Discussion: Politics and the Patient Protection and Affordable Care Act
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 Discussion: Politics and the Patient Protection and Affordable Care Act.
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).
- Discussion: Politics and the Patient Protection and Affordable Care Act
- 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 votes views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid) Discussion: Politics and the Patient Protection and Affordable Care Act. 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 Discussion: Politics and the Patient Protection and Affordable Care Act.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.
*Note: Throughout this program, your fellow students are referred to as colleagues.
REPLY QUOTE
6 months ago
KAREN MARUYAMA
Main Post – Discussion – Week 3
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. (Walden University, (n.d.)) Discussion: Politics and the Patient Protection and Affordable Care Act.
Lee et al. (n.d.) describes how voters can significantly influence political candidates, to favor certain policies, purely by the candidate’s need to win the majority vote for an election win. According to Pramuk (2019), ObamaCare, also known as the Patient Protection and Affordable Care Act (PPACA), has played a pivotal role in the re-election of a Democratic based Presidential Administration since its enactment in 2010, by the Obama Administration. Pramuk (2019), describes that “In 2010, a voter rebellion against the health-care law helped Republicans wallop Democrats and gain House control”.
Pramuk (2019) further identifies how ObamaCare was not very much accepted initially, but gained popularity during the Trump Administration, when the effects of it likely was seen by The American Public. A survey on Obamacare by Kaiser had shown that the majority were in favor of it. (Pramuk, 2019). Trump at the time of his election against Biden, had placed a great deal of focus on counteracting ObamaCare; And it did not place him in the most favorable eye of the American Public, with the popular vote then changed to favor of Obamacare. (Pramuk, 2019). More than any policy issue, the AAPCA has taken a front seat as a significant issue on the outcome of presidential elections since it was signed into law. (Pramuk, 2019). The Republican Party had repealed the PPACA more than 50 times. (Pramuk, 2019).
Since the PPACA’s enactment, millions had gotten coverage through the Medicaid expansion, funding for which Republicans were going to eliminate, or with the help of federal subsidies for private coverage, which Republicans proposed to redirect and shrink. Others had come to count upon guarantees of coverage for people with preexisting conditions, which Republicans proposed to undermine, albeit in roundabout ways. (Cohn, 2020).
It can be therefore argued that if The Trump Administration had not taken the approach of undermining the PPACA, that perhaps President Trump would have had the majority vote and re-elected into a second term. (Pramuk, 2019) Discussion: Politics and the Patient Protection and Affordable Care Act.
References
Cohn, J. (2020, March 6). The aca, repeal, and the politics of backlash. Health Affairs Blog. https://www.healthaffairs.org/do/10.1377/hblog20200305.771008/full/
Lee, D., Moretti, En., & Butler, M. (n.d.). Do voters affect or elect policies? Evidence from the u.s. house. https://econ.duke.edu/~psarcidi/lunchf08/leemorebutler.pdf
Pramuk, J. (2019, December 27). A decade of obamacare: How health care went from wrecking to boosting democrats. CNBC.
https://www.cnbc.com/2019/12/26/how-obamacare-affected-democrats-in-presidential-elections.html
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
REPLY QUOTE EMAIL AUTHOR
6 months ago
Scott Lamprecht
RE: Main Post – Discussion – Week 3
Great post! But please consider the ACA increased the number of individuals with insurance that resulted in a major increase in patients seeking care Discussion: Politics and the Patient Protection and Affordable Care Act. Many wait times were several months for a Primary Care appt. This had many individuals going to the ER for primary care which added millions in healthcare spending. This made the ACA unaffordable. Was there another option to control costs?
REPLY QUOTE
6 months ago
KAREN MARUYAMA
Response to Main Post – Discussion – Week 3
Hello Dr. Lamprecht! Thank you for the reply about how the PPACA negatively impacted the public’s access to primary healthcare, that created burden on the emergency care system, and as a result an increase in healthcare spending, ultimately rendering the PPACA unaffordable Discussion: Politics and the Patient Protection and Affordable Care Act
Blumenthal, et al. (2020), describes that although the PPACA has increased its latitude of coverage eligibility to the uninsured or underinsured across America; The “law’s effects on the cost and quality of health care services are difficult to discern given the complexity of our health system”. Blumenthal, et al. (2020), further relates that individual “states have had considerable discretion in how the ACA is implemented, creating variability in how the law has affected people across the country”.
Health Payer Intelligence (n.d.), describes how “in 2012, a Supreme Court ruling further complicated the landscape by allowing states to choose whether or not to expand their Medicaid coverage to insure more low-income individuals.” Health Payer Intelligence (n.d.) further describes how “currently, nineteen states have still not expanded their Medicaid programs, which is causing disparities in healthcare access and leaving millions of patients with few coverage options.”. It could be argued that with increase in health care spending that you mentioned Dr. Lamprecht, is perhaps due in large to Americans utilizing emergency care instead of primary care, because of the lack of expanded Medicaid coverage option of the uninsured in select states. Another possible reason for the increase in health care spending according to Health Payer Intelligence (n.d.), is that the PPACA required payers to cover preventative services for their clients, resulting in payers charging the public higher insurance rates.
