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

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

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

The U.S. Federal Government is made up of three branches: legislative, executive, and judicial. To ensure the government is effective and citizen’s rights are protected, each branch has its powers and responsibilities, including working with the other branches. The legislative branch is made up of the House and Senate, known collectively as the Congress. Among other powers, the legislative branch makes all laws, declares war, regulates interstate and foreign commerce, and controls taxing and spending policies. (United States House of Representatives, n.d.).


The members of the house are elected every two years. In general, the elected officials usually have much passion and want to make good policy during their terms. Many come to their respective legislative bodies because they want to make a difference and be part of good government (National Council for the Social Studies, n.d.).

One of the most essential policies enacted by the legislators is the ACA (Affordable Care Act), famously known as Obamacare, a comprehensive care reform law enacted in March 2010. The three main goals of the ACA (Affordable Care Act) are: to make affordable health insurance available to more people, enhance Medicaid programs, and support innovative medical care delivery methods designed to lower the costs of health care (Health Care, n.d.). However, some conservatives objected to the policy. It is because of the increase and high insurance premiums that we need to pay for Obamacare. They also think that it may have adverse effects on the quality of care. According to Laureate (2018), the ACA (Affordable Care Act) passed without Republicans’ signatures. After it was passed and implemented, half of the states, led by either Republican governors or legislatures, are actively challenging or ignoring the law. So it is clear that obviously, politics is playing a significant role in both the design at the outset and now the implementation of the ACA (Affordable Care Act). During Trump’s administration, the republicans tried to replace the ACA (Affordable Care Act) with AHCA (American Health Care Act). The AHCA (American Health Care Act) ensures more affordable health by not requiring everyone to buy the insurance and not paying penalties if they decide to buy later. However, the AHCA (American Health Care Act) has not to get the majority of the vote and has not become a law. According to a national poll done by Quinnipiac University, 56% of American voters disapproved of the AHCA, and 46% of voters said they would be less likely to vote for their representative if they supported the AHCA. If doing the right thing wasn’t enough to get Republican representatives to oppose the bill, knowing that they could lose their seats in the next election sure was (Iyamah J., 2017).

Also Read:

Discussion 2: The Role Of The RN/APRN In Policy-Making NURS 6050

Discussion 1: Evidence Base In Design NURS 6050

Assignment: Regulation For Nursing Practice Staff Development Meeting NURS 6050

Discussion: Professional Nursing And State-Level Regulations NURS 6050

Assignment: Legislation Grid And Advocacy Statement NURS 6050

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: Discussion: Politics and the Patient Protection and Affordable Care Act NURS 6050


The primary responsibility of a legislator is to be re-elected. Legislators want to stay or leave office on their own terms. Legislators must be aware of not only the political climate, but also how specific votes will affect their ability to remain in office if they are to be re-elected on a regular basis. They must consider the wishes of their constituents, the needs of their state, and the wishes of their party (National Council for the Social Studies, n.d.). Legislators are expected to make sound decisions about who they support and what causes they champion once elected. Policy and legislative decisions should be subjected to a rigorous cost-benefit analysis. Their arguments must persuade other legislators. There should be enough data and research to support a bill’s passage through debate and into the Senate. The bill must receive a majority of votes in order to become law. If a legislator is not re-elected, the policy that he or she enacted or amended may be repealed. To become a policy, a bill must be supported by officials. The policy should take into account the general well-being of the population. Re-election of a legislator means either continuing the policy they started or repealing a current policy.


Health Care.gov (n.d.). Affordable Care Act (ACA). Retrieved from https://healthcare.gov/glossary/affordable-care-act/

Imayah, J. (2017). Why did the American Health Care Act Fail?. Friends Committee on National Legislation. Retrieved from https://fcnl.org/updates/2017-04/why-did-american-health-care-act-fail

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum (Video file). Baltimore, MD: Author.

National Council for the Social Studies. (n.d.). How Legislators Make Decisions. Retrieved from https://socialstudies.org/advocacy/how-legislators-make-decisions

The White House. (n.d.). The Legislative Branch. Retrieved from https://whitehouse.gov/about-the-white-house/our-government/thr-legislative-branch/

United States House of Representative. (n.d.). Retrieved September 20, 2018, from https://www.house.gov/

Unites States Senate. (n.d.). Senate organization chart for the 115th Congress. Retrieved September 20, 2018, from https://www.senate.gov/reference/org_chart.htm

