Discussion: Politics and the Patient Protection and Affordable Care Act

Discussion - Week 3-Initial

COLLAPSE

Before the Affordable Care Act (ACA) a lot of people in the United States did not have insurance coverage. The affordable care act (ACA) main goal was to “expand the number of people with health insurance” (Skinner & Chandra, 2016), this goal was achieved. From the beginning of ACA there has been people in congress that wanted to repeal this law. For years it was hard to do until the Trump administration. They started out with wanting to repeal outright which did not work so they decided to bring a new law. Discussion: Politics and the Patient Protection and Affordable Care Act All their “proposals focused on many of the ACA provisions that aimed to create stability, comparability, comprehensiveness, and affordability in the health insurance market” (Nadash et al., 2018, p. 270) This new law wasn’t passed but a new tax rule was passed which removed the ACA tax rule. This in turn removed a big aspect of the ACA which was a huge setback for the law Discussion: Politics and the Patient Protection and Affordable Care Act.

In all things, votes affects policies. Every party wants to be re-elected, so they cater to their constituents. As said earlier millions of United States citizens had insurance when the ACA was enacted. This led to voters wanting to keep their insurance which led to elected officials having to vote for keeping the ACA. The fact that senators want to be re-elected is one of the reasons the ACA is still in place.      

 

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 & Social Policy, 30(3-4), 259–281. https://doi.org/10.1080/08959420.2018.1462683

 Skinner, J., & Chandra, A. (2016). The past and future of the affordable care act. JAMA, 316(5), 497. https://doi.org/10.1001/jama.2016.10158

West‐Oram, P. (2018). Solidarity as a national healthcare strategy. Bioethics, 32(9), 577–584. https://doi.org/10.1111/bioe.12443

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6 months ago

Angela Sullivan 

RE: Discussion - Week 3

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"A cost-benefit analysis is the process of comparing the projected or estimated costs and benefits (or opportunities) associated with a project decision to determine whether it makes sense from a business perspective" (Stobierski, 2019). 

The Affordable Care Act, also known as the ACA, was developed in 2010. It's purpose was to provide affordable health insurance and coverage for those currently uninsured. It allowed those with limited finances or preexisting conditions the opportunity to obtain medical coverage for themselves and their families."By our estimates – based largely on what’s available from the Congressional Budget Office a full repeal of the ACA would cost $350 billion through 2027 under conventional scoring and $150 billion under dynamic scoring. Both estimates would be about $100 billion lower through 2026" (Committee for a Responsible Federal Budget,  2017). "Repealing the ACA’s coverage provisions would save $1.55 trillion through 2027, while repealing its tax increases would cost $800 billion, and repealing its Medicare (and related) cuts would cost another $1.10 trillion. Repeal would also lead to a small increase in economic growth, which could produce over $200 billion of additional net savings" (Committee for a Responsible Federal Budget, 2017).

Candidates running for election make promises, or at least try to. "When presidents have high levels of public approval, they are likely to act quickly and try to accomplish personal policy goals. They can use their position and power to focus media attention on an issue. This is sometimes referred to as the bully pulpit approach. The term “bully pulpit” was coined by President Theodore Roosevelt who believed the presidency commanded the attention of the media and could be used to appeal directly to the people" (Learning, n.d.).

President Trump wanted to totally repeal the ACA and replace it. By repealing it, it would have left around 23 million American's without the medical insurance needed for affordable medical care. At the time of the election, medical care was a major priority as the world was facing a new pandemic, COVID-19.  However, President Trump and fellow Republicans never presented a new plan before he left office. I think if he had made some sort of announcement of what he would replace it with, that may have influenced his chances for reelection. "Building on the ACA has been a focal point for Joe Biden’s presidential bid, as he has proposed creating a government-run public option health care plan that will compete with private insurers and be available for all Americans" (Hamel, 2017). Of course, with the continued pandemic and the recent events in Afghanistan, new or revised health care policies have yet to be presented to Americans.

Learning, O. S. & L. (n.d.). American government. Lumen. Retrieved September 16, 2021, from https://courses.lumenlearning.com/amgovernment/chapter/the-effects-of-public-opinion/.

Hamel, Liz. Follow @lizhamel on Twitter, A. K. F. @A. K. on T. (2021, June 17). 5 charts about public opinion on the Affordable Care act and the Supreme Court. KFF. Retrieved September 16, 2021, from https://www.kff.org/health-reform/poll-finding/5-charts-about-public-opinion-on-the-affordable-care-act-and-the-supreme-court/.