One way to curb the health care spending cost America, was in the form of federal or state subsidiaries that allowed for non-Medicaid eligible Americans to receive tax subsidization. (Health Payer Intelligence, n.d.). Health Payer Intelligence (n.d.), then in contrast describes how those that don’t qualify for these subsidies are “left facing large health insurance costs on the exchange” and “while the individual mandate led to a large increase in the number of Americans with health insurance, many are still choosing to take the tax penalty because they are ineligible for subsidies but can’t afford the full price of insurance from the exchange.” This would therefore, perhaps appear that the PPACA is not affordable, when perhaps there are other variables such as individual state options to expand their Medicaid eligibility to more of the uninsured, increase in charges by insurance payers because the PPACA requires payers to cover preventive costs and clients are ultimately up charged in premiums, and also because there are Americans that don’t qualify for state or federal subsidization or able to pay for the cost of maintaining health insurance coverage.
Blumenthal, D., Collins, S., Fowler, E. (2020, February 26). The affordable care act at 10 years: What’s the effect on
health care coverage and access? The Commonwealth Fund. . Retrieved September 16, 2021, from
https://www.commonwealthfund.org/publications/journal-article/2020/feb/aca-at-10-years-effect-health-care-coverage-access
Health Payer Intelligence. (n.d.). The progress and challenges of the affordable care act. Retrieved September 16,
2021, from https://healthpayerintelligence.com/features/the-progress-and-challenges-of-the-affordable-care-act
REPLY QUOTE EMAIL AUTHOR
6 months ago
Scott Lamprecht
RE: Response to Main Post – Discussion – Week 3
Great post! This worked for a little bit and did lower premiums, but insurance companies drastically increased deductibles up to and exceeding $15,000 annually. This means an individual has to pay $15,000 out of their pocket before any insurance kicks in. Discussion: Politics and the Patient Protection and Affordable Care Act This means the insurance companies are collecting premiums without paying any money out. In 2020, BCBS turned record profits even with COVID.
REPLY QUOTE
6 months ago
KAREN MARUYAMA
Response – Discussion – Week 3
Hi there, Dr. Lamprecht!
Thank you for your reply on the hardships Americans go through with out-of-pocket expenses with jarring increases of insurance deductibles and the record-setting profits that companies such as BCBS had gained from American citizens. A ridiculous amount of money that citizens are required to sacrifice to obtain coverage in healthcare.
Idowu wrote a post within this thread that stated ” The aim of the ACA is to grant all America access to a health insurance with a reasonable premium Discussion: Politics and the Patient Protection and Affordable Care Act.” It sounded like the concept of universal health care. According to Zief, et al. (2020) the approval of the ACA was partly due to the intent of moving The United States of America towards a step into universal health care. Hughes (2020) also confirms that the ACA had “brought the U.S. closer to providing universal health care through subsidized private health insurance”. Hughes (2020) further describes how our current health care system is based on a collective pool of insurance from private and public sources “and politics that drives up costs, creating significant barriers to lifesaving medical treatment for large segments of the population”. In America, access to quality health care often depends on income, employment and status. (Hughes, 2020).
Hughes believes that equal access to medical care is beneficial for both liberty and social stability. Health, he says, should not be tied to wealth. “I think it’s very disturbing that people have to go to GoFundMe in order to get their medical treatments paid for. It creates a power imbalance,” he said, referring to the crowdsourcing platform used to help raise money for patient bills. “That’s why I say that truly universal health care would be good for people’s liberty. Because you’re not really free if you’re depending on charity, especially discretionary charity like the kind you see on GoFundMe, for a basic need like health care.” (Hughes, 2020) Discussion: Politics and the Patient Protection and Affordable Care Act.
I am wondering what will happen to the insurance companies in their ability to remain in business once we reach a level equivalent to universal health care in other countries such as The United Kingdom, Japan, Australia, etc. If they still will be a part of the system then, I wonder how much involvement they would have with the healthcare coverage of the American public. With the extravagant profits that insurance profiled companies generate, it appears that the health care system in America continues to have an imbalance of healthcare and financial management across the public, private, and political sectors. Perhaps when a more even balance is reached, we could then say that the United States of America has a universal healthcare system.
Hughes, R. (2020, December 8). Does the u.s. need universal health care? Wharton University.