Discussion: Politics and the Patient Protection and Affordable Care Act

A cost-benefit analysis (CBA) is a process that is used to estimate the costs and benefits of decisions to find the most cost-effective alternative. A CBA is a versatile method that is often used for a business, project, and public policy decisions. The Affordable Care Act is one policy that has been subjected to cost-benefit analysis and risk assessment by the legislatures.  The ACA contains an array of controversial policies that contravene policy principles and political priorities held by the contemporary Republican Party (Béland et al., 2019). It also imposes costs on stakeholder groups whose opposition, in many cases, to measures that altered the status quo has never ceased. In this manner, there have been numerous failed attempts to repeal and replace the law by Legislatures (mostly republicans). Firstly, the Republicans have been unable to prove the ineffectiveness of ACA or provide a better option to the public.  In essence, the ACA benefits often have been obscured due to its complex structure and incoherent programmatic identity (Jacob & Mettler, 2017). Its primary objective of making healthcare affordable has yielded mixed results. ACA confers benefits on populations that command less political sympathy than those previously favored with public coverage. For both sides of the political divide, replacing the law must be balanced with the voters’ support. For a legislator, the cost of repealing the law without a better replacement would likely be the loss of their elected office especially if a large population from his political base is affected.  Nearly 90 million Americans rely on health care benefits through Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP) (Grogan & Park, 2017). This population constitutes a significant portion of eligible voters. In this manner, the legislators’ policy decisions and efforts have always been channeled to enhance these organizations as healthcare affordable is one of the key determinants of the presidential and senatorial election outcomes.


Béland, D., Rocco, P., & Waddan, A. (2019). Policy feedback and the politics of the Affordable Care Act. Policy Studies Journal, 47(2), 395-422. https://doi.org/10.1111/psj.12286

Jacobs, L. R., & Mettler, S. (2018). When and how new policy creates new politics: Examining the feedback effects of the Affordable Care Act on public opinion. Perspectives on Politics, 16(2), 345-363. https://doi.org/10.1017/S1537592717004182

Grogan, C. M., & Park, S. (2017). The politics of Medicaid: most Americans are connected to the program, support its expansion, and do not view it as stigmatizing. The Milbank Quarterly, 95(4), 749-782. https://doi.org/10.1111/1468-0009.12298

Individuals, regardless of political affiliation, are frequently concerned when they consider perceived competing government interests and their impact on topics of interest to them. The healthcare industry is no exception. Some people believe that local, state, and federal policies and legislation can be aided or hampered by interests other than societal benefit as stated in Discussion: Politics and the Patient Protection and Affordable Care Act NURS 6050.

Consider that the most important job of a legislator is to be re-elected. Cost can be

Discussion Politics and the Patient Protection and Affordable Care Act NURS 6050
Discussion Politics and the Patient Protection and Affordable Care Act NURS 6050

expressed in both votes and dollars. As a result, it is critical to consider the legislator’s perspective on whether or not to promote a particular initiative in the political landscape as discussed in Discussion: Politics and the Patient Protection and Affordable Care Act NURS 6050.

Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion: Politics and the Patient Protection and Affordable Care Act NURS 6050

RE: Discussion – Week 3

    It is to no avail that health care is one of the most important topics when it comes to the legislators and the public. The Affordable Care Act (ACA) is the most controversial yet needed health care plans that has been established. The ACA which was introduced in 2010 during former President Obama’s term provides health care to millions of people young and old that would not previously have health care. The ACA’s purpose was to expand the Medicaid program, and support innovative medical care delivery methods designed to lower the costs of health care generally (Healthcare.gov, n.d.). The Affordable Care Act has met much debate as it has not been as affordable as it was deemed to be. Also, it created a liability for the American people to have insurance such as penalizing anyone who did not have insurance. One unsettling aspect was the cuts that had to be put forward to make the ACA and expansion happen. These have been the cons of ACA that have made for huge political viewpoints. This has been the mark for many politicians in terms of putting forth their stance to get re-elected. Rather than caring about the actual future of health care accessibility and out of pocket expenses that people face, the ACA is being used during this time as a re-election tool. As President Trump wants to see the ACA depleted while others would like to see it built up, it seems legislators are either for it or against it. The goal for their viewpoint on the matter is for support and re-election purposes. “When one thinks like a politician, it means he or she is looking beyond the issue itself and considering other forces and factors that affect what is likely to work and what has no chance of success” (Milstead & Short, 2019, p. 51). “The legislators cost-benefit calculations are not the cost-benefit to society of enacting particular legislation, but the benefits are the additional political support the legislator would receive from supporting legislation and lost political support they would incur as a result of their action” (Milstead & Short, 2019, p55). Politicians and legislators look for what they think will bring them success, such as staying in office for re-election. The decisions of legislative leaders are affected through the voter’s views. According to National Council for the Social Studies, legislators consider the Triangle Test when deciding how to vote. They think, do my constituents care about this issue? Is this good policy for the Nation and does this make sense? Is this press worthy? (n.d.).

