NURS 6050 Politics and the Patient Protection and Affordable Care Act

NURS 6050 Politics and the Patient Protection and Affordable Care Act

Sample Answer for NURS 6050 Politics and the Patient Protection and Affordable Care Act Included After Question

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.

Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

  • Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
  • Consider who benefits the most when policy is developed and in the context of policy implementation.

BY DAY 3 OF WEEK 3

Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.

BY DAY 6 OF WEEK 3

Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

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

Title: NURS 6050 Politics and the Patient Protection and Affordable Care 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.

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Failing to take the voters’ views can have negative consequences on the law maker’s future elections. Furthermore, to continue

NURS 6050 Politics and the Patient Protection and Affordable Care Act
NURS 6050 Politics and the Patient Protection and Affordable Care Act

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 Medicine377(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 2 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act

When starting the discussion assignment for this week I found myself feeling extraordinarily overwhelmed.  I was unfamiliar with cost-benefit analysis, and I had no idea the main job for a legislator is to be re-elected!  Therefore, I had to take a very systematic approach to this week’s discussion.  First, it was important to understand cost-benefit analysis.  After much research it appears this is an umbrella term that is applied to any situation where one weighs the advantages versus the price or cost of a decision.  Price or cost is relative.  What ideals or issues a legislator chooses to support impacts if groups of people will vote for them in the future.  For example, in one of the articles for this week the authors discuss limiting political interference in sexual and reproductive health education and research (Taylor et. al., 2017).  The American Academy of Nursing is the group behind these driving principles and likely supports a legislator or legislators that advocate for these beliefs.  As nurses in the current political climate we are in a unique position of influence.  “Participation by nurses will help the public see the breadth of expertise nurses bring to the table” (Milstead & Short, 2019, p.39).

As it pertains to our discussion this week, the cost for a legislator to support repealing or replacing the Affordable Care Act (ACA) could be an actual monetary value or a vote.  There are supporters on both sides of the proverbial fence when it comes to the ACA.  In the current divided political atmosphere, there is a clear delineation of support split into democrat and republican.  A legislator typically takes a stance on the issue and thereby attains support which equals votes.  The legislator then must decide how to vote, or which acts or reforms to support or refute.  If a legislator who gained their position by supporting democratic issues, then supports republican views they would likely stand to lose the support of their democratic voters.  When considering this they must ask themselves which views their supporters’ advocate.  There is another consideration; the legislator’s financial supporters, which often have conflicting interests, must also be taken into consideration.  Deciding one way or the other could cost votes or financial support.  Considering the above mentioned, it stands to reason the agendas of those who vote for or financially support the legislator are influential in legislation.

The voter’s views and an analysis thereof would reasonably influence the decisions being made.  After all it is the job of the legislator to “make decisions regarding bills and resolutions pending before the legislative body to which they have been elected” (Milstead & Short, 2019, p 38).  Legislators also must be aware of their political health.  In an effort to retain their position “legislators must be aware of not only the political climate but also be aware of how certain votes will affect their ability to stay in office” (National Council for the Social Studies., n.d.).

References

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

National Council for the Social Studies. (n.d.). https://www.socialstudies.org/advocacy/how-legislators-make-decisions

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.

A Sample Answer 3 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act

Title: NURS 6050 Politics and the Patient Protection and Affordable Care 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 Medicine377(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

 

 

I agree with your statement that it will cost a lot to support legislation unpopular with the constituency that elected them. It has been noted that Republicans oppose Medicaid expansion in states headed by Democratic governors that support the development and vice versa (Pacheco et al.,2020). That is why so far, the republican and the Democrat’s respective stand regarding these issues cannot be faulted regarding where their constituencies are leaning towards. However, from the people’s eyes, especially the ones that cannot afford health insurance, by keeping the ACA, it is no doubt that the Democrats stand to gain the support of this population. Hence, according to Glied & Lambrew (2018), the Democrats have worked tirelessly to defend the ACA despite the Republicans’ efforts to repeal or replace it. Numerous people out there support the ACA because of its benefits.

References

 

Glied, S. A., & Lambrew, J. M. (2018). How Democratic candidates for the presidency in 2020 could choose among public health insurance plans. Health Affairs37(12), 2084-2091.