Retrieved Retrieved September 18, 2021, from, https://knowledge.wharton.upenn.edu/article/u-s-need-universal-health-care/
Zief, G., Kerr, Z., Moore, J., Stoner, L. (2020, November). Universal healthcare in the united states of
america: A healthy debate. Medicina (Kaunas), 56 (11): 580. Retrieved September 18, 2021, from, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692272/
REPLY QUOTE EMAIL AUTHOR
6 months ago
Afanwi Ntumngia
RE: Main Post – Discussion – Week 3
Interesting post-Karen. I agree with you; perhaps President Trump would have had the majority vote and re-elected into a second term if The Trump Administration had not taken the approach of undermining the PPACA. Former President Donald Trump was no fan of the Affordable Care Act, more commonly known as Obamacare. He wanted it gone, replaced by the American Health Care Act — a.k.a. Trumpcare. His plan would be far superior to Obamacare, Trump boasted. It would be cheaper, better, and provide “insurance for everybody.” Obamacare “is one of the greatest threats our country faces. It is unsustainable and will lead Americans into complete insolvency,” Trump said in one of his 435 tweets that bashed the Affordable Care Act (Collier, R.2017). Other political insiders have suggested that Trump appeared more interested in saving face than learning the complexities of the health care system. He feared the optics of losing and how it would affect his first-term plan and, eventually, his chances for re-election in 2020. Many Americans became so concerned that they turned to activism, both online and in public. They engaged on social media, and this affected the Trump administration because Voters views analysis involves national policies due to people’s different choices (Canfield. D et al.,2010) Discussion: Politics and the Patient Protection and Affordable Care Act
Reference
Collier, R. (2017). Why Trumpcare failed. CMAJ: Canadian Medical Association Journal, 189(17), E645–E646. https://doi-org.ezp.waldenulibrary.org/10.1503/cmaj.1095414
Canfield-Davis, K., Jain, S., Wattam, D., McMurtry, J., & Johnson, M. (2010). FACTORS OF INFLUENCE ON LEGISLATIVE DECISION.
REPLY QUOTE EMAIL AUTHOR
6 months ago
KAREN MARUYAMA
Response – Discussion – Week 3
Hi Afanwi!
Thank you for your reply of how Trump had antagonized Obamacare, as an example of how he had appeared to be more concerned with the tactics of being re-elected into a second term, rather than having been focused on creating a new health care act or modifying/building upon Obamacare. This then swayed the American public to speak out through activism, and ultimately played in Trump’s inability to be re-elected into a second term. This is a clear example of how political players are primary focused on obtaining the majority vote for re-election Discussion: Politics and the Patient Protection and Affordable Care Act.
Collier (2017) further describes how Trumpcare did not have any political support with his repeal as it was not presented as an acceptable and possibly appropriate replacement bill to Obamacare. Leonhardt (2017) further affirmed and described that the agenda that Trump created to appeal Obamacare was not coherent. Booker (n.d.) relates that the Trumpcare bill would have escalated the costs of health insurance for Americans, would have covered fewer Americans, and would have provided less health care coverage to the American people. Collier (2017) further details that Trump was not able to realistically grasp the financial ramifications of repealing Obamacare with a projected loss of $880 billion from Medicaid, with the Congressional Budget costs over the next 10 years. Trump later “admitted that the challenge of transforming health care was bigger than he had imagined” and that “Nobody knew that health care could be so complicated”. (Collier, 2017).
Booker, Cory. (n.d.). Trumpcare fails. Retrieved September 17, 2021,
from, https://www.booker.senate.gov/news/videos/watch/trumpcare-fails
Collier, R. (2017, May 1). Why trumpcare failed. CMAJ. 189 (17) E645-E646. Retrieved September 17,
2021, from, DOI: https://doi.org/10.1503/cmaj.1095414
Leonhardt, D. (2017, March 27). Why trumpcare failed. The New York Times. Retrieved September 17,
2021, from, https://www.nytimes.com/2017/03/27/opinion/why-trumpcare-failed.html
REPLY QUOTE EMAIL AUTHOR
6 months ago
Andrea Cholagh
RE: Main Post – Discussion – Week 3
Great post Karen, you cover great points on how a voter’s views can impact a legislator’s decision in favoring certain policies. As Lee et al. (n.d.), describes in your post, Milstead & Short (2019) describe a similar statement; those legislators are more focused on how developing policies affect people but rather on how those changes will affect their own re-election chances. I also read about Obamacare being less favorable in the beginning but, more favorable after the Trumps administration (Hawryluk, 2020). Do you think that the COVID-19 pandemic has impacted voter’s viewpoints on the ACA? Discussion: Politics and the Patient Protection and Affordable Care Act
References
Hawryluk, M. (2020, August 28). Opposition to Obamacare becomes political liability for GOP incumbents. Retrieved September 13, 2021, from https://khn.org/news/opposition-to-obamacare-becomes-political-liability-for-gop-incumbents/
Lee, D., Moretti, E., & Butler, M. (n.d.). Do voters affect or elect policies? Evidence the u.s. house. Retrieved September 15, 2021, from https://econ.duke.edu/~psarcidi/lunchf08/leemorebutler.pdf
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6h ed.). Burlington, MA: Jones & Barlett Learn
REPLY QUOTE EMAIL AUTHOR
6 months ago
KAREN MARUYAMA
Response to Main Post – Discussion – Week 3
Hi there Andrea!
Thank you for pointing out the relationship with voter’s views and legislators and their re-election changes. You posed an interesting question – if the COVID-19 pandemic has impacted voter’s viewpoints on the ACA. Seervai (2020) reports that Pre-existing health conditions was the heaviest worry on the minds of the American people in 2020 because of the onset of the Covid 19 pandemic. This public concern triggered a voting poll on who Americans were more likely to vote as our next president, Biden or Trump, on the focus topic of preexisting conditions; Biden had won the majority vote. (Seervai, 2020). Seervai (2020) went on further to detail that Biden supported the ACA and had plans to build further on it, whereas Trump had plans to repeal it. And because Trump was not able to clearly state how he would bring about maintaining or even improving upon protecting Americans with pre-existing conditions, despite his plans to repeal the ACA, it created a lack of confidence in the minds of citizens, leading the public to select Biden over Trump of who they were willing to elect as our next president. Even with the statistics analyzed over the battleground states, Biden still came out as the majority president select when it came to pre-existing conditions. v Those states felt that “Biden would be more likely to address the health needs and economic costs of COVID-19, as well as to lower health care costs” and that “Biden is most likely to protect health coverage for people with preexisting conditions.” (Seervai, 2020).