A legislator whose goal is to be re-elected would be smart to go with the popular vote.


Healthcare.gov. (n.d.). Affordable Care Act (ACA)-HealthCare.gov Glossary. Retrieved September 17,

2020. from https://www.healthcare.gov/gossary/affordable-care-act/

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide. (p.51, 55). Burlington,

MA: Jones & Bartlett Learning

National Council for the Social Studies. (n.d.). How Legislators Make Decisions. Retrieved September

17, 2020, Retrieved https://www.socialstudies.org/advocacy/how-legislators-make-decisions

The Patient Protection and Affordable Care Act and Politics

Any political leader’s primary goal in the political system is to be re-elected. Since 2016, the Trump administration and legislators aligned with the ruling have attempted and failed three times to repeal the Patient Protection and Affordable Care Act (ACA). What Americans may require in terms of universal healthcare entails minor changes to the ACA rather than repealing it (Milstead & Shortm, 2019). As a result, in order to win reelection, legislators may conduct a cost-benefit analysis in order to repeal the ACA.

Because Americans have made it clear that they do not support repealing the ACA, exercising patience may be critical in ensuring that legislators are re-elected. However, legislators may incur costs if they insist on repealing the policy. According to Milstead and Shortm (2019), legislators who take the position of making policy changes could reap significant benefits that could help them win re-election because it is clear that this is what American voters want.

As a result, analyzing voter opinions could have a significant impact on legislators’ decisions regarding the recommendation of such national policies as impacting changes to the Centers for Medicare and Medicaid Services, which has been a source of contention for years (Taylor et al., 2017). Despite the fact that the ACA failed to deliver Americans to the promised land of universal health care, voters favor making specific changes to ensure that the policy ensures universal health coverage. As a result, in their bid for reelection, legislators may decide to make policy recommendations that align with the views of voters (United States House of Representatives, n.d).


Milstead, J.A., & Shortm, N.M. (2019). Health Policy and Politics: A nurse’s guide (6thEd.) Burlington, MA: Jones & Bartlett learning.

Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, VC.,Safriet, B. J., & Hagan, T. (2017). Corrigedum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346-350. DOI: 10.1016/j.outlook.2017.05.003

United States House of Representatives. (n.d). Retrieved from https://www

RE: Discussion – Week 3

     I agree with you that legislators should agree on making policy changes or recommendations that align with the views of the voter. Voters desire the expansion of universal health coverage; however they oppose some of the regulations that the Affordable Care Act proposed along with it. Enacting penalties to individuals who were not covered under a health plan did not set well with the public. In efforts of repeal the ACA, the Graham-Cassidy Bill, the American Healthcare Act, and the Better Care Reconciliation Act all attempted to lessen or remove the penalties to individuals who were without healthcare coverage and to remove the penalties enacted upon businesses that failed to meet the coverage requirements (Nadash, 2018). Republicans saw the repeal as an opportunity to gain votes due to the unpopular mandates (Nadash, 2018).

Politics has never been something I have been interested in. In my opinion, there is a lot of scheming, finger pointing and truth stretching. However, I know that politics must go on. Milstead and Short (2019) state, “Many nurses and other healthcare professionals see “politics” as a negative term and perceive “playing politics” as a reason for not getting involved in political advocacy.” As I have advanced in my nursing career, I have gained knowledge and can see how political advocacy can help shape health policy. This does not mean that I agree with how politics works, but that if I am involved in informing politicians on healthcare issues, I may be able to make a difference in our populations health.


Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide(6thed.). Burlington,   MA:       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

RE: Discussion – Week 3

Week 3 Discussion

Main Response

The Affordable Care Act of 2010 was put in place by President Obama and supported mainly by the Democratic Party. The act offers affordable insurance to all Americans and is a step in the direction of healthcare as a human right (Laureate Education, 2018). The ACA has expanded Medicaid, made it illegal to charge extra or give less coverage to the elderly, infirm, or disabled, and mandated that companies employing more than 50 people offer quality health insurance. These fit the Democrat agenda. Democrats are known to fight against social inequality and embrace civil rights. The Republican agenda under Trump, leans towards cutting back on Federal Funding of healthcare and even seems to be racially biased. Attempts to repeal the ACA have been met with outrage from the groups that benefit most from affordable insurance, namely the millions of low-income seniors, disabled and infirm (Nadash et al., 2018).

