video file]. Baltimore, MD: Author.

Laureate Education (Producer). (2018). Peter Beilenson: Population Health [Video file]. Baltimore, MD: Author.

A Sample Answer 4 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

The Affordable Care Act (ACA) of 2010, popularly known as Obamacare, is a law that intended to make sure that all Americans had access to health insurance. One of its key factors is that it is determined to ensure that low-income earners can access health services. Most of such people are unemployed, with disabilities, tasked with household responsibilities, or unable to meet the necessity because of the history of their health, such as a chronic disease or medical condition. However, the act is an issue to various political debates with some advocates arguing that it will ensure improved longevity to Americans and advocates stating that it is not in line with the development agenda. The ACA has various winners and losers in terms of legislators seeking reelection and voters having differing interests in the enactment of the policy.

The impact of the enactment of the ACA policy has positive and negative impacts on policymakers seeking reelection. Concerning elected members, those who voted for the bill would benefit by serving people. On the other hand, most politicians are funded by pharmaceutical and medical corporate organizations that make one of the most significant industries in the United States (Hathi & Kocher, 2017). Therefore, although lawmakers will benefit from the electorate’s goodwill, they will lose from the campaign funds. On the other hand, the ACA policy has immeasurable benefits to voters (McKay, 2018). Therefore, ACA influences people positively and negatively.

ACA has positive and negative impacts on the electorate. The higher income citizens realize that the act is a corrective measure towards people earning higher incomes that the unprivileged ones because of the increased taxes. In contrast, lower-income citizens perceive the act as beneficial because most of them have suffered because of lack of sufficient funds to access healthcare services (Milstead & Short, 2019). Therefore, the perception depends on the income of the person.

The cost-benefit analysis affects those legislators who are seeking reelection because they must balance between their need to appease the people and ensure that they can access funds from the corporate entities. The legislators must guarantee that all people are satisfied with the policy. The most significant embarrassment is that politicians are not in a position to please the entire electorate because some Americans, mostly the low-income earners, are concerned about their wellbeing, while others are concerned about having to take care of other humans in the market. Moreover, legislators must consider the impact of their decisions to support the policy and their need to garner campaign money from affected companies.

References

Hathi, S., & Kocher, B. (2017, July/August). The right way to reform health care: To cut costs, empower patients. Foreign Affairs, 96, 17-25.

McKay, A. M. (2018). Fundraising for favors? linking lobbyist-hosted fundraisers to legislative benefits. Political Research Quarterly, 71(4), 869-880. doi:http://dx.doi.org/10.1177/1065912918771745

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

A Sample Answer 5 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

Thank you for your interesting post. The Affordable Care Act is indeed a beneficial law. According to HHS.gov (n.d.), “the law addresses health insurance coverage, health care costs, and preventive care.” Many Americans and immigrants benefited from this law as it reflects equality when accessing health care services. For instance, I know a family friend of mine who is a low-income worker. He has a chronic condition and was unintentionally non-compliant with his medications and doctor follow-ups because of high co-payments or total out of pocket spending. However, when the ACA was signed in 2010, he decided to take the opportunity of accessing all the health care benefits that he could get. He started availing free medications and following up with his doctors. It also has been easier for him to attend preventive programs to avoid condition exacerbation.

Unfortunately, just like the other laws, the Affordable Care Act is not perfect and needs improvement as it affects high-income workers. But instead of improving it, many people who are against the law want it repealed instead. This is where the legislator’s discretion on cost-benefit analysis is applied; it is a “way to compare the costs and benefits of an intervention, where both are expressed in monetary units” (CDC.gov, n.d.). Even if the legislator intends to make an acceptable policy for the goodwill, they would also have to consider the campaign funds that they will need to be re-elected. According to Glassman (2018), “most of the time, members of Congress do want to pass good public policy, but they also have two other important goals, re-election and increased power in the legislature.”

In the end, I still believe that it is always ideal for the legislators to depend on their decision making for the public good without thinking about the electoral consequences. But just like an ordinary individual, legislators have needs to fulfill, and number one of them is to be re-elected.