 

Pacheco, J., Haselswerdt, J., & Michener, J. (2020). The Affordable Care Act and polarization in the united states. RSF: The Russell Sage Foundation Journal of the Social Sciences6(2), 114-130.

 

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

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act of 2010 (ACA) is a revolutionary policy. This Act wanted to address social injustices in the American healthcare system. However, this policy has met stiff opposition from Republican legislators who openly opposed it. When Donald Trump came to power, repealing ACA was one of his number one priorities. They, however, did not get the requisite number to repeal ACA since other legislators felt like many Americans would be affected. Many Republican lawmakers started seeing that they may not get reelected if they continued to support the repeal of ACA. 

In May 2017, the House of Representatives passed the American Health Care Act (Jost, 2017). This was the first attempt at repealing ACA. The Trump administration wanted to use this act to repeal ACA. However, this Act would make millions of Americans lose health insurance coverage. AHCA proposed that tax credit be based on age, which would increase healthcare costs. This Act also created the Patient and State Stability Fund, which would reduce premiums by 25% after 2026 (Jost, 2017). This would increase healthcare costs for Americans with preexisting comorbid conditions. 

A cost-benefit analysis by Republican lawmakers revealed that they would not get reelected because of the negative effects of repealing. Repealing ACA would lead to millions of Americans losing insurance coverage (Straw & Aron-Dine, 2020). This was the main reason for implementing ACA. ACA aimed to increase insurance coverage to millions of Americans and reduce healthcare costs (Sommers, 2020). Due to reelection purposes, the Senate Majority Leader McConnell found it hard to garner support for AHCA. To protect their political interest, the US senators came up with another proposal known as the Better Care Reconciliation Act of 2017 (Smith & Gibbs, 2017). 

Members of Congress and Senators are elected leaders who must be voted for by the public. Due to this, their positions on policies such as Obamacare are influenced by how their electorates feel. Because of this, their interest is reelection and not ACA. 

Healthcare and the Election of Legislators 

The reelection cycle of legislators promotes actions taken by legislators to not run counter to their future efforts to be reelected. In regards to the ACA, I believe Milstead & Short illustrate how these two items combined may play out. It is stated that as the Republican party began to take legislative majority, repeal or revision of these ACA programs would interfere with the upcoming 2018 election cycle (Milstead & Short, 2019, p. 39). As such, some of the major changes to the ACA made as talking points by Republican legislators were held back, relative to an aggressive perusal of overhauling the ACA. If such an attempt was made, the breadth of changes needed would be disruptive enough to have voters possibly lose support for the actions of the Republican party, and as such, pose a major risk to reelection/loss of majority. This demonstrates the cost-benefit calculation that legislators must keep in mind when making legislative decisions in our current system of reelection. 

Voter views thereby affect the actions of elected legislators. If an overwhelming and vast majority of Legislator A’s constituents want ACA essentially abolished, this legislator will support relatively aggressive policies and positions which lead to that outcome. In Legislator B’s constituency, the vast majority seem mixed or even indifferent about the fate of the ACA. Legislator B will then likely not show strong support for any policies affecting the ACA, one way or another. This would be partially because any policy support either direction would likely not upset legislator B’s chances of reelection. This would also incentivize legislator B to show strong opinions toward other issues that their constituency does care about greatly, shifting attention elsewhere. 

Surveying and polling the constituency is one way to represent and extrapolate voter views. However according to Pew Research Center in 2014 regardless of party, roughly half of voters said their house member was “in touch with the district” (Pew Research Center, 2014). Meaning even if there was a Republican elected, half of the republicans in that representative’s constituency would still say their representative was out of touch. Later Pew Research in 2022 found that the majority of people did believe that it was important that their preferred party held majority in the congress (Pew Research Center, 2022). This lends evidence that voters in general tend more look at the beliefs and policies the party as a whole has rather than the individual representative of their region, when making voting decisions. This definitely simplifies any vote choice but also at the downside of less specificity when it comes to more detailed issues and talking points. 

References 

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

Pew Research Center. (2014). GOP Has Midterm Engagement Advantage. Pew Research Center. 

Pew Research Center. (2022). Midterm election preferences, voter engagement, views of campaign issues. Pew Research Center.