Quality healthcare and preventative care for high risk groups is offered under the ACA, with the justification that this will lead to better outcomes and less spent in the long run. Republicans would like to overturn the ACA and allow individual insurance companies high-risk pools, where insurance companies balance out the cost of covering high utilization customers with a higher number of younger, healthier low utilization customers. The ACA outlawed this. They would also like to cut back on Medicare and Medicaid. Knowing that they are coming up on an election year, the Republicans do not want to lose votes. They have backed off on the repeal, which is unpopular with their constituents and special interest groups.

Legislators cannot go too far astray from the agenda of their political party. Politics is a game of making deals. At times legislator’s votes may be based on a strategy to be re-elected. Sometimes there will be an agreed-upon trade of votes, quid pro quo. While the timing and the current state of political affairs affect a legislator’s vote, it is always essential for a legislator to be open-minded and willing to bend (Milstead & Short, 2019). Keeping in the good graces of colleagues and constituents is the best bet of being re-elected. Voting to cut Medicare and repeal the ACA would not be in the best interest of legislators trying to be re-elected in the current political climate regardless of their political affiliation.


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

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author.

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

RE: Discussion – Week 3

Cost-Benefit Analysis and Legislator’s Reelection

The cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the Affordable Care Act in numerous ways. Many variables affect legislative decisions: legislators, constituents, special interest groups, lobbyists, committees, chief executives, legislative aids, and many more (Milstead, 2019). Another complication to the process is if an interest group has enough money to support a legislator to be reelected. In return, that legislator could put the interest group’s views before their views on policy decisions. (Milstead, 2019). Therefore the cost-benefit analysis can be misconstrued by the reelection supporter views (wealthy people or special interest groups) being the main goal is to be reelected (Milstead, 2019).

Nurses bring a valued insight into the healthcare system, allowing them to present what is improving the health of their patients (American Nurses Association, n.d.). A rational nurse can stand behind “the ultimate point in participating in policymaking is to improve patient outcomes.” (Milstead, 2019, p. 39) This conflicts “the realization that policymakers are not necessarily focused on how real people will be affected by the changes to Obamacare or Medicare and Medicaid but rather on how the changes will affect their reelections chances.” (Milstead, 2019, p. 40) Nurses who are passionate about something they would like on the agenda could be overridden by a particular interest group with the funds to support the legislator. The reelection supporter may think in the opposite way of the legislator but will have a voice in the policymaking decision because of their money. It is understandable how nurses are overwhelmed with the policy process being there are many complexities to the equation.

The analyses of voter’s views impact national policies broadly. If the main goal for a legislator is to be reelected, they have to have the votes. This can make the Affordable Care Act and other health care system solutions so tricky. While half of the population wants to leave the Affordable Care Act in place, 19% wants to repeal and replace the Affordable Care Act, and 24% wants to know the replacement plan before the repeal (Milstead 2019). That makes it difficult on when to make healthcare policy moves and how to make them. With 20% of the United States on Medicaid in 2017 and 55.5 million on Medicare in 2015, the voters’ views will immensely impact Congress’s decisions (Milstead, 2019).

On the positive side, if legislators or other government officials were not voted in, they would not consider what the people want or what they believe is best. In that situation, we would have someone making all of our decisions without thinking twice about what the voters think. The Affordable Care Act did not have any republican signatures when it came into place (Laureate Education, 2018). As a result, half of the states (republican lead states) are going against the law (Laureate Education, 2018). All voters’ views must be under consideration because even if a policy is put into place, the other half of the population may stand up against the policy and make it unsuccessful. This is why President Trump should consider changing parts of the Affordable Care Act instead of getting rid of it completely


American Nurses Association (n.d.). Health Policy. https://www.nursingworld.org/practice-policy/health-policy/

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

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

Politics and the Patient Protection and Affordable Care Act

Citizens of the United States were presented with a new healthcare reform act known as the Patient Protection and Affordable Care Act in 2010. The Patient Protection and Affordable Care Act also known as Obamacare was intended to develop healthcare and health insurance businesses in America. The main aim of Obamacare is to increase new benefits for healthcare, more patient rights, more patient protection, and making healthcare more affordable and accessible to the citizens in the United States. Attempts to repeal and replace Obamacare has been a subject matter constitutionally contested and have the subtle meaning of egotism by politicians to capitalize on voter support.  From a cost-benefit approach, for a system to be cost-effective, the benefits must be higher in comparison to the amount acquired during the enactment of the program (Milstead & Short, 2019). When the Patient Protection and Affordable Care Act was developed, it made access to healthcare available to most of the American citizens, and thus, repealing and replacing the act will make political lawmakers lose voter support.

