NURS 6050 week 3 Discussion: Politics and the Patient Protection and Affordable Care Act

Cost Benefit Analysis

 President Obama’s 2010 Affordable Care Act (ACA) was primarily designed to allow people to acquire insurance coverage. The law also provided coverage for people who were already managing some pre-existing diseases; it was also established to enable citizens to access affordable health insurance, support creative healthcare delivery strategies, and expand the Medicaid program coverage (Clanagan et al., 2011). However, the ACA has been subjected to criticism since it failed to achieve the intended ends fully. Besides, having health insurance become a liability for the people of America. Those without health insurance would always face penalties. Another cost incurred regards the budget cuts that had to be implemented to expand and integrate the ACA (Clanagan et al., 2011). These have been some of the Obamacare cons, which politicians are using as critical political points of argument. Because of this, many politicians have been using these issues for re-election. Instead of showing concern for the future of healthcare accessibility, politicians have and continue to use the ACA as a tool to be re-elected. 

 During President Trump’s reign, he wanted the ACA eliminated, while other interested stakeholders wanted it developed further, leading to divided interests from the legislators. The primary reason why these politicians have been exploiting the ACA subject is for them to be re-elected. The political approach to public interest issues causes skewed and biased perspectives since politicians often prioritize issues that benefit them (Guenther & Searle, 2019). This goal does not support the intended benefits for the American people but personal political interest.

Voter’s Perspective 

 The voters’ perspectives have a significant impact on legislative decisions. The National Council for the Social Studies postulates that legislators employ the Triangle Test (TT) in their voting decisions (n.d). For example, they must consider whether their constituents care about the issue at hand, whether the policy is good for the nation, and whether the approach makes sense and is press-worthy. However, when a legislator’s primary interest is re-election, they would support the popular side, making election or re-election to office straightforward.



Clanagan, S. L. , Ferrier, T., & Patel, S. (2011). Cost-benefit analysis to address runaway health care expenditures through lifestyle modification recommendations. IEEE Systems and Information Engineering Design Symposium (198-203). IEEE. doi: 10.1109/SIEDS.2011.5876880

Guenther, S. M., & Searle, D. M. (2019). Limited time, limited resources: Trade-offs in congressional earmarking and policymaking. American Politics Research, 47(4), 832-851.

National Council for the Social Studies (NCSS). (n.d). How legislators make decisions. Retrieved from


Discussion: Politics and the Patient Protection and Affordable Care Act

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.

sample response

You are so right Trevonda; health care reform should be an ongoing process and not a tool for reelection by politicians. The affordable care act (ACA) solved some health care coverage issues. The uninsured rate declined by 43%, from 16% in 2010 to 9.1% in 2015 (Obama, 2016). It enabled the state to expand Medicaid, which in turn helped with the treatment of opioid abuse. Some parts of the ACA needed replacement, and others developed on; instead, we have politicians with special interest asking for a total replacement. Replacing the ACA was not budget-friendly, and voters supported it, so it was difficult for the politicians to replace it.

Voters do impact who gets elected or reelected. So, nurses who are about 3.8 million in American (Smiley et al., 2018) need to be more involved in policymaking because there is power in numbers.


Obama, B. (2016). United states health reform: Progress to date and next step. JAMA 316: 524-


Smiley, R.A., Lauer, P., Bienemy, C., Berg, J.G., Shireman, E., Reneau, K. A., & Alexander, M.

(2018). The 2017 national nursing workforce survey. Journal of Nursing Regulation, 9(3), S1-S88.

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