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NURS 6050 Politics and the Patient Protection and Affordable Care Act

NURS 6050 Politics and the Patient Protection and Affordable Care Act

NURS 6050 Politics and the Patient Protection and Affordable Care Act

Politicians’ main interest is to be re-elected to continue maintaining their political positions. The interest of being reelected every campaign has greatly impacted the policymaking process. Politicians would rather support what looks good in the eyes of people to ensure they do not lose quorum (Milstead & Short, 2019). Since President Trump became the president of the United States of America, he has been against the Affordable Care Act. As a result, he has tried to repeal the policy but the efforts have failed. President Trump’s administration has not given up since many trials to repeal the Affordable Care Act are expected. Most probably, the repeal trials have failed so that politicians can safeguard their likelihood of being re-elected. This paper explains how the cost-benefit analysis in terms of legislators being re-elected affected efforts to repeal/replace the ACA. It also explains how analysis of the voter views may impact politicians’ recommendations about the Medicare Prescription Drug Savings and Choice Act of 2019
. How The Cost-Benefit Analysis in Terms of Legislators Being Re-Elected Affected Efforts to Repeal/Replace The ACA
The ‘Obamacare’ commonly known as the Affordable Care Act was launched by President Barack Obama. The policy has enabled most Americans to receive health insurance. However, the repeal process has failed perhaps because election matters a lot to politicians. Just within a year of Trump’s inauguration, Republicans began the debate to repeal ‘Obamacare’ and revise the long-standing Medicare and Medicaid programs (Obama, 2017). Because replacing the ACA would result in many people losing their insurance and this would limit medical care, it would impact negatively the 2018 election. Many leaders who supported the repeal would lose their seats. The leaders could not support the repeal upon realizing that it would negatively impact their reelection. A clear picture here is that political leaders do not care about how repealing the Affordable Care Act would affect Americans but how it would affect their reelection chances (Taylor et al., 2017). Therefore, it is clear that not just election results matters to politicians but also the threat of upcoming elections.

The Medicare Prescription Drug Savings and Choice Act of 2019

Politicians’ interest in being reelected also impacted the Medicare Prescription Drug Savings and Choice Act of 2019. This bill was introduced by the representative for Illinois’s 9th congressional district who is a Democrat (Congress.Gov, 2020). The bill is still in the first stage of the legislative process. It was introduced to Congress on 21st October 2019. It must be first considered by the committee before it is send to the House or Senate as a whole. Politicians will have to examine this bill to identify whether or not it will impact the upcoming election. This bill touches part D of Medicare, which is a voluntary program that helps pay for outpatient prescription drugs (Congress.Gov, 2020). This section, therefore, might affect many Americans. How this bill will influence the next election will determine whether or not it will be passed as a part of the law that governs Medicare operations in the United States. The cost-benefit analysis in terms of politicians being reelected therefore has a significant influence on their recommendations and positioning of legislative policies (Dickinson & Reinmuth, 2017, October).

References

Congress.Gov. (2020). H.R. 4769: Medicare Prescription Drug Savings and Choice Act of 2019. Retrieved from https://www.congress.gov/
Dickinson, M. J., & Reinmuth, K. (2017, October). Trump, Congress, and Health Care: All Politics Is National. In The Forum (Vol. 15, No. 3, pp. 431-450). https://rowman.com/ISBN/9781538105740/The-Trump-Presidency-Outsider-in-the-Oval-Office
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Obama, B. H. (2017). Repealing the ACA without a replacement—the risks to American health care. Obstetrical & Gynecological Survey, 72(5), 263-264. doi: 10.1056/NEJMp1616577
Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum 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

I couldn’t agree with you more, and I appreciate Dr. A.E.’s intentions in prompting this question and mentioning social determinants of health. Healthcare quality and access to health care is a major obstacle in healthcare reform. The ACA and AHCA not only strategize to increase access to health care by providing Americans affordable insurance options, but also include interventions to force the improvement of healthcare quality, which becomes a major source of contentions for economic healthcare stakeholders.
NURS 6050 Politics and the Patient Protection and Affordable Care ActAn example of this can be explored by discussing the AHCA element of transitioning care from a fee-for-service reimbursement model to a value based reimbursement model. This AHCA enforced change resulted in a major shift for many health care organizations. Fee-for-service reimbursement rewarded providers for the volume of services they provide, while the value-based approach payments are rendered based off of meeting agreed-upon quality and performance measures directly tied to patient outcomes.

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According to McHugh, M. D., et al, (2013), the AHCA’s Hospital Readmissions Reduction Program (HRRP) highly invests and highlights the value of quality measures and services offered by health care professionals outside of the provider, specifically nurses. HHRP penalizes hospitals with excessive readmission rates of Medicare beneficiaries; the primary objective of the HRRP is to reduce the rate of readmissions in accordance with the hospitals’ financial incentives with payers’ and patients’ quality goals (McHugh, M. D., et al, 2013). According to McHugh, M.D., et al, (2013), hospitals with higher nursing staff had 25 percent lower odds of being penalized compared to other similar hospitals with lower staffing. One can see why penalties like these would create resistance and motivation for repeal of the AHCA in primary healthcare economic stakeholders and highly influence their political affiliation despite social determinants of health.

