Discussion: Politics and the Patient Protection and Affordable Care Act 

The Affordable Care Act, also known as the ACA had a common goal to make health care and insurance both available and affordable to all individuals. This passed law as of March 2010, allows consumers who fall within a poverty bracket to lower the cost of households, have medicaid coverage, and lower all healthcare costs generally (Affordable Care Act, 2021).
According to Joel Teitelbaum, the ACA was a step in the direction to helping individuals but still left millions of people uninsured. He speaks on future politicians not taking the initiative to continue the movement with the ACA, as it only would continue to be a challenge as there were many “pitfalls” (Teitelbaum,2018) Discussion: Politics and the Patient Protection and Affordable Care Act. Joel discussed social determinants of health that influence where we live, work and play. He spoke upon an example of mold in an apartment and a child who is suffering from Asthma in which who a lawyer could be more of a help to that child over a physician. Joel brings up a very interesting point, in which I would have never look at the situation from this perspective. Although the child can be treated by a physician multiple times until the child feels better, he states that it is the lawyer who will make the difference. The lawyer has the connections to bring the issue up through housing laws, which will then reach public health and be affected for the greater good.

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More so, if legislators do not believe in the different movements to help aid in these changes, then we are at a stand still with the ACA. If legislators only have a goal in being re-elected, rather than having the common greater goal of something such as aiding individual’s and the ACA, then it seems like it is all for nothing. For families, the ACA is about security, not about votes. They want a leader is going to be there to support them in this movement Discussion: Politics and the Patient Protection and Affordable Care Act.

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

Affordable care Act (ACA) – HEALTHCARE.GOV GLOSSARY. HealthCare.gov. (n.d.). Retrieved September 12, 2021, from https://www.healthcare.gov/glossary/affordable-care-act/.

Great post,

Although the United States has not established Universal Health Care, many uninsured individuals obtained insurance coverage due to the initiation of the Affordable Care Act ( ACA) (Laureate Education, 2018). Currently there are still barriers in place preventing some individuals from obtaining health care insurance. Discussion: Politics and the Patient Protection and Affordable Care Act Legislators must put party lines aside and work collectively to make the ACA work to provide all Unites States citizens health care insurance.

References

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

Walden University. (n.d.). Discussion: Politics and the patient protection and affordable care act. Nurse 6050 Policy and Advocacy for Improving Population Health.

https://class.content.laureate.net/e8517d23c2d0ac3f4b543fdb9c5ef220.html#section_container_20

               The Affordable Care Act (ACA) was passed by Congress in 2010 and signed by President Obama.  The idea was to provide affordable healthcare to all American’s by expanding Medicaid and giving access to different health insurance marketplaces (Ercia, 2021). Despite an inconsistent role out from state to state on whether Medicaid was expanded, it is estimated that 10.8 million low income or uninsured Americans enrolled in Medicaid in 2014 (Erica, 2021) Discussion: Politics and the Patient Protection and Affordable Care Act. People had expectations of keeping the same primary care providers and that proved to be challenging with the ACA. Americans should have equal access to quality healthcare and the ACA attempted to give just that. Unfortunately, legislators have been fighting the different aspects of the ACA since its role out in 2010, both Democrats and Republicans.

According to Milstead & Short (2019), the threat of an upcoming reelection cycle directly affects what policymakers are willing to do in terms of making changes and implementing these changes. Unfortunately, while they should be making decisions based on their constituents, they do not always have their interest in mind. Due to this fact, many legislators have been fighting to make changes with the ACA but have not moved forward due to losing the majority vote. Overall, the ACA had a good foundation, and increased healthcare options for millions of Americans. Unfortunately, at the same time made it very difficult for small business owners to provide health insurance to their employees, increased costs of prescription drugs, and was the largest tax increase in American History (Yu, 2020). Due to these conflicting reasons, the ACA has remained a political battle and these factors affected decisions by leaders on both sides of the spectrum Discussion: Politics and the Patient Protection and Affordable Care Act.

References:

Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: perspectives from FQHC administrators in Arizona, California and Texas. BMC Health Services Research, 21(1), 920. https://doi-org.ezp.waldenulibrary.org/10.1186/s12913-021-06961-9.