Stobierski, Tim. (2019, September 5). How to do a cost-benefit analysis: Hbs online. Business Insights - Blog. Retrieved September 16, 2021, from https://online.hbs.edu/blog/post/cost-benefit-analysis.

The cost of full repeal of the Affordable Care Act. Committee for a Responsible Federal Budget. (2017, January 26). Retrieved September 16, 2021, from https://www.crfb.org/papers/cost-full-repeal-affordable-care-act.

 

 

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6 months ago

Cyrin Natividad 

RE: Discussion - Week 3

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Hi Angela,

 

Your post is interesting! Up to now, Affordable Care Act is still a big deal to Americans and legislators. It's engaging how President Biden approached this act by supporting President Obama when he signed this into law (Biden, 2021). I think he's on President Obama's side in the majority since he was the vice-president during the era. Moreover, he plans to protect the law now he is the President.

 

President Biden also remarked that he would further pursue the ACA during the Covid-19 Pandemic (NY Times, 2021). President Biden is one of the supporters of ACA, which might be one of the many reasons he won the American voters' hearts to make him win since many people find ACA helpful after all.

 

References:

 Joe Biden, 2021. Plan to protect and build on Obamacare. https://joebiden.com/healthcare/

 

The New York Times, 2021. Pandemic relief bill fulfills biden’s promise to expand Obamacare, for two years. https://www.nytimes.com/2021/03/08/us/politics/obamacare-biden.html

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6 months ago

Sophie Enjema Ndumbe 

RE: Discussion - Week 3

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The cost- benefit analysis in terms of the legislators being re-elected affected the efforts to repeal/replace the ACA in many aspects. Most of the legislators had different points of view so this made it difficult for them to come up with a solid decision for people to agree to repeal / replace ACA. The Affordable Act is drafted according to the federal poverty level of an individual or the household, some people were angry because they were not eligible for it for insurance, so they had to vote against it. Some other voters preferred the policy because under the Affordable Care Act, many Americans were able to get insurance. In 2016 during an assessment that was done regarding the Affordable Care Act 51% of people disapproved of it while only 44% of people approved of it (Blendon et al., 2016).

 The voter’s point of view also matters, and the legislators takes that into account before making any decision. Many individuals who were  uninsured got insurance under the Affordable care Act; they were happy because they enjoyed the benefits of it. Bindman et al. (2018) states “the passage of the ACA temporarily relieved states of the need to take the lead in expanding health care coverage” (p. 1367).

Legislators are re-elected based on how successful they have been throughout their term and on party affiliation. If they do not have a strong affiliation with their political party, then it becomes very difficult for them. State legislators always have differences in their priorities depending on their political affiliation and this affects re-election (Pagel et al., 2017).

 

References

Bindman, A. B., Mulkey, M. R., & Kronick, R. (2018). Beyond The ACA: Paths to universal coverage in california. Health Affairs, 37(9), 1367–1374. https://doi-org. /10.1377/hlthaff.2018.0504

Blendon, R. J., Benson, J. M., & Casey, L. S. (2016). Health Care in the 2016 Election - A View through Voters’ Polarized Lenses. New England Journal of Medicine, 375(17), e37. https://doi-org. edu/10.1056/NEJMsr1606159

     Pagel, C., Bates, D. W., Goldmann, D., & Koller, C. F. (2017). A Way Forward for Bipartisan Health Reform? Democrat and Republican State Legislator Priorities for the Goals of Health Policy. American Journal of Public Health, 107(10), 1601–1603. https://doi-org. /10.2105/AJPH.2017.304023

 

 

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6 months ago

Lucy Njogu 

RE: Discussion - Week 3

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Great Post, Sophia,

I have found your post really interesting and further giving me a chance to research more. From the post, I got the chance to read more about the Affordable Care Act. In 2016, 51% of people disapproved of ACA, and 44% approved it (Blendon et al., 2016). However, interestingly, ACA increased insurance coverage for many people though in many years. Understanding ACA coverage is very crucial to the future of ACA. The repeal failed in march 2017, but a revised bill passed that May 2017. The bill's cost–benefits are questionable as it seems like the country is spending so much on it. The unfortunate thing about ACA is that it seems more political than anything else. Listening to Walden university's video, I got a broad understanding and actualization of the Act. The legislators vote in waves, and only a few do not follow the wave, and they are labeled. I release how sad the cost-benefit of this Act may burden the country. The legislators are about to be re-redirected. to even 2017 during the repeal/replace it a failure, makes me think legislators have moved towards political voting and caring more about what be

 "The most telling insight that this peek behind closed doors offers is the realization (for better or worse0 that Policymakers are not necessarily focused on how real people will be affected by the changes to Obamacare or Medicare and Medicaid but rather on how the changes will affect their own re-election chances" (Milstead & Short, Pg 40, 2019).