Seervai, S. (2020, October 1). COVID-19 and preexisting conditions are voters’ biggest health care
fears. The Commonwealth fund. Retrieved September 17, 2021, from,
https://www.commonwealthfund.org/publications/podcast/2020/oct/covid-19-and-preexisting-conditions-are-voters-biggest-health-care
REPLY QUOTE EMAIL AUTHOR
6 months ago
Andrea Cholagh
RE: Response to Main Post – Discussion – Week 3
Thank You for answering my question! Those are great facts, I also really enjoyed your article choice!
REPLY QUOTE EMAIL AUTHOR
6 months ago
salome ugwu
RE: Main Post – Discussion – Week 3
Karen
I definitely agree with your post gaining or losing support when they vote in favor, or against, health care matters. The biggest percentage of lobbyist that support the Affordable Care Act comes from the pharmaceutical industry. Sanofi, Roche, Novartis and AstraZeneca are a few big corporations that supported the Affordable Care Act (OpenSecrets.org, n.d.). From Feldstein’s statement, the cost-benefit analysis of legislators revolves on political supporters; cost are lost supporters and benefit are gained supporters (Feldstein, 2006).
If the ACA were repealed the group of people who lost their coverage would surely not be in favor of those people. The Repeal and/or replace efforts to the Affordable Care Act (ACA) have been ongoing since the first day the bill was enacted. The American Health Care Act (AHCA) was one of the proposed replacements of the ACA. Despite of the increasingly unpopular ACA, the AHCA failed to be passed because of the strong influence of lobbyist and their efforts. According to the (McGreal, 2009), “there are six registered healthcare lobbyists for every member of Congress and that healthcare firms’ money has a lot of influence”. Milstead and Short (2019, p. 40), state, “Policymakers are not necessarily focused on how real people will be affected by changes to Obamacare or Medicare and Medicaid but rather on how the changes will affect their own re-election chances”. With the 2020 elections coming up, we might be able to see how, health care lobbyist can sway the outcome with the amount of campaign contributions made to a specific candidate endorsing their cause Discussion: Politics and the Patient Protection and Affordable Care Act.
References
OpenSecrets.org (n.d.) H.R.3590:Summary. Retrieved from https://www.opensecrets.org/lobby/billsum.php?id=hr3590-111
McGreal, C. (2009, October 1). Revealed: millions spent by lobby firms fighting Obama health reforms. The Guardian. Retrieved from https://www.theguardian.com/world/2009/oct/01/lobbyists-millions-obama-healthcare-reform
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
REPLY QUOTE
6 months ago
KAREN MARUYAMA
Response – Discussion – Week 3
Hi there Salome!
Thank you for the interesting reply on how the largest supporters of the ACA were lobbyists representing wealthy pharmaceutical companies, and that said supporting lobbyists translated into votes for those seeking re-election seats. I also note that you mentioned that it does appear to be commonplace that the primary goal of a policymaker is to be re-elected into office as we have seen with many posts here on this discussion thread, and that as you have said that they are focused on how policy changes will affect their re-election chances as opposed to how the changes will affect the public.
Lobbying is an important lever for a productive government. Without it, governments would struggle to sort out the many, many competing interests of its citizens. Fortunately, lobbying provides access to government legislators, acts as an educational tool, and allows individual interests to gain power in numbers. (Weiser, 2021).
Hancock (2018) affirms that a representing lobbyist group of a top pharmaceutical company made their support of the ACA public and had invested millions to promote the ratification of the ACA. Hancock (2018) further describes how in contrast another pharmaceutical big company had invested millions in a move to repeal the ACA. On either end of the spectrum, in support of or against the ACA, pharmaceutical lobbyists’ supporting or negating positions played a large part in voter influence with legislators. (Hancock, 2018). Some of their tactics ranged from “TV ads, phone calls, grass-roots organizing and other investments used to influence politics”. (Hancock, 2018) Discussion: Politics and the Patient Protection and Affordable Care Act.
Hancock, J. (2018, July 27). The stealth campaign to kill off obamacare. The New York Times.