References

McHugh, M. D., Berez, J., & Small, D. S. (2013). Hospitals With Higher Nurse Staffing Had Lower Odds Of
Readmissions Penalties Than Hospitals With Lower Staffing. Health Affairs, 32(10), 1740–1747.
https://doi-org.ezp.waldenulibrary.org/10.1377/hlthaff.2013.0613
Murphy, L. S., & Warshawsky, N. E. (2015). Nursing Education A Solution to Healthcare’s Gordian Knot?
JONA: The Journal of Nursing Administration, 45(6), 302–304. https://doi-
org.ezp.waldenulibrary.org/10.1097/NNA.0000000000000203

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This is insightful. Affordable Care Act has provided opportunities for millions of Americans to get access to affordable healthcare services. The policy has greatly improved healthcare delivery processes in different healthcare institutions. Affordable Care policy was one of the focuses in the previous elections (Glied & Jackson, 2017). The creation and implementation of different policies in the healthcare system often impact a number of individuals. Particularly, nurses and general healthcare professionals, as well as patients, are mostly affected. The legislation on the Affordable Care Act involved consideration of different factors, including insurance policies from different health insurance companies (Laureate Education, 2018). Also, there was voting based on the party line. However, some of the legislators went beyond the party requirements to consider the impacts of the policy on the citizens. The repealing of the Affordable Care Act by the Trump administration was meant to influence the voting patterns in the subsequent election (Milstead & Short, 2019). The president knew that individuals who cast their votes based on the issues around the affordable care act would remain on his side in the upcoming election.

References

Glied, S., & Jackson, A. (2017). The future of the Affordable Care Act and insurance coverage. American journal of public health, 107(4), 538-540. Retrieved from: https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2017.303665
Laureate Education (Producer). (2018). Introduction to Health Policy and Law 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.

The Affordable Care Act (ACA) was enacted in 2010, and it considerably changed the U.S. health care landscape. The goals of the ACA were to make insurance coverage more affordable, reduce the number of uninsured, and expand access to care. To attain these goals, the ACA expanded eligibility for Medicaid and established new marketplaces where Americans without employer coverage could purchase policies directly from insurers (Oberlander, 2017). The ACA faced strong opposition from Republicans, who described it as unrealistic because it required every American to have medical insurance (Oberlander, 2017). When the Trump administration took power in 2017, the president and Congress members of the Republican Party vowed to replace the ACA. However, one year after taking office, Republicans could not agree on whether to repeal the ACA immediately, repeal right away and replace it later, or repeal it later after establishing a replacement strategy (Oberlander, 2017).  Although the Republicans repealed parts of the ACA, including the budgetary and fiscal provisions, they did not replace it.

The Senate Republicans’ failure to honor their promise of passing a bill to replace ACA, can be attributed to the unpopularity of this bill to the public. The legislators had to assess the political impact of repealing the ACA with no replacement on their chances of being reelected (McCarthy, 2017). They had to perform a cost-benefit analysis on the cost of repealing the ACA on the future chance of being reelected and the benefits of repealing it. For instance, if the Senate replaced the ACA right away, with no replacement, the number of uninsured Americans would increase drastically, which would be opposed by their voters (McCarthy, 2017). This would negatively affect the public view of the lawmakers on their constituents, and lower their odds of being reelected if they did not have a better plan to replace the ACA.  Besides, the cost-benefit analysis can explain why the Republicans had two canceled votes in March 2017 and had to introduce a new amendment to the American Health Care Act to unite the party behind the bill (McCarthy, 2017). The failure to replace the ACA as promised shows that lawmakers can be unwilling to support bills that are a potential threat to their election results in upcoming elections.

Legislative leaders’ decisions regarding recommending or positioning national policies are often influenced by their voters’ views. Voters are known to influence legislators’ policy choices and are at times forced to compromise their choices including partisan politicians (Pacheco & Maltby, 2017). Lawmakers have to consider their voters’ views before making a policy decision that affects their constituents to maintain a positive public image (Pacheco & Maltby, 2017). In the case the voters’ views contradict a legislator’s decision regarding a policy, the lawmaker is forced to compromise their position on the policy and move to the center.

Failing to take the voters’ views can have negative consequences on the law maker’s future elections. Furthermore, to continue supporting and voting for a legislator in future elections constituents must remain convinced that their lawmaker is listening to them and consider their views (Pacheco & Maltby, 2017). For instance, members of congress had to assess the voters’ view on repealing the ACA provisions that would cut funding for Medicaid or change Medicaid to a block grant program. Since many Americans benefited from the expansion of Medicaid, it affected Congress’ decision to pass bills that would hinder their voters’ access to the program and ultimately affect their public image.

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References

McCarthy, M. (2017). U.S Republican attempt to repeal and replace Affordable Care Act collapses. https://doi.org/10.1136/bmj.j3508

Oberlander, J. (2017). Repeal, replace, repair, retreat—Republicans’ health care quagmire. New England Journal of Medicine377(11), 1001-1003.

Pacheco, J., & Maltby, E. (2017). The role of public opinion—does it influence the diffusion of ACA decisions?. Journal of Health Politics, Policy and Law, 42(2), 309-340.https://doi.org/10.1215/03616878-3766737

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.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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.

*Note: Throughout this program, your fellow students are referred to as colleagues.

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6050_Module01_Week01_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness
10 (10%) – 10 (10%)
Posts main post by day 3.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not post by day 3.
First Response
17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response
16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation
5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100

Also Read: NURS 6050 Discussion Presidential Agendas