 

 

 

 

 

 

 

References

 

Blendon, R. J., Benson, J. M., & Casey, L. S. (2016). Health Care in the 2016 Election - A View through Voters’ Polarized Lenses. New England Journal of Medicine, 375(17), e37. https://doi-org. edu/10.1056/NEJMsr1606159

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

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

 

 

 

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6 months ago

Lyndsey Cline 

RE: Discussion - Week 3

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6 months ago

Sophie Enjema Ndumbe 

RE: Discussion - Week 3

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Hi Lyndsey,

            I agree with you that the Affordable Care Act made many uninsured Americans to have access to healthcare. People could go to the hospital and get treated for their conditions. The Republicans and the democrats had different views about the Affordable Care Act, but it favored mostly the democratic party. People who did not like the Affordable care Act considered it as something that was very complex (Jarman, & Greer, 2020).

 Legislators are re-elected based on how well they have been doing their job and the ties to their party. The voters are aware of things that happen in their community, when things are not done the right way voters  start thinking of switching to another party. Blendon et al. (2016) States “Americans remain divided on what the future role of the federal government should be in making sure that all Americans have health care coverage” (p. 3).

References

Blendon, R. J., Benson, J. M., & Casey, L. S. (2016). Health Care in the 2016 Election - A View through Voters’ Polarized Lenses. New England Journal of Medicine, 375(17), e37. https://doi-org. edu/10.1056/NEJMsr1606159

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 & Law, 45(4), 677–691. https://doi-org. /10.1215/03616878-8255589

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6 months ago

Sophie Enjema Ndumbe 

RE: Discussion - Week 3

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Hi Lyndsey,

            I agree with you that the Affordable Care Act made many uninsured Americans to have access to healthcare. People could go to the hospital and get treated for their conditions. The Republicans and the democrats had different views about the Affordable Care Act, but it favored mostly the democratic party. People who did not like the Affordable care Act considered it as something that was very complex (Jarman, & Greer, 2020).

 Legislators are re-elected based on how well they have been doing their job and the ties to their party. The voters are aware of things that happen in their community, when things are not done the right way voters start thinking of switching to another party. Blendon et al. (2016) States “Americans remain divided on what the future role of the federal government should be in making sure that all Americans have health care coverage” (p. 3).

References

Blendon, R. J., Benson, J. M., & Casey, L. S. (2016). Health Care in the 2016 Election - A View through Voters’ Polarized Lenses. New England Journal of Medicine, 375(17), e37. https://doi-org. edu/10.1056/NEJMsr1606159

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 & Law, 45(4), 677–691. https://doi-org. /10.1215/03616878-8255589

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6 months ago

Cyrin Natividad 

RE: Discussion - Week 3

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     Legislators often believe they are doing the right thing and making difficult decisions for their constituents. They often wanted to stay in office for as long as possible or leave on their terms. To find the support to be re-elected continually, legislators must be aware of the political climate and be mindful of how specific votes will affect their ability to stay in office (Socialstudies.org). Legislators spend large amounts of time assisting constituents, studying state issues during the interim, and campaigning for the next election; doing so helps them and their party (NCSL.org).

Reference

How Legislators Make Decisions | Social Studies. (n.d.). www.socialstudies.org. https://www.socialstudies.org/advocacy/how-legislators-make-decisions

 

Full- and Part-Time Legislatures. (n.d.). www.ncsl.org. https://www.ncsl.org/research/about-state-legislatures/full-and-part-time-legislatures.aspx

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6 months ago

salome ugwu 

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6 months ago

Scott Lamprecht 

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The ACA is great in theory, but many cannot afford to use the new found insurance because of the $15000+ deductible. In NV anyone making more than $748 monthly does not qualify for Medicaid. 

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6 months ago

John Michael Natividad 

RE: Discussion - Week 3

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          An estimated 22.8 million people reported losing access to their healthcare if the Legislators repeal the Affordable Care Act.  Americans will not forget which Legislators were for or against the change (The ACA Times). This is certainly evident in the electoral votes of Cory Gardner, who lost to John Hickenlooper “Because Cory Gardner has made this decision to unequivocally support the president no matter what he says or does, he’ll be paying the price for that,” said David Flaherty (Wingerter,2020).