Retrieved September 18, 2021, from, https://www.nytimes.com/2018/07/27/business/the-stealth-campaign-to-kill-off-obamacare.html
Weiser, D. (2021, July 12). Why lobbying Is legal and important in the u.s. Investopedia. Retrieved
September 18, 2021, from, https://www.investopedia.com/articles/investing/043015/why-lobbying-legal-and-important-us.asp
REPLY QUOTE EMAIL AUTHOR
6 months ago
Jessica Ferrin
RE: Discussion – Week 3
In terms of legislation reelections, one must consider the population to which the legislator is appointed. Following the census reports every ten years, states are required to redraw district lines (National Conference of State Legislatures, 2021). A diplomatic approach must be made when developing strategies and positions of their agenda during reelection. For example, Cory Gardner, an elected Republican from Colorado who in 2014 opposed the Affordable Care Act (ACA) during his campaign and promised to repeal it (Hawryluk, 2020). While his stance on the ACA benefitted his election in 2016, American views on healthcare have now shifted due to the pandemic. Discussion: Politics and the Patient Protection and Affordable Care Act During the 2020 campaign, Gardner removed his ACA repeal ads from his campaign site (Hawryluk, 2020). Gardner lost the 2020 election to the Democratic former Colorado Governor who supported the ACA and promised to expand healthcare even further during his 2020 campaign Discussion: Politics and the Patient Protection and Affordable Care Act.
Peter Beilenson discusses that one should develop their stance based on the population’s needs, making it essential to assess their needs (Laureate, 2018). In 2017 the first attempt to replace the ACA by Congressional Republicans and The White House were unsuccessful (Willison & Singer, 2017). In the 2020 election, President Trump continued to campaign for the repeal of the ACA while in the middle of a pandemic. A huge topic that appealed to Americans was that the ACA prohibits health insurance companies from denying coverage based on pre-existing conditions (Huguet et al., 2021). Due to the uncertainty of the long-term effects COVID-19 may have on individuals, I believe the election swayed away from President Trump and his stance on the ACA.
References
Hawryluk, M. (2020, August 28). Opposition to Obamacare Becomes Political Liability for GOP Incumbents. Retrieved from https://khn.org/news/opposition-to-obamacare-becomes-political-liability-for-gop-incumbents/
Huguet, N., Schmidt, T., Larson, A., O’Malley, J., Hoopes, M., Angier, H., . . . DeVoe, J. (2021, February). Prevalence of Pre-existing Conditions Among Community Health Center Patients With COVID-19: Implications for the Patient Protection and Affordable Care Act. The Journal of the American Board of Family Medicine, 34(Supplement). Retrieved from https://www.jabfm.org/content/34/Supplement/S247.full
Laureate Education (Producer). (2018). Peter Beilenson: Population Health [Video file]. Baltimore, MD: Author.
National Conference of State Legislatures. (2021, March 29). Redistricting. Retrieved from Redistricting Systems: A 50-State Overview: https://www.ncsl.org/research/redistricting/redistricting-systems-a-50-state-overview.aspxm Discussion: Politics and the Patient Protection and Affordable Care Act
Willison, C. E., & Singer, P. M. (2017, August). Repealing the Affordable Care Act Essential Health Benefits: Threats and Obstacles. American journal of public health, 107(8), 1125-1226. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508159/ Discussion: Politics and the Patient Protection and Affordable Care Act
REPLY QUOTE EMAIL AUTHOR
6 months ago
Scott Lamprecht
RE: Discussion – Week 3
Great post! Many people do not realize that politicians are about re-election, not representing constituents. They will do or change whatever is needed to get elected. This is sad, but it is reality. Being aware of this can be used to bring agenda items forward.
REPLY QUOTE
6 months ago
Faith Momodu
RE: Discussion – Week 3-Response 1
Hello Jessica,
Great post for the topic of discussion this week. I didn’t think of the district lines affecting the legislators’ perspective on if to support appealing the Affordable Care Act (ACA). It does make sense that if a senator’s constituents were supportive of the repeal effort, they would back it because they need them happy. It would be nice for legislators to think of what is best for their citizens instead of elections. The ACA was put in place to help because the main goal was to “expand the number of people with health insurance” (Skinner & Chandra, 2016). As you said, the Trump administration tried to repeal the ACA a couple of times but was unable to except for removing the individual tax mandate. Discussion: Politics and the Patient Protection and Affordable Care Act
The pandemic made the need for health insurance higher, and the ACA helped a lot with this. “Before the Affordable Care Act (ACA) was implemented, people who lost their jobs had limited choices for health insurance” (Agarwal & Sommers, 2020, p. 1603). It is a good thing the ACA was not repealed Discussion: Politics and the Patient Protection and Affordable Care Act.
Agarwal, S. D., & Sommers, B. D. (2020). Insurance coverage after job loss — the importance of the ACA during the COVID-ASSOCIATED RECESSION. New England Journal of Medicine, 383(17), 1603–1606. https://doi.org/10.1056/nejmp2023312
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
REPLY QUOTE EMAIL AUTHOR
6 months ago
Lyndsey Cline
RE: Discussion – Week 3
Great post! Discussion: Politics and the Patient Protection and Affordable Care Act The pandemic was a big influencer on voters and not knowing how COVID would affect you. People are about health care and the cost of things.
REPLY QUOTE EMAIL AUTHOR
6 months ago
Orsela Younano
RE: Discussion – Week 3
It is no secret that politicians, including legislators use cost-benefit analysis (CBA) to structure both their re-elections and to frame their policies and political agendas. Although, their policies and promises may not always be attainable or successful once their re-election has been secured. In addition, CBA seems to be limited within the bureaucracy institution as some have pointed out its lack of impartiality, depending on which party affiliation, agency, or personnel are conducting the analysis (Mouter, 2019) Discussion: Politics and the Patient Protection and Affordable Care Act.