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

Yu, X. (2020). Effect of ACA on American Health System: —— Is Affordable Care Act Worth it? 2020 International Conference on Public Health and Data Science (ICPHDS), Public Health and Data Science (ICPHDS), 2020 International Conference on, ICPHDS, 310–315. https://doi-org.ezp.waldenulibrary.org/10.1109/ICPHDS51617.2020.00067.

A wonderful post!

I agree with you. Despite ACA decreasing the uninsured and expanding Medicare and Medicaid, the legislator has remained divided on how ACA should operate. The difference of state-to-state decisions, and further looking at the cycle of voting, independence of the legislator lacks, its partisanship. Legislators vote more for a party than what is best for the people, and re-election is their paramount objective.  The fighting between democrats and republicans is evident; when late John McCain voted against repeal of ACA as a Republican, he was almost an outcast within his party. As indicated, it is about the party member’s re-election. During the repeal, only three republicans voted against the bill. The Maine, Alaska and Arizona, although for McCain re-election played no impact in his decision, for the others two it was obvious re-lection was their agenda,

References:

https://www.npr.org/2017/07/27/539907467/senate-careens-toward-high-drama-midnight-health-care-vote

Great post! I agree that politicians are forced to vote along party lines. Personally, we need to scrap teh Party system and remake the government, but that would require the current Parties/politicians to give up power which will never happen. Same as getting rid of the lobby system or setting term limits. Politicians will never vote against themselves for the good of the public.

Week 3 Discussion Main Post

September 14, 2021

Salome Ugwu

A cost benefit analysis (also known as a benefit cost analysis) is a process by which organizations can analyze decisions, systems, or projects, or determine a value for intangibles. The model is built by identifying the benefits of an action as well as the associated costs and subtracting the costs from benefits. When completed, a cost benefit analysis will yield concrete results that can be used to develop reasonable conclusions around the feasibility and/or advisability of a decision or situation. (online, n.d.). I believe a lot of legislators make decisions that for the most part will affirm their reelection. Each legislator depending on what cities or state they represent will analyze the interests of their voters and determine what legislation should be included and what should be eliminated.  The Affordable Care Act (ACA) expanded and improved health insurance coverage in two primary ways. First, the number of individuals receiving insurance coverage expanded by increasing access to coverage through Medicaid expansion and providing subsidies to purchase private insurance on the health care exchanges. (Charley et al, 2017).

House Republicans efforts to repeal/replace the ACA included eliminating essential health benefits (EHBs) from the individual and small-group markets. Even with the amendment and pressure from President Trump, House Republicans did not have enough votes to pass AHCA and pulled the bill from consideration. (Charley et al, 2017). There were not enough votes to replace/repeal the AC because voters made their voices heard. I believe legislators fearing to lose reelection made an impact on their decision to repeal/replace the ACA. Politics is the mechanism by which policies are made, policies affect the healthcare system and thus our work. (Laureate Education, 2018). Legislators hold town halls and meetings where healthcare providers and individuals in their communities speak up about health care issues. Any legislator up for re-election will think first about securing their votes in the community by supporting the decisions of voters. Does policy responsiveness on the part of incumbent legislators affect their prospects for reelection? Recent studies of congressional campaigns demonstrate that incumbents who support policies that are more congruent with their constituents’ preferences face fewer reelection obstacles. (Robert, 2008).

References

Online reference. N.d. An Expert Guide to Cost Benefit Analysis. Available from https://www.smartsheet.com/expert-guide-cost-benefit-analysis (Accessed: September14, 2021).

Charley E. Willison and Phillip M. Singer. August 2017. Repealing the Affordable Care Act Essential Health Benefits: Threats and Obstacles. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508159/ (Accessed: September 14, 2021).

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

Hogan, R. (2008). Policy Responsiveness and Incumbent Reelection in State Legislatures. American Journal of Political Science, 52(4), 858-873. Retrieved September 14, 2021, from http://www.jstor.org/stable/25193854

President Obama’s one of the campaign’s undertaking is healthcare reform that led him to pass the Protection and Affordable Care Act Bill on Christmas Eve in 2009 on the senate level and eventually signed into law in 2010. (Faguet,2013). The Affordable Care Act’s goal, in summary, is to expand access to insurance coverage, increase consumer insurance protections, emphasize prevention and wellness, improve health quality and system performance and promote health workforce development (NCSL,2011) Discussion: Politics and the Patient Protection and Affordable Care Act.