Despite reported accomplishments by the Affordable Care Act, there is still political deliberation to repeal and replace. Many political leaders are concerned that if the Act is repealed many Americans will lose coverage by insurance companies (Taylor, et al., 2017). Consequently, many low-income or middle-class families insured under the Act by the Medicaid program will lose their coverage. A study by DaVanzo (2016), projected that if the Affordable Care Act is repealed, by 2026 the number of uninsured persons would have increased by 22 million persons which can lead to an unparalleled heath crisis as persons would no longer be covered and able to receive the care they need.

Since the Act has been enacted, it has encountered many disputes amongst politicians. Since in office, the Trump administration has attempted to repeal and replace Obamacare but has since not succeeded. During his elections, many legislators supported this idea but at present time, considers this decision a liability as they are up for re-elections (Hawryluk, 2020). Legislators are more likely to support agendas that are favorable to them based on a cost-benefit analysis. As such, repealing The Affordable Care Act will not be of benefit to them and the American people. Therefore, they are unlikely to reverse the act.

The Affordable Care Act allows for many Americans to have access to services in healthcare and repealing the Act will only make legislators lose the voter support they want. Most political decisions and policies are driven by and appeal to the expectations of their voters.


DaVanzo, D. (2016, December 6). Estimating the Impact of Repealing the Affordable Care Act on Hospitals. Retrieved from AHA.org: https://www.aha.org/system/files/2018-02/impact-repeal-aca-report_0.pdf

Hawryluk, M. (2020, August 28). Opposition to Obamacare Becomes Political Liability for GOP Incumbents. Retrieved from KHN: https://khn.org/news/opposition-to-obamacare-becomes-political-liability-for-gop-incumbents/

Milstead, J. A., & Short, N. M. (2019). Health Policy and Politics: A Nurse’s Guide (6 ed.). Burlington, MA: Jones & Bartlett Learning.

Taylor, D., Olshansky, E. F., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017, May 1). Corrigendum to position statement: Political interference in sexual and reproductive health research and health. Nursing Outlook, 65(3), 346-350. doi:https://doi.org/10.1016/j.outlook.2017.05.003

RE: Discussion – Week 3

            Under the Patient Protection and Affordable Care Act (ACA), approximately 20 million individuals gained access to health insurance. Also sometimes referred to as “Obamacare,” the ACA became highly politicized. During the 2016 presidential election, the discussion of repealing the ACA was a large point of contention that millions were concerned for (Karaca-Mandic, et al., 2017).  After President Trump was elected, the bill known as the American Health Care Act (AHCA) was voted on to be passed. This bill would repeal major aspects of the Affordable Care Act. One particular point of interest was the repeal of major funding for Medicaid had this bill been passed (McCarthy, 2017).

Budget Reconciliation has been used when passing major legislation since 1980. The Congressional Budget Act of 1974 established the Congressional Budget Office (CBO) and sought to rationalize the process by which Congress set the federal budget (Hirsch, et al., 2017). In March of 2017, the CBO released its report of the potential implications of replacing the ACA with the AHCA. The report stated that if the bill was passed in 2017, by 2018, 14 million people would become uninsured (Hirsch, et al., 2017).

These legislators who sit as members of the house are up for election every two years (National Council for the Social Studies, n.d.).  As a legislator’s career can be short-term, they strive to be reelected. For reelection, legislators must be viewed as making positive changes for the people they serve, rather than passing their own personal agenda. While many of the legislators working on the AHCA may have had their own agenda for wanting it passed, they could not risk millions of individuals losing their insurance. This surely would not become popular and would not warrant a reelection.


Hirsch JA, Rosenkrantz AB, Nicola GN, et al. Contextualizing the first-round failure of the AHCA: down but not out

     Journal of NeuroInterventional Surgery 2017;9:595-600.

Karaca-Mandic, P., & Jena, A. (2017, April 1). Health care among individuals at risk for losing insurance with repeal of the aca. JAMA Internal Medicine. Retrieved September 14, 2021, from https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2598797.

McCarthy M. US Representatives vote to repeal Affordable Care Act BMJ 2017; 357 :j2217 doi:10.1136/bmj.j2217

National Council for the Social Studies. (n.d.). How Legislators Make Decisions. Retrieved from https://socialstudies.org/advocacy/how-legislators-make-decisions