The Affordable Care Act (ACA) increased insurance coverage by two methods. First, the expansion of Medicaid allowed more individuals to have access and be covered for health insurance. It also assisted with subsidies to buy private insurance on the health care exchanges. Second, it promoted and broadened the essential health benefits (EHB). Discussion: Politics and the Patient Protection and Affordable Care Act The two main components of ACA that still has general bipartisan support from the American people is the coverage for individuals with pre-existing health conditions and expanding the scope of Medicaid (Willison & Singer, 2017).
In 2010 Democrats lost 64 seats in the House of Representatives with primary reason of voters being upset with the ACA. Fast forward to 2018 and this time Republicans lost more than a dozen seats as a result of voter frustration with the repeal efforts of the ACA. More than half the democratic political ads focused on the ACA. However, there was a reversal of public opinion and voters were afraid they may lose popular aspects of the law such as coverage for those with pre-existing conditions. This swayed voters to the Democrats (Cohn, 2020).
The current Covid-19 pandemic will further play a role in the repeal/replace of the ACA. Before the pandemic, a repeal of the ACA may have resulted in 20 million individuals losing health coverage. The repeal of the ACA would only increase that number (Straw & Aron-Dine, 2020) With the current economic uncertainty and public health crisis, voters may dissuade policy makers from acting against the ACA at this time and many will yield to the voters as re-election is always the goal Discussion: Politics and the Patient Protection and Affordable Care Act.
References
Cohn, J. (2020, March 6). The ACA, repeal, and the politics of Backlash: Health AFFAIRS BLOG. Health Affairs. Retrieved from https://www.healthaffairs.org/do/10.1377/hblog20200305.771008/full/.
Mouter, N. (2019). The politics of cost-benefit analysis. Oxford Research Encyclopedia of Politics. https://doi.org/10.1093/acrefore/9780190228637.013.1007
Straw, T., & Aron-Dine, A. (2020, October 5). Commentary: Aca repeal even more dangerous during pandemic and economic crisis. Center on Budget and Policy Priorities. Retrieved September 14, 2021, from https://www.cbpp.org/research/health/commentary-aca-repeal-even-more-dangerous-during-pandemic-and-economic-crisis.
Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act essential HEALTH Benefits: Threats and obstacles. American Journal of Public Health, 107(8), 1225–1226. https://doi.org/10.2105/ajph.2017.303888
REPLY QUOTE EMAIL AUTHOR
6 months ago
Jessica Ferrin
RE: Discussion – Week 3
Orsela,
Great post! The pandemic is having a large impact on many issues including the past election. I agree that the pandemic shifted voters to support the ACA who may have previously been in favor to repeal it. As explained by Straw and Aron-Dine (2020), a major concern of the repeal during the pandemic was the end of insurance companies covering preventative services. This would include vaccines, which was a major concern at the time due to the hopefulness of a vaccine development. Unfortunately as Milstead and Short (2019) discussed, timing is of the essence to policymakers. They are mostly concerned with how changes will affect their own re-election likelihoods (Milstead & Short, 2019). Do you feel the election may have resulted differently if Trump would have dropped the ACA stance, and focused on other issues at hand? Discussion: Politics and the Patient Protection and Affordable Care Act
References
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6 ed.). Burlington, MA: Jones & Bartlett Learning.
Straw, T., & Aron-Dine, A. (2020, October 5). (Center on budget and policy priorities) Retrieved from Health: https://www.cbpp.org/research/health/commentary-aca-repeal-even-more-dangerous-during-pandemic-and-economic-crisis
REPLY QUOTE EMAIL AUTHOR
6 months ago
Scott Lamprecht
RE: Discussion – Week 3
Great discussion, but policy-maker politicians are concerned with re-election as their main priority.
REPLY QUOTE
6 months ago
Andrea Cholagh
RE: Discussion – Week 3
Great post, you make some great points! Legislators do use CBA to structure their re-elections and to frame their policies and political agendas. Since Trumps administration, more people support the ACA now than they did in 2016 (Hawryluk, 2020). So, it is interesting to know that Republicans have also lost more than a dozen seats due to the voter’s frustrations with the repeal efforts of the ACA (Crohn, 2020)! I also read the information provided from Mouter (2019), where he identifies the barriers of CBA such as the results being received too late into the process, and politicians not having enough trust in the CBA’s partiality. Even with this said, do you still think it affects a legislator’s decision in developing a policy?
References
Crohn, J. (2020, March 6). The aca, repeal, and the politics backlash: Health affairs blog. Health Affairs. Retrieved September 15, 2021, from https://www.healthaffairs.org/do/10.1377/hblog20200305.771008/full/
Hawryluk, M. (2020, August 28). Opposition to Obamacare becomes political liability for GOP incumbents. Retrieved September 13, 2021, from https://khn.org/news/opposition-to-obamacare-becomes-political-liability-for-gop-incumbents/
Mouter, N. (2019). The politics of cost-benefit analysis. Oxyford Research Encyclopedia of Politics. https://doi.org/10.1093/acrefore/9780190228637.013.1007
REPLY QUOTE EMAIL AUTHOR
6 months ago
Lyndsey Cline
RE: Discussion – Week 3
Great post! I agree, the COVID-19 pandemic played a role in the 2020 election. People don’t want to lose health coverage, especially in a time of uncertainty Discussion: Politics and the Patient Protection and Affordable Care Act.