References

Glassman, M. (2018, February 7). Why congress doesn’t always do the right thing. The New York Times. Retrieved September 16, 2020, from

https://www.nytimes.com/2018/02/07/opinion/congress-incentives-public-good.html

What is the affordable care act? (2015, June 7). HHS.gov. Retrieved September 16, 2020, from

https://www.hhs.gov/answers/affordable-care-act/what-is-the-affordable-care-act/index.html

Cost-benefit analysis. (n.d.). Centers for Disease Control and Prevention (CDC). Retrieved September 16, 2020, from

https://www.cdc.gov/policy/polaris/economics/cost-benefit-analysis.html

A Sample Answer 7 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

The Affordable Care Act (ACA) legislation was enacted into law to ensure all Americans had access to a health care plan that provided both adequate and affordable health care coverage. This legislation has been the subject of discussion and political debate since. In our cost-benefit analysis we consider what the ACA and changes to the ACA mean politically and for the individual American.

The ACA provides access to affordable health care coverage, and it has helped many Americans. A February 2019 article indicated about twenty million Americans were no longer uninsured since the implementation of the ACA in 2010 (McIntyre & Song, 2019, p.1). Prior to the law being passed, many Americans were either not covered or had inadequate health care coverage. The reason for the lack of adequate coverage in some cases was strictly because the coverage was not affordable, and in other cases it was a matter of coverage not being available through their employer(s) or the available coverage was inadequate. Another big concern for would-be insurance shoppers prior to the implementation of the ACA was pre-existing conditions. The Affordable Care Act addressed all of these situations and concerns. Republican posturing about repealing the ACA in its entirety left the many Americans that have benefitted from the law concerned and wondering if they will again be unable to afford adequate health care coverage for themselves and their families.

Mr. Himes, US Representative from the fourth district of Connecticut, stated while addressing the House that one of the proudest moments of his career in the Chamber “was the passage of the Affordable Care Act, not because it was perfect–it wasn’t–but because it changed the lives for the better of tens of millions of Americans.” (H. Rep No. 165-108, 2019, H5176). In an attempt to illustrate what repeal would look like, he goes on to say “overturning the ACA would raise the number of uninsured people in the United States by 20 to 21 million people. Due to preexisting conditions, more than 100 million Americans could face higher health insurance premiums or the possibility that they might not get insured at all” (H. Rep No. 165-108, 2019, H5176). There are parts of the ACA that many Americans agree should stay, and therefore a total repeal of the ACA seems like a gamble. Mr. Himes asks that as you consider the claim from his “Republican friends that they will preserve preexisting condition coverage, remember that they promised for 10 years to repeal the Affordable Care Act, and they didn’t do it. Then they promised to repeal and replace the Affordable Care Act, and they didn’t do it. So when they promise to preserve preexisting conditions, take that with a grain of salt” (H. Rep No. 165-108, 2019, H5176). It is fair to point out that politicians do not always do what they say they will do, but that is of little comfort to the millions of Americans worried about losing their health insurance coverage.

“Nearly nine years after its passage, the Affordable Care Act (ACA) remains at the forefront of public policy debate” (McIntyre & Song, 2019, p.1), which is worth mentioning since the textbook for this course points out that “policymakers are not necessarily focused on how real people will be affected by changes to Obamacare or Medicare and Medicaid but rather on how the changes will affect their own re-election chances” (Milstead & Short, 2019, p.44). Cost-benefit analysis of the changes to the ACA and the politics surrounding it, along with the potential loss of favor and even future votes for elected officials, highlights the potential for politicians to make decisions they feel will cost them the least votes. The fact that too much deviation from an agreed party agenda could cost a politician favor and votes is something they must consider if they would like to remain in office.

Bottom line, one should consider that elected officials’ decisions could be, at least in part, based on how the decision will impact their future in politics. Unfortunately, this could mean that not all political decisions are being made in the best interest of the American people but rather in the best interest of elected officials worried about losing their jobs. Given this thinking, counting on a politician keeping a promise that might make it harder for him or her to get reelected seems foolish. Therefore, Americans are right to be concerned that a complete repeal of the ACA could remove protections without replacing them in any new health care legislation.

References

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

ed.). Burlington, MA: Jones & Bartlett Learning.

McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a

decade. PLoS medicine, 16(2), e1002752. https://doi.org/10.1371/journal.pmed.1002752

165 Cong. Rec. No. 108. (June 26, 2019) p.H5176. (statement of Rep. Himes)

A Sample Answer 8 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

Legislators who assume elective positions are always determined to support initiatives that will influence voters to re-elect them. However, due to competing interests of the government, some legislators might get concerned with the potential impacts that some bills, when signed into law, might affect their possibilities of getting re-elected (The Commonwealth Fund, 2017). Borrowing from the events that surround the efforts to repeal/replace the Affordable Care Act (ACA), conducting a cost-and-benefits analysis, in terms of both dollars and votes, can help legislators to decide whether they should support or oppose government initiatives.

Repealing/replacing the ACA is associated with benefits and costs measured in dollars and votes. According to the Committee for a Responsible Federal Budget. (2017), the cost of repealing or replacing the ACA through 2027 is estimated to be 350 billion United States dollars. However, the United States government will save approximately 1.55 trillion through 2027 when only the coverage provisions of the ACA are replaced. It is further anticipated that although repealing Medicare cuts would cost about 1.10 trillion United States dollars, it is likely to cause a slight improvement in economic growth, which would translate into additional net savings of about 200 billion United States dollars (Committee for a Responsible Federal Budget, 2017). As for Americans, their concern is whether they will still benefit from increased health coverage, enabling them to continue receiving affordable prescription drugs and accessing other healthcare services (The Commonwealth Fund, 2017; Willison & Singer, 2017). In this respect, legislators will likely benefit from their political maneuvers and get re-elected only when repealing/replacing ACA increases health coverage for Americans and economic growth. In this respect, legislative leaders must analyze the voters’ views before positioning or recommending national policies.

A Sample Answer 9 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

The Affordable Care Act (ACA), or Obamacare, was signed into legislation in 2010. The ACA changed the healthcare system by reducing the amount citizens paid for themselves and their families for uncompensated care. The act also required every US citizen to have health insurance and provided assistance to those who could not afford it (eHealth, 2020). Although the ACA has been beneficial for most Americans, the Republicans and Democrats have not seen eye to eye on the act. Republicans believe that the ACA violates “American independence with its individual mandate and increased taxation” (HealthNetwork, 2017), hence one of the reasons why Trump has been trying to repeal and replace the act.

Politics is not a strong suit of mine so before starting this week’s discussion post I had to first look into what cost-benefit analysis (CBA) is. CBA is a way to compare the costs and benefits of an intervention. After learning the definition of CBA, I was able to apply it to legislation. One of the main goals of any legislator is to be re-elected. Legislators have to always be on their toes because a simple act such as wanting to repeal and replace the ACA could cause them a vote or monetary losses. By analyzing voters’ views, legislators can then make recommendations for new or changes to policies. When a legislator knows what the people want, they then have a greater chance of achieving their goal of being re-elected.

References

eHealth. (2020, October). History and Timeline of the Affordable Care Act (ACA). Retrieved from https://www.ehealthinsurance.com/resources/affordable-care-act/history-timeline-affordable-care-act-aca

HealthNetwork. (2017, July). What’s Dividing Republicans and Democrats on Healthcare Reform? Retrieved from HealthNetwork: https://healthnetwork.com/blog/differences-between-republicans-and-democrats-on-healthcare

A Sample Answer 10 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

The Affordable Care Act (ACA) was enacted in 2010, and it considerably changed the U.S. health care landscape. The goals of the ACA were to make insurance coverage more affordable, reduce the number of uninsured, and expand access to care. To attain these goals, the ACA expanded eligibility for Medicaid and established new marketplaces where Americans without employer coverage could purchase policies directly from insurers (Oberlander, 2017). The ACA faced strong opposition from Republicans, who described it as unrealistic because it required every American to have medical insurance (Oberlander, 2017). When the Trump administration took power in 2017, the president and Congress members of the Republican Party vowed to replace the ACA. However, one year after taking office, Republicans could not agree on whether to repeal the ACA immediately, repeal right away and replace it later, or repeal it later after establishing a replacement strategy (Oberlander, 2017). Although the Republicans repealed parts of the ACA, including the budgetary and fiscal provisions, they did not replace it.