         Ideology, Party, and Public opinion comes into play when running for legislation arises. Politicians’ belief or support on a particular issue, especially the controversy surrounding Obamacare, exemplified the votes the implementation of the ACA highly salient (Shor,2018). It played a significant role on the electoral voters; as the pandemic unfolded, healthcare took center stage as the need for healthcare rose. Many Americans look upon the repeal as an attack on their livelihood; if the dissolution is approved, people would have to spend more on their insurance rather than spending it on necessities, especially on a pandemic state. Voters play a significant role in how government policies are adapted or revised; if the politician has the public’s best interest, they are likely to gain votes from them, and vice versa.

 

Reference

Will GOP Senators Struggle with Re-Election with an ACA Repeal? | The ACA Times. (1488). Acatimes.com. https://acatimes.com/will-gop-senators-struggle-with-2018-re-election-due-to-aca-repeal/

 

Wingerter, J (2020). Why John Hickenlooper won and Cory Gardner lost Colorado’s U.. Senate race. The Denver Post. https://www.denverpost.com/2020/11/05/john-hickenlooper-cory-gardner-us-senate-2020/

 

Shor, B. (2018). Ideology, Party, and Opinion: Explaining Individual Legislator ACA Implementation Votes in the States. State Politics & Policy Quarterly, 18(4), 371–394. https://doi.org/10.1177/1532440018786734

 

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6 months ago

Michael Collins 

RE: Discussion - Week 3

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Hello John, 

            I want to start out by saying I completely agree with your statement about voters playing a significant role in policies and decisions that are made. The public opinion in the end is what truly matters to politicians because without the support of the public, the chances of the politicians getting re-elected reduce dramatically. This in my opinion, was one of many major downfalls of the Trump Administration. President Trump wasn’t concerned about the public opinion but rather using his own agenda and attempting to run a business instead of fair democracy. Trump tried through his whole term to repeal the Affordable Care Act (ACA). These efforts continued through his last year in office when in 2020 the Trump Administration asked the Supreme Court to overturn the ACA which had this been successful, 23 million Americans would have had their insurance coverage taken away (Stolberg, 2020). It became clear as the presidential election came to an end how the public viewed these ideas from the Trump Administration. As a result President Trump lost the election. 

            However it isn’t just the Trump Administration or the position of President that feeds, or lack there of, off of the public opinion. Our book for this course, Health Policy and Politics: A Nurse’s Guide (6^th Ed.), states that policymakers in general aren’t necessarily focused on how real people will be affected by policy decision, in this case the ACA or Medicare and Medicaid. Instead, they are focused on how changes made will affect their chances of re-election (Milstead & Short, 2019). These politicians truly only care about their chances of remaining in office. Through a cost-benefit analysis, defined as the process of comparing estimated costs and opportunities associated with a decision to determine whether it makes sense from a business standpoint, politicians try to do what makes the most economical sense disregarding the effects on the American people (Stobierski, 2019). As I said, the Trump Administration didn’t have the public opinion in mind when making these decisions, but rather intended to use the cost-benefit analysis theory in making a decision he thought would financially help the United States. His repeal and replace plan for the ACA came to a haunt when he realized replacing this program would be no cheaper or more effective than the current program was Discussion: Politics and the Patient Protection and Affordable Care Act.  

  

References

Milstead, J. A., & Short N. M. (2020). Health Policy and Politics: A Nurse’s Guide (6^th Ed.). Jones & Bartlett Learning. 

Stolberg, S. G.(2020, November 10). Trump Administration Asks Supreme Court to Strike Down Affordable Care Act. New York Times. 

https://www.nytimes.com/2020/06/26/us/politics/obamacare-trump-administration-supreme-court.html

Stolberg, S. G.(2020, November 10). Trump Administration Asks Supreme Court to Strike Down Affordable Care Act. New York Times. Discussion: Politics and the Patient Protection and Affordable Care Act

https://www.nytimes.com/2020/06/26/us/politics/obamacare-trump-administration-supreme-court.html

 

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6 months ago

Misty Williams 

RE: Discussion - Week 3

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        Hi John. I found your post interesting. While researching for the response to the Discussion, I looked for an example of someone who lost an election due to being for or against the Affordable Care Act. Your post about Corey Gardner gave me the opportunity to investigate this event. I found it interesting that Hickenlooper made many errors that made him look bad in the public's eye. However, he chose to turn his focus to support for the Affordable Care Act  and Gardner's support for Trump especially during the pandemic. This was sure to put Hickenlooper ahead of Gardner.  Gardner lost to Hickenlooper with made this the first electoral loss for Gardner in his career. It was also the largest margin of defeat for a U.S. senator from Colorado in 42 years (Wingerter,2020)Discussion: Politics and the Patient Protection and Affordable Care Act.  