REPLY QUOTE EMAIL AUTHOR
6 months ago
Idowu Oshokoya
RE: Discussion – Week 3
Orsela,
Great post! You are right that The Affordable Care Act (ACA) has improved health coverage by extending Medicaid to permit more citizens to have gain reasonable health insurance coverage and to buy plan regardless of preexisting illness or diseases. This method expands the scope of Medicaid (Willison & Singer, 2017).
Also , the pandemic might play a role in the repeal/replace of the ACA. However, the repeal of the Affordable Care Act can make millions of Americans to lose health insurance. The result will be an increase in rate of uninsured people in the United States (Straw & Aron-Dine, 2020). Discussion: Politics and the Patient Protection and Affordable Care Act
References
Straw, T., & Aron-Dine, A. (2020, October 5). Commentary: Aca repeal even more dangerous during pandemic and economic crisis. Center on Budget and Policy Priorities. Retrieved September 14, 2021, from https://www.cbpp.org/research/health/commentary-aca-repeal-even-more-dangerous-during-pandemic-and-economic-crisis.
Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act essential HEALTH Benefits: Threats and obstacles. American Journal of Public Health, 107(8), 1225–1226. https://doi.org/10.2105/ajph.2017.303888
REPLY QUOTE EMAIL AUTHOR
6 months ago
Afanwi Ntumngia
RE: Discussion – Week 3
The Affordable Care Act (ACA), also known as Obamacare, was signed into law in March 2010. The Act was meant to extend health coverage to millions of uninsured Americans. The Act expanded Medicaid eligibility, created a Health Insurance Marketplace, and prevented insurance companies from denying coverage due to pre-existing conditions. It further required plans to cover a list of essential health benefits. It made it possible for lower-income families to qualify for subsidies for coverage purchased through the Marketplace.
The Patient Protection and Affordable Care Act (ACA) of 2010 have proven to be one of the most hotly debated and politically contentious national policy initiatives in decades (Mayer, M et al.,2018). Late in the day on July 19, 2017, the Senate released the Obamacare Repeal Reconciliation Act (ORRA) of 2017. The bill would repeal the Affordable Care Act’s (ACA’s) coverage provisions but delay the repeal of the coverage provisions until 2020, presumably giving Congress time to develop a replacement. (Health Affairs, 2017).
Since its introduction, many attempts have been made to repeal and replace the ACA with part and full achievement (Hall, 2013). Also, the ACA repeal has significantly been affected because legislators’ decision depends on their reelection since their main goal is to win the election and be re-elected. So, they do what it takes to get the votes to win the election, thereby influencing efforts to repeal and replace, leading to been cost-benefit analysis through legislator reelection.
However, they are fundamental mechanisms that have affected Medicaid and other ACA health coverage expansion over the past years, including electoral competition, ballot-box initiatives, interest-group coalitions, and entrepreneurial administrators. While each mechanism has helped place Medicaid expansion on the agenda, they have done so unevenly. (Health Affairs,2020) For example, in Republican-controlled states where electoral competition is weak and ballot initiatives are unavailable, Medicaid expansion remains unlikely. Even when development is thriving at the ballot box, state legislatures and governors have delayed and reverse voter-led initiatives Discussion: Politics and the Patient Protection and Affordable Care Act.
The future of Medicaid expansion and other significant portions of the ACA will continue to depend on the character of representative democracy in the states. (health affairs) There is a reason the ACA is as complicated as it is. It had to be that way to work. The moral nucleus of the law is the insurance market reforms that protect people with severe illnesses like cancer from being denied coverage. Also, older and chronically ill people from being charged impossibly high rates; families from going bankrupt after their costs exceed lifetime coverage limits; dependents up to the age of 26 from walking around without any insurance protection; and so on. The complexity comes in because these universally praised reforms are impossible without sufficient relatively healthy enrollees in the insurance market, thus requiring the mandate to buy the insurance and the subsidies to make doing so affordable Discussion: Politics and the Patient Protection and Affordable Care Act. Every health care economist on the left or right agrees that if you take that critical mass of enrollees away, the market crumbles, making the consumer protections unsustainable.
Furthermore, with all these controversies, it is clear why several trials to repeal the ACA turn to failure because decision-making on policy implementation impacts legislator reelection. However, because legislators want to remain in office or at least leave on their terms and find the support to be re-elected continually, legislators consider the political climate and the awareness of how some particular votes will affect their ability to stay in office. They feel they will think of their constituents, the needs of their state, and their party’s desire. This has been the case of ACA and why it has been under appeal for several years because legislators are looking for voters’ approval of their policy agenda. Vote analysis has a significant impact on decision-making by the legislative in recommending or positioning national policies. Vote analysis affects national policies due to people’s different choices (Canfield. D et al.,2010). Discussion: Politics and the Patient Protection and Affordable Care Act The people mostly vote for the one closer to their preferences; therefore, voters’ preferences play a significant role in recommending national policies.
