NURS-6050, week 3 discussion. Politics and the patient protection and affordable care act
Politics, patient protection and Affordable Care Act
Efforts to repeal or replace Affordable Care Act (ACA) have been subject of much political debate that have the subtle connotation of selfishness by politicians with a view to maximizing voter support. In fact, it is not uncommon for factual information to be misrepresented with the intention of swaying public opinion and gaining ‘political mileage’ (Feldstein, 2006). NURS-6050, week 3 discussion. Politics and the patient protection and affordable care act
A review of ACA and the reasons for its enactment in 2010 shows that it…
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Discussion – Week 3
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.
The suppliers of legislative benefits are legislators, and their primary goal is to be re-elected. Thus, legislators need to maximize their chances for re-election, which requires political support. Legislators are assumed to be rational and to make cost-benefit calculations when faced with demands for legislation. However, the legislator’s cost-benefit calculations are not the cost-benefits to society of enacting particular legislation. Instead, the benefits are the additional political support the legislator would receive from supporting legislation and the lost political support they would incur as a result of their action. When the benefit to legislators (positive political support) exceeds their costs (negative political support) they will support legislation. (page 27) NURS-6050, week 3 discussion. Politics and the patient protection and affordable care act
Source: Feldstein, P. (2006). The politics of health legislation: An economic perspective (3rd ed.). Chicago, IL: Health Administration Press.
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 the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid).
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.
Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message. NURS-6050, week 3 discussion. Politics and the patient protection and affordable care act
*Note: Throughout this program, your fellow students are referred to as colleagues.
Politics, patient protection and Affordable Care Act
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Politics, patient protection and Affordable Care Act
Efforts to repeal or replace Affordable Care Act (ACA) have been subject of much political debate that have the subtle connotation of selfishness by politicians with a view to maximizing voter support. In fact, it is not uncommon for factual information to be misrepresented with the intention of swaying public opinion and gaining ‘political mileage’ (Feldstein, 2006).
A review of ACA and the reasons for its enactment in 2010 shows that it was intended to expand access to care, make coverage more affordable, and reduce the number of uninsured Americans. To realize these objectives, the legislation created new marketplaces where insurers offer polices directly to persons without employer coverage, and expanded Medicaid eligibility. Over the course of the nine years that ACA has been operational, health insurance coverage has increased by 20 million, while 24 million Americans have enjoyed free and subsidized medical care through expansions to Medicaid and marketplace tax credits.
Despite the major successes reported from ACA, the legislation faces strong political debate over its repeal and replacement. The political debate has presented four proposals. The first proposal is to make no changes to ACA and maintain the status quo. This proposal would continue increasing the federal deficit and health insurance coverage thus making it unappealing to voters concerned with federal deficit and appealing to voters who are only able to get health insurance coverage through ACA (Rand Corporation, 2019). NURS-6050, week 3 discussion. Politics and the patient protection and affordable care act
The second proposal is to repeal ACA while replacing it through either adopting the American Health Security Act that was introduced by Senator Bernie Sanders in 2011, or the Health Insurance Solution. This proposal is based on the fact of financial estimates that health care spending would increase to $1 trillion, a concern for the blooming government spending. The proposal is anticipated to reduce federal expenditure by $40 billion and national health care expenditure by $211 billion relative to ACA. However, the savings would be accompanied by uninsured persons increasing by 9 million Americans. This proposal appeals to voters who are concerned by the blooming government expenditures but who also support the ideals presented in ACA. Through adopting the proposal, they are able to reduce tax burden, and reduce the guilt linked to denying others health insurance coverage since they would argue that most Americans have coverage and only a minority are not covered. In presenting this proposal, politicians would receive support from persons concerned about the tax burden, but not from the 9 million Americans who will lack insurance coverage (Rand Corporation, 2019).
The third proposal is to repeal ACA without replacement. This proposal is anticipated to allow the government save on ACA expenditure, a figure of close to $1 trillion that would then be allocated towards other government endeavors. Although this proposal would appeal to taxpayers, especially the high income earnings who feel particularly burdened, it would increase insurance prices by 8% and deny more than 12 million Americans access to health care. The implication is that the proposal would appeal to voters who are able to access healthcare without ACA (increasing the politician’s popularity among them), but would not appeal to the voters who cannot health care without ACA (reducing the politician’s popularity among them) (Rand Corporation, 2019).
The fourth proposal is to replace ACA with a single payer approach (the American Health Care Act – AHCA). AHCA proposes to make significant changes to ACA to include repealing mandates, introducing continuous coverage, change the age-based rate banding, and replacing income-based subsidies with fixed age-based subsidies. Applying this proposal would initially increase federal deficit by $38 million before reducing it by $5 billion 6 years later, and reduce insurance enrollment by 14 million Americans. This proposal would appeal to persons concerned with federal deficits but not-appeal to the 14 million Americans who would lack insurance coverage. This implies that the politicians who make this proposal would receive support from voters concerned with federal deficit and receive condemnation from voters who would lack insurance coverage (Rand Corporation, 2019).
One must accept that political decisions are typically guided by voter expectations. In addition, one must acknowledge that the debate surrounding ACA is polarized because of voter expectations with politicians tending to make proposals that appeal to the majority of voters in their constituents. Overall, voters’ expectations affect decisions by legislative leaders in recommending and positioning national policies as evidenced by the political debates about ACA. NURS-6050, week 3 discussion. Politics and the patient protection and affordable care act
References
Feldstein, P. (2006). The politics of health legislation: An economic perspective (3rd ed.). Chicago, IL: Health Administration Press.
Rand Corporation (2019). The Future of U.S. Health Care: Replace or Revise the Affordable Care Act? Retrieved from https://www.rand.org/health-care/key-topics/health-policy/in-depth.html
NURS-6050, week 3 discussion. Politics and the patient protection and affordable care act