        I find it disturbing that politics is such a game where the intention is to get votes. What appears to be a passion for a particular subject or issue is not necessarily an interest unless it will get attention and gain a following of potential votes. When watching the video about why nurses should be involved in politics the speaker states that we are the voice of healthcare issues challenges, and policies Discussion: Politics and the Patient Protection and Affordable Care Act. This speaks volumes to me after reading and listening to the assigned topics because subjects involving healthcare do involve us as nurses and it is crucial to learn as much as we can about the way politics work and to get involved once we gain an understanding. 

Reference 

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

Wingerter, J. (2020, November 5). Why John Hickenlooper won and Cory Gardner lost Colorado’s U.S. Senate race. The Denver        Post. https://www.denverpost.com/2020/11/05/john-hickenlooper-cory-gardner-us-senate-2020/ 

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6 months ago

Cyrin Natividad 

RE: Discussion - Week 3

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Hi John Michael,

Your post is insightful. According to the cost-benefit analysis, the legislator's calculations during the enactment of specific laws are not the cost-benefits to society. Political affiliations hampered the efforts to repeal/replace the Affordable Care Act. The Republican Party, led by President Trump, attempted to replace it with the American Health Care Act (Olorunnipa,2020) Discussion: Politics and the Patient Protection and Affordable Care Act.

 

However, They did not receive enough votes to pass the law (Kaplan&Pear,2017). The legislators who supported the repeal of the Affordable Care Act were Republicans, while those who opposed it were Democrats. Legislators' political allegiances and interests influence their decision-making, expecting that they will vote to improve healthcare in the state.

 

 References:

Kaplan, T., & Pear, R. (2017, May 4). House passes measure to repeal and replace the affordable care act. https://www.nytimes.com/2017/05/04/us/politics/health-care-bill-vote.html

 

Olorunnipa, T. (2020, September 24). After years of promising his own health care plan, Trump settles for rebranding rather than repealing Obamacare. Washington Post. https://www.washingtonpost.com/politics/trump-health-care-affordable-care-act/2020/09/24/e1cd928a-fe6b-11ea-9ceb-061d646d9c67_story.html

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6 months ago

Scott Lamprecht 

RE: Discussion - Week 3

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The ACA has many benefits but is not financially sustainable.  Many cannot afford to use the new found insurance because of the $15000+ deductible. In NV anyone making more than $748 monthly does not qualify for Medicaid. 

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6 months ago

Misty Williams 

RE: Discussion - Week 3

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        According to the Center for Effective Government, cost-benefit analysis (CBA) is a tool used by regulatory decision makers to find the costs and benefits, in financial terms, of a regulation to society. It is necessary to use cost benefit analysis to predict future outcomes for proposed solutions to present problems. Congress responded to the crisis of 50 million people in the United States living without health insurance. Discussion: Politics and the Patient Protection and Affordable Care Act The Affordable Care Act (ACA) was passed in 2010 and expanded health insurance access to the American people. As a result, 20 million people in the United States were able to obtain health insurance coverage since the ACA was enacted (Calsyn et al., 2020). 

        Since 2010 House Republicans have proposed multiple bills to repeal or replace the Affordable Care Act. If the Affordable Care Act is repealed these 20 million people will lose coverage, 135 million people with preexisting conditions could suffer by being denied medical coverage, and access to prescription drugs would be significantly reduced due to inability for Americans to be able to afford their prescriptions (Goodnough, 2021). Discussion: Politics and the Patient Protection and Affordable Care Act In addition, those receiving treatment for mental health issues and drug treatment would lose their Medicaid coverage. 

        Regardless of political affiliation, the primary goal for a politician is to be reelected. When concerns over matters such as ACA are on the agenda of voters, politicians will make decisions based on getting the vote and promoting their chance of being reelected. Legislator's cost-benefit calculations differ from cost-benefits to society due to the basis of support or lost political support the legislator will receive because of their action (Milstead & Short, 2017, p. 55). Their top concern must be whether the legislative leader will survive their next party based on their position on national policies. If they think that their standpoint on an issue will dictate whether they get reelected, they will form a different position based on the possibility of not being reelected Discussion: Politics and the Patient Protection and Affordable Care Act.  