The cost-benefit analysis in the Affordable Care Act is encumbered by controversy on what should be reformed in the possibility of repeal. During President Trump’s administration, he strongly supported the retrovert of ACA implementation (Jost,2018) since he believed that replacing it would provide better coverage at lower insurance premiums. In addition, republican legislators have attempted without success to repeal the ACA.

On the other hand, legislator’s political shift on health care may be accelerating. Many Americans embrace the Affordable Care Act despite the struggle in the health insurance marketplace (The New York Times, 2016). Voters impact government policies by compelling legislators to adopt on different platforms. Competition for votes is robust in that it can force the legislators to mediate on policy choices. Hence, it is crucial for the legislators to be reelected for them because at the end of the day, the winning legislator, after acquiring a position, will most definitely pursue his most highly favored policy.

References:

Walden University Library, Guy Faguet, 2013. Affordable Care Act: A Missed Opportunity, A Better Way Forward. https://ebookcentral.proquest.com/lib/waldenu/reader.action?docID=1363733&query=

King, M., & Garcia, A., March 2011. The Affordable Care Act: A brief Summary. https://www.ncsl.org/research/health/the-affordable-care-act-brief-summary.aspx

Sanger-Katz, M., & Bui, Q., October 2018. The Impact of Obamacare, In Four Maps. https://www.nytimes.com/interactive/2016/10/31/upshot/up-uninsured-2016.html

Timothy Jost, August 2018. The Affordable Care Act Under the Trump Administration. https://www.commonwealthfund.org/blog/2018/affordable-care-act-under-trump-administration

Hi Cyrin,

You make great points in your post regarding the Affordable Care Act (ACA) and the effect it has had on both the Republican and Democratic legislators. Your statement on the fact that legislators will be forced to mediate on topics, so that once they win the popular vote, they may be able to pursue policies that they feel most strongly about is so true and a mechanism that is widely used to be reelected Discussion: Politics and the Patient Protection and Affordable Care Act.

Despite the current pandemic, the ACA has shown its sturdiness. People continue to hold medical insurance through Medicaid expansion and its marketplaces (Glied, 2021). So, despite the different presidential and legislator opposing views, The ACA has still yet to be fully repealed and has proven to be beneficial for people navigating the pandemic. Milstead & Short (2019), state that legislators are directly affected by their reelection status when it comes to decision making on policies. Your post points that out perfectly!

-Betsy

References:

Glied, S. (2021). Continue Moving Forward on the Affordable Care Act Path. American Journal of Public Health, 111(4), 612–613. https://doi-org.ezp.waldenulibrary.org/10.2105/AJPH.2021.306175

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

Great post; I agree that the Affordable Care Act is encumbered by controversy with Trump’s intention to repeal or replace it with Trumpcare. While consumers and public health advocates have welcomed the essential health benefits, they are now under threat. A handful of federal policy proposals on the table could undermine the benefits rule, make comprehensive coverage less accessible and affordable, and take a significant step backward for public health (Krisberg, 2018). It has struck the nerves of the voting public who are beneficiaries of the affordable care act. Health policy is complicated, and the average voter doesn’t have the time or inclination to read through all the legal arguments associated with the ACA. In this environment, voters look to party leaders for cues (A Conundrum). When legislators took advantage of the issue and sided with the voters, need for the Affordable Care Act, those who defended the ACA significantly benefited from retaining office than their opposition.

References

Krisberg, K. (2018, May). ACA essential health benefits come under threat. Nation’s Health, 48(3), 1–10.

A Conundrum: Majority of Republican Voters Want to Overturn ACA but Keep Protections for People with Pre-existing Conditions. (2020, November 2). KFF. https://www.kff.org/policy-watch/a-conundrum-majority-of-republican-voters-want-to-overturn-aca-but-keep-protections-for-people-with-pre-existing-conditions/

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.