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The American Affordable Care Act (ACA) passed in 2010 without one Republican vote. Since the passing of the ACA, there have been several attempts to repeal the law and amend some of the law. The American Healthcare Act was passed in the House in 2017 and would have created an environment where the older and sicker population would pay more for coverage (Nadash et al., 2018). Several other bills were introduced but failed to get passed into law. The Tax Cuts and Jobs Act passed in 2017 and repealed the tax penalty for not having health insurance coverage (Nadash et al., 2017).

The bills that were introduced to repeal the ACA also threatened to cut funding for Medicare and Medicaid. The elderly that would have been most affected participated in town hall meetings and used their political power to persuade Congress to vote against repeals (Nadash et al., 2017). Any threats to downsize Medicare and Medicaid cause a public uproar. The bills wanted to change the federal matching funds of Medicaid from 90% to 50% to 75% (Thompson et al., 2018). The fact that these bills failed is due mainly to the cost of potential lost votes and reelection.

Those that are most affected by policy changes in healthcare are patients and nurses. Nurses need to take an active role in policy changes in healthcare. According to Milstead and Short (2019), nurses can make a difference by joining professional organizations and paying their dues. Professional organizations can use the money to help fund healthcare policy change. Unfortunately, although nurses make up most healthcare workers, their monetary donations are below other healthcare organizations (Milstead and Short, 2019). The elected officials often do not care what people are affected but will help them get reelected.

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

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.ezp.waldenulibrary.org/10.1080/08959420.2018.1462683

Thompson, F.J., Gusmano, M.K., & Shinohara, S. (2018). Trump and the Affordable Care Act: Congressional repeal efforts, executive federalism, and program durability. Publius: The Journal of Federalism, 48(3), 396-424. https://doi-org.ezp.waldenulibrary.org/10.1093/publius/pjy007

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.