                                                                                                                          References 

Calsyn M., Gee E., & Rapfogel N. (2020, October 6). 10 ways the ACA has improved health care in the past decade. Center for American Progress. https://www.americanprogress.org/issues/healthcare/news/2020/03/23/482012/10-ways-aca-improved-health-care-past-decade/ 

Cost-benefit analysis. (n.d.). Center for Effective Government | Because government matters. https://www.foreffectivegov.org/node/3470 

Goodnough, A. (2021, June 17). If the Supreme Court ends ObamaCare, here’s what it would mean. The New York Times - Breaking News, US News, World News and Videos. https://www.nytimes.com/article/supreme-court-obamacare-case.html#commentsContainer 

Milstead, & Short, N. M. (2017). Health policy and politics (6th ed.,p. 55). Jones & Bartlett Learning. 

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6 months ago

Angela Sullivan 

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"The Center for American Progress estimated last year that 135 million non elderly Americans have a preexisting condition. As the pandemic surges on, every American is at risk of contracting COVID-19 and becoming uninsurable if the ACA is repealed" (Rapfogel, 2020) Discussion: Politics and the Patient Protection and Affordable Care Act. 

Due to the continued COVID crisis, many people have lost their careers and incomes. The ACA protects people from highly inflated prices from private insurance companies for affordable insurance as well as protects those who have preexisting conditions Discussion: Politics and the Patient Protection and Affordable Care Act. It also prevents the insurance companies from limiting necessary coverage. Now that COVID has shown to product long-term effects, the ACA or a comparable health plan needs to stay in effect as those with COVID or COVID-related complications would be discriminated against and unable to obtain coverage without having to pay premiums that no one could possibly afford.

Nicole Rapfogel, M. C. (2020, October 6). The chaos of repealing the Affordable Care Act during the coronavirus pandemic. Center for American Progress. Retrieved September 18, 2021, from https://www.americanprogress.org/issues/healthcare/news/2020/10/01/490916/chaos-repealing-affordable-care-act-coronavirus-pandemic/.

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6 months ago

Orsela Younano 

RE: Discussion - Week 3

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Great post, Misty.  I believe many factors played into why the repeal of the ACA was unsuccessful, but the pandemic significantly impacted its repeal and popularity.  For instance, before the pandemic in 2019, the ACA’s Medicaid expansion covered 15 million individuals and 12 million of those individuals were newly entitled to the ACA.  However, this number has been increasing ever since the pandemic and the effects of its economic and health consequences.  The timing of the pandemic and any talk of repeal made the possibility of overturning it even less likely Discussion: Politics and the Patient Protection and Affordable Care Act.  If that had happened, not only would all those individuals lose their federal coverage, but fiscally it would have been devastating to the states who would no longer be able to claim the 90% of their Medicaid costs that the federal government was matching (Garfield & Rudowitz, 2020).  The impact of overturning the ACA would negatively effect any progress made into the expansion and coverage of Medicaid.  During turbulent times, the American people changed their perspective of the ACA to a more favorable one (Jacobsen & Fowler, 2020).

 

References

 

Garfield , R., & Rudowitz, R. (2020, November 4). Eliminating the ACA: What could it mean for Medicaid expansion? KFF. Retrieved September 17, 2021, from https://www.kff.org/policy-watch/eliminating-the-aca-what-could-it-mean-for-medicaid-expansion/.

Jacobsen, G., & Fowler, E. (2020, October 29). Could repealing the ACA impact medicare? definitely, but many questions remain. Commonwealth Fund. Retrieved September 17, 2021, from https://www.commonwealthfund.org/blog/2020/could-repealing-aca-impact-medicare-definitely-many-questions-remain Discussion: Politics and the Patient Protection and Affordable Care Act.

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6 months ago

Annisha Mcgowan 

RE: Discussion - Week 3

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Hi Misty, I enjoyed reading your post. I agree with you that the goal of the politicians is to get reelected. What most of the population want the politicians will agree with them at that time even if they do not believe in what they are saying. Members of congress tailor their desires in what the public wants to hear despite their own political views on a subject. The object is to grab as many people as possible attention by telling them what they want to hear. It is all about getting people to believe in your vision and gain their trust to get the vote needed. Without the affordable healthcare act millions of people would be uninsured. The Trump Administration is making it even harder for millions of people to access affordable health care, leaving more Americans uninsured, and further raising out-of-pocket costs (Democratic Health Leaders, 2021) Discussion: Politics and the Patient Protection and Affordable Care Act. During this time of an epidemic millions of Americans depend on having health insurance. People are deciding what to cut out of there everyday expenses to pay for healthcare. Since COVID 19, people are adjusting their spending patterns in order to account for healthcare costs (Sharma, 2021).