In conclusion, the legislative leaders recommend national policies based on the voter’s interest and the desire to retain the votes during the reelection process.
Reference;
Canfield-Davis, K., Jain, S., Wattam, D., McMurtry, J., & Johnson, M. (2010). FACTORS OF INFLUENCE ON LEGISLATIVE DECISION.
Hall, M. A. (2013). Evaluating the Affordable Care Act: The eye of the beholder. Hous. L. Rev., 51, 1029.
Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act Essential Health Benefits: Threats and Obstacles. American journal of public health, 107(8), 1225–1226. https://doi.org/10.2105/AJPH.2017.303888
Obama BH. Repealing the ACA without a Replacement – The Risks to American Health Care. N Engl J Med. 2017 Jan 26;376(4):297-299. doi: 10.1056/NEJMp1616577. Epub 2017 Jan 6. PMID: 28058966.
Affordable Care Act (ACA) Definition. https://www.investopedia.com/terms/a/affordable-care-act.asp
State Politics And The Uneven Fate Of Medicaid Expansion …. https://www.healthaffairs.org/doi/10.1377/hlthaff.2019.01414
Enactment of a Law – Congress.gov. (2021, June 16). https://www.congress.gov/help/learn-about-the-legislative-process/enactment-of-a-law
Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act Essential Health Benefits: Threats and Obstacles. American journal of public health, 107(8), 1225–1226. https://doi.org/10.2105/AJPH.2017.303888 References
Jeri A. Milstead. (2016). Health Policy and Politics: Vol. Fifth edition. Jones & Bartlett Learning.
6 months ago
Faith Momodu
RE: Discussion – Week 3-Response 2
It was great reading your post this week, it had a lot of great points. The ACA has been a hot topic since the day it was introduced. There are legislators that want to repeal the law. The biggest hindrance to this is the fact that they have to think of their constitutes and how it will affect their ability to be re-elected. Even though the job of a legislator is to do what is right for their voters. The United States is certainly poor at delivering policy outcomes that reflect the overall preferences of its population (Jarman & Greer, 2020, p. 680). It is important that voters have insurance, and the ACA has made a big difference in this. A lot more Americans have insurance because of the ACA. This has helped tremendously during the pandemic. I would say the ACA achieved its goal of “expand[ing] the number of people with health insurance” (Skinner & Chandra, 2016). Discussion: Politics and the Patient Protection and Affordable Care Act
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 and Law, 45(4), 677–691. https://doi.org/10.1215/03616878-8255589
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
REPLY QUOTE EMAIL AUTHOR
6 months ago
Shelley Lalush
response
Faith,
Great post in response to Afanwi. I agree that the ACA has done a great job in helping Americans with obtaining insurance. I cannot even imagine what it would have been like for Americans going through the global COVID-19 pandemic without having health insurance.The cost of not being able to get tested or receive care if sick would have been through the roof for many family members. Fatality rates would have probably risen as well because people would have most likely not been able to get the care they would have needed without having health insurance.
Affordable care Act (ACA) – HEALTHCARE.GOV GLOSSARY. HealthCare.gov. (n.d.). Retrieved September 12, 2021, from https://www.healthcare.gov/glossary/affordable-care-act/. Discussion: Politics and the Patient Protection and Affordable Care Act
REPLY QUOTE EMAIL AUTHOR
6 months ago
Misty Williams
RE: Discussion – Week 3
This was an interesting post. However, I find it concerning that 30 million U.S. residents did not have health insurance in the first half of 2020 (Feingold,
2021). The Affordable Care Act has not necessarily made insurance more affordable for everyone. Most highly affected individuals are the middle
class. People who are unable to qualify for subsidies can find that obtaining health insurance plans are unaffordable. For example, an article written in
the Washington Post stated that in some areas in the United States a 60-year-old with an income of $50,000 a year would have to pay one fifth of their
income for the least expensive premiums for health plans in Affordable Care Act marketplaces (Goldstein, 2019) Discussion: Politics and the Patient Protection and Affordable Care Act.
While the ACA does bring many changes it is not flawless to say the least. An alternative to the Affordable Care Act seems to be the answer but what that entails lies in the hands of the White House. Hopefully, a solution will not mean a loss for those who depend on the coverage to survive.
References
Feingold, K. (2021, February 11). TRENDS IN THE U.S. UNINSURED POPULATION, 2010-2020. ASPE | Office of the Assistant Secretary for Planning and
Evaluation. https://aspe.hhs.gov/sites/default/files/private/pdf/265041/trends-in-the-us-uninsured.pdf
Goldstein, A. (2019, March 4). ACA premiums rising beyond reach of older, middle-class consumers. The Washington
Post. https://www.washingtonpost.com/national/health-science/aca-premiums-rising-beyond-reach-of-older-middle-class-consumers/2019/03/04/bdd07d9e-
3e9a-11e9-922c-64d6b7840b82_story.html
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. Discussion: Politics and the Patient Protection and Affordable Care Act.
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.
- Discussion: Politics and the Patient Protection and Affordable Care Act
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 Discussion: Politics and the Patient Protection and Affordable Care Act.
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 Discussion: Politics and the Patient Protection and Affordable Care Act.