The Senate Republicans’ failure to honor their promise of passing a bill to replace ACA, can be attributed to the unpopularity of this bill to the public. The legislators had to assess the political impact of repealing the ACA with no replacement on their chances of being reelected (McCarthy, 2017). They had to perform a cost-benefit analysis on the cost of repealing the ACA on the future chance of being reelected and the benefits of repealing it. For instance, if the Senate replaced the ACA right away, with no replacement, the number of uninsured Americans would increase drastically, which would be opposed by their voters (McCarthy, 2017). This would negatively affect the public view of the lawmakers on their constituents, and lower their odds of being reelected if they did not have a better plan to replace the ACA. Besides, the cost-benefit analysis can explain why the Republicans had two canceled votes in March 2017 and had to introduce a new amendment to the American Health Care Act to unite the party behind the bill (McCarthy, 2017). The failure to replace the ACA as promised shows that lawmakers can be unwilling to support bills that are a potential threat to their election results in upcoming elections.

Legislative leaders’ decisions regarding recommending or positioning national policies are often influenced by their voters’ views. Voters are known to influence legislators’ policy choices and are at times forced to compromise their choices including partisan politicians (Pacheco & Maltby, 2017). Lawmakers have to consider their voters’ views before making a policy decision that affects their constituents to maintain a positive public image (Pacheco & Maltby, 2017). In the case the voters’ views contradict a legislator’s decision regarding a policy, the lawmaker is forced to compromise their position on the policy and move to the center.

Failing to take the voters’ views can have negative consequences on the law maker’s future elections. Furthermore, to continue supporting and voting for a legislator in future elections constituents must remain convinced that their lawmaker is listening to them and consider their views (Pacheco & Maltby, 2017). For instance, members of congress had to assess the voters’ view on repealing the ACA provisions that would cut funding for Medicaid or change Medicaid to a block grant program. Since many Americans benefited from the expansion of Medicaid, it affected Congress’ decision to pass bills that would hinder their voters’ access to the program and ultimately affect their public image.

References

McCarthy, M. (2017). U.S Republican attempt to repeal and replace Affordable Care Act collapses. https://doi.org/10.1136/bmj.j3508

Oberlander, J. (2017). Repeal, replace, repair, retreat—Republicans’ health care quagmire. New England Journal of Medicine, 377(11), 1001-1003.

Pacheco, J., & Maltby, E. (2017). The role of public opinion—does it influence the diffusion of ACA decisions?. Journal of Health Politics, Policy and Law, 42(2), 309-340.https://doi.org/10.1215/03616878-3766737

A Sample Answer 11 For the Assignment: NURS 6050 Discussion: Politics and the Patient Protection Act

Title: NURS 6050 Discussion: Politics and the Patient Protection Act

It’s fascinating to delve into the variations in regulations for Advanced Practice Registered Nurses (APRNs) between New Jersey and Alaska. Exploring these disparities not only accentuates the diversity in healthcare governance but also sheds light on the impact that such regulations can have on the practice, autonomy, and responsibilities of APRNs in various states. This comparison provides a valuable lens through which we can appreciate the dynamic nature of healthcare regulation and its influence on the delivery of advanced nursing care across different regions. Regulating health professions serves as a crucial mechanism to safeguard public safety interests (Milstead & Short, 2019).

It’s interesting to observe the considerable variation among states in the stringency of regulations governing Advanced Practice Registered Nurses (APRNs). Some states enforce strict supervision requirements like New Jersey, while others grant APRNs the autonomy to work independently like Alaska. This discrepancy raises important considerations about the potential impact on healthcare delivery. States like Alaska that allow APRN’s full autonomy empower (NP) with the authority to assess patients, diagnose, order and interpret tests, and oversee treatment, including prescription of medications and controlled substances. States like New Jersey reduce the (NP) ability to engage in at least one element of NP practice and requires a career-long regulated collaborative agreement with another health provider in order to provide patient care (American Association of Nurse Practitioners, 2023).

Restricting APRNs from working to their full capabilities seems, in my view, to be a disservice. Allowing APRNs to practice autonomously can contribute significantly to optimizing their skills and expertise, ultimately enhancing the efficiency and effectiveness of healthcare services.

Reference

Milstead, J. & Short, N. (2019). Health Policy and Politics: A Nurse’s Guide (6th ed.). Jones & Bartlett Learning.

American Association of Nurse Practitioners. (2023, October). State Practice Environment. Retrieved from https://www.aanp.org/advocacy/state/state-practice-environment

Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost	-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.