 

 

 

References

Democratic Health Leaders Urge Reversal of Trump Administration’s Latest Attack on the Affordable Care Act. (2021, January 15). States News Service.

Sharma, M. (2021). A Study on the 10 Essential Factors Affecting Adaptability of Health Insurance During Covid 19 Pandemic. Journal of the Insurance Institute of India, 9(1), 51–59.

 

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6 months ago

Lucy Njogu 

RE: Discussion - Week 3

COLLAPSE

1. 1. 1.                Politics and the Affordable Care Act

           The Affordable Care Act is the current policy in a series of propositions that have caused nationwide debate and political engagement (Amadeo, 2018). The ACA was solely concerned with making health care processes affordable to the citizens and addressed some of the longstanding social injustices in health care delivery. However, the ripple effects (political) continue to rock the nation and further divide opinions on either side of the nation's political classes. From the start of the act was dogged with political undertones – with the politicians opposed to the sitting president showing open hostility to the act. Due to their cost-benefit analysis – what political influence they would gain in their backyards and parties from opposing the legislation – these politicians became preoccupied with efforts to repeal and replace the ACA (Eibner & Hussey, 2019). 

           The continued persistence of the ACA hinges mainly on the politics of board access and political dissonance between the republican representatives and their voters (Eibner & Hussey, 2019). While the republicans (supported by President Trump) initially strongly supported the 'repeal and replace' proposals, these legislators soon realized that the voters were not supportive of such proposals (Amadeo, 2018). As such, they noticed that their chances of reelections continued to grow thin with their persistence on the 'repeal and replace proposals. When the House of Representatives passed the American Health Care Act (AHCA) in 2017, it was seen as the grand plan to replace the Obamacare proposals. However, word would soon leak to the public that the new act (AHCA) would cause many Americans (up to 24 million) to lose their coverage. Furthermore, the new act would require patients with chronic conditions to pay for their treatment and care (Eibner & Hussey, 2019). Finally, this new act would allow states to repeal sections of the ACA when they saw fit. 

Overwhelmingly, the proposed AHCA presented itself as an inferior alternative to ACA. As such, legislators who initially had supported the act vehemently began distancing themselves from this act from the fear that their electorate would not reelect them if they associated with such legislation. This cost-benefit analysis by the legislators caused the house to fail in gathering enough votes for the AHCA legislation. Instead, the senate proposed a new compromise to the AHCA called the Better Care Reconciliation Act of 2017 due to the negative coverage that the AHCA received. 

Voters' perspectives will always influence a legislator's choice in a legislation process. As discussed above, the fear of losing reelection influenced the republican senators in the ACA debate. As their repeal or replace proposals continued to be less and less popular among the voters, these legislators changed the tune to reposition themselves in line with the demands of their voters. The overriding motivation of voters in public and policy engagement is to remain electable and re-electable. As such, when large numbers of voters become hostile to various legislations, the legislators will be compelled to soften their stance and either abstain from voting the legislation or introduced new legislations that offer compromises. Therefore, decisions that impact Medicaid and Medicare must closely align with the population's values and promote people-based care processes. A failure to listen to the public and respond to their needs will always amount to political suicide for the politicians. Therefore, the electorate has been closely responsible for the continued existence of various monumental legislations like ACA and Medicaid and Medicare legislation. 

 

 

 

References

Amadeo (October 17, 2018). Obamacare repeal and replacement plans: What a Congressional plan to repeal Obamacare would look like. The Balance. Retrieved 15 September 2021 from https://www.thebalance.com/us-economy-4073968

Eibner, C., & Hussey, P. S. (2019). The future of U.S. health care. RAND Corporation. Retrieved September 15, 2021, from https://www.rand.org/health-care/key-topics/health-policy/in-depth.html

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

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

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6 months ago

Roseline Evans 

RE: Discussion - Week 3

COLLAPSE

 Hi Lucy,

I enjoyed reading your post and getting your insight on the politics of the Affordable Care Act. I do agree with you that legislators’ concerns about winning reelections greatly influence their positions on the issue. Frequent attempts have been made by Congress to repeal the Patient Protection and Affordable Care Act (ACA) since its enactment. In January 2016, a repeal bill passed both houses of Congress for the first time and was vetoed by the president. For one, the bill did not define any replacement for the ACA because there was no general agreement among congressional Republicans on what should replace it (Buettgens et al., 2016).  The Trump administration and the Republican legislators sought to use the American Health care Act (AHCA) to repeal and replace the Affordable Care Act (ACA).

You mentioned in your post that “Overwhelmingly, the proposed AHCA presented itself as an inferior alternative to ACA. As such, legislators who initially had supported the act vehemently began distancing themselves from this act from the fear that their electorate would not reelect them if they associated with such legislation.” One of the major reasons for this was because under the AHCA, 24 million Americans were going to lose health insurance coverage. The AHCA proposed a tax credit not based on income but based on age. This alone was going to raise healthcare costs for many Americans. It also brought a Patient and State Stability Fund that would reduce premiums after 2026 by twenty percent. The consequence of this proposal was higher costs for Americans especially those with pre-existing conditions. In addition, states would have the power to suspend several rules in the ACA, and this was also going to result in Americans with chronic diseases paying higher rates of premium for health insurance coverage (Amadeo, 2018) Discussion: Politics and the Patient Protection and Affordable Care Act

References

Amadeo (October 17, 2018). Obamacare repeal and replacement plans: What a Congressional plan to repeal Obamacare would look like. The Balance. https://www.thebalance.com/us-economy-4073968

 

Buettgens, M. B., Blumberg, L. J., Holahan, J. H., & Ndwandwe, S. N. (2016, June). The Cost of ACA Repeal. Http://Www.Urban.Org. http://www.urban.org/sites/default/files/publication/81296/2000806-The-Cost-of-the-ACA-Repeal.pdf

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6 months ago

Annisha Mcgowan 

RE: Discussion - Week 3

COLLAPSE

Hi Lucy, I enjoyed reading your post. Implemented in 2014, the Affordable Care Act (ACA) aimed to reshape the U.S. healthcare system with the goal of making healthcare coverage more accessible to low-income individuals through key provisions on Medicaid eligibility expansions, subsidies, healthcare exchanges, greater consumer protections, and individual and employer mandates (Ye & Rodriguez, 2021). A large amount of uninsured people gained coverage under the ACA. Low-income communities now can gain access to primary healthcare. Growing up in a low-income community I have seen many people die because they did not have access to healthcare. They were afraid to seek proper healthcare because of the thought of accumulating a bill that they knew they could not afford. According to Bell & Little (2020), African Americans, American Indians, and Hispanics, are significantly more likely to report not having health insurance and not being able to see a doctor due to costs. I do agree with you that politicians want to get reelected so instead of repealing the act they compromised to get the votes they need. It is all about what will get the most votes at the end of the day not what matters the most to the American people.

References

Ye, W., & Rodriguez, J. M. (2021). Highly vulnerable communities and the Affordable Care Act: Health insurance coverage effects, 2010-2018. Social Science & Medicine (1982), 270, 113670. https://doi-org.ezp.waldenulibrary.org/10.1016/j.socscimed.2021.113670

Bell, R. A., & Little, N. R. G. (2020). Sidebar: The Impact of the Affordable Care Act on the Health of Racial and Ethnic Minority Communities in North Carolina. North Carolina Medical Journal, 81(6), 372–373. https://doi-org.ezp.waldenulibrary.org/10.18043/ncm.81.6.372

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6 months ago

Angela Sullivan 

RE: Discussion - Week 3

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"Despite promises made by presidential candidates, the President has no direct power to pass any legislation" (Independence Hall Association, n.d.). Passing of legislation is accomplished through the senate and house of representatives. Voting patterns are influenced by constituents' views, party views and personal views Discussion: Politics and the Patient Protection and Affordable Care Act. 

Members of congress visit their home states and towns speaking with their constituents and their local and state political figures. The work to influence those in their own designated party to vote for them and express their reasons as to why their plans are better than the other party's. I feel this is one reason why we only have two political parties, Republican or Democrat, that ever obtain a position in any federal government office. People vote for the candidate that they trust. If they feel a candidate is untrustworthy, only saying what they feel the people want to hear to gain their votes, etc, this could alter the election with people switching from their normal affiliation.

Independence Hall Association. (n.d.). Congress: The People's Branch? ushistory.org. Retrieved September 17, 2021, from https://www.ushistory.org/gov/6.asp.

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6 months ago

Scott Lamprecht 

RE: Discussion - Week 3

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Great post and I agree! Unfortunately I do not think we can trust any of them at this point. Politicians are about re-election and not about the betterment of society.

 

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