Discussion: Politics and the Patient Protection and Affordable Care Act

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

Discussion: Politics and the Patient Protection and Affordable Care Act

The Affordable Care Act (ACA) is a comprehensive healthcare reform that was signed into law by President Obama in 2010. It was created to enable all American citizens both low-income, and uninsured adults without an affordable option for health insurance be able to have adequate and affordable health insurance (Borelli et al., 2016).

The cost-benefit analysis in terms of legislators being re-elected affected efforts to repeal/replace the ACA would cost Americans a lot of money and a decrease in the quality of healthcare. For instance, in 2016, Congress passed a bill repealing ACA without a

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

replacement which was voted by presidents. The repealing was to reduce government spending on healthcare and the elderly; although government spending on the elderly would go down by $90.9 billion in 2021 and $927 billion between 2017 and 2026 resulting in a decrease of 21.1 percent, it would cause the number of uninsured people to rise by 24 million by 2021, an increase of 81 percent of people without coverage including working families, high school students, young adults, and non-Hispanic whites. 14.5 million fewer people with Medicaid coverage by 2021, about 9.4 million that was supposed to receive a tax credit for private health coverage would no longer receive assistance and state spending would increase by $68.5 billion between 2017 and 2026 (Buettgens et al., 2016). Voters’ view has a big impact on decisions by legislative leaders because voters’ decision to keep them in the office will encourage the work they are doing whether the work is for the good of the people and the benefit of our country or not.

The number one job of a legislator is to be re-elected, to create and process bills that will become state law if approved. Training should be provided to legislators and staff about ethics laws, and they should be encouraged to meet the highest ethical standards, not just the letter of the law (Kurtz, 1994). Because they want to remain in the office for a long time or leave when they want to, they must recognize that the decisions they make will affect the lives of others (Fitch, 2011).

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Buettgens, M., Blumberg, L. J., Holahan, J., & Ndwandwe, S. (2016, June). The cost of ACA repealUrban institute | social and economic policy research

Borelli, M. C., Bujanda, M., & Maier, K. (2016). The Affordable Care Act Insurance Reforms: Where Are We Now, and What’s Next?. Clinical diabetes: a publication of the American Diabetes Association34(1), 58–64.

Fitch, B. (2011, February 1). How legislators make decisionsCitizen’s handbook

Kurtz, K. T. (1997, December). Public participation and confidence in the legislatureLegislative news, studies, and analysis | National Conference of State Legislatures


The Affordable Care Act (ACA) was groundbreaking in an that it aimed to bring accessibility of coverage to all Americans. Some facets that were argued were the affordability of insurance options through the Marketplace and the individual mandates. The Trump administration budget cuts of 2018 included cuts to Medicaid and public funding cuts to the FDA, NIH, and CDC (Jost, 2017). Insurance premiums were increased during the Trump administration, but Glied (2020) argues that what needs to be reworked are the high costs of health care (Jost, 2017).

As Milstead and Short (2019) write, a legislator’s primary goal is re-election. They are to be in a role that facilitates the interest of constituents, but the majority voter view is really the focus of legislators when it comes to decision making. You made a great point that ethics or what is best for the people isn’t what determines whether an agenda or bill moves forward. This is more reason why nurses should involve themselves in politics to ensure that local and state legislators are aware of what health determinants face large populations of voters.

Thank you so much for your posting!

Glied, S. (2021). Continue moving forward on the affordable care act path. American Journal of Public Health111(4), 612–613.

Jost, T. S. (2017). ACA replacement battle moves to senate. Health Affairs (Project Hope)36(7), 1173–1174.

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

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.


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

The Affordable Care Act’s repeal has for sure been a priority for Republican lawmakers due to their concern about the government’s control over healthcare and insurance. According to Milstead and Short (2019), Republicans have sought to reduce funding to the ACA as they believe it gives the government too much power over healthcare. Furthermore, they argue that providing healthcare to everyone, regardless of state expenditure, is an issue, which is why they are looking to decrease funding to the ACA (Milstead & Short, 2019).

However, I believe that public opinion also plays a significant role in the efforts to repeal the ACA. As you mentioned, legislators are focused on being reelected, and their decision-making is influenced by their constituents’ opinions. As Brodie (2020) found, over 50% of Americans approved of the ACA in 2019, indicating that repealing it might not be in their best interest. Moreover, according to Blendon et al. (2021), there is a sharp partisan divide in Americans’ preferences for healthcare. Seventy-five percent of Democrats reported they prefer government-run healthcare, while 79% of Republicans want private insurance. This division in public opinion indicates that legislators’ decisions are not solely based on their own interests, but they must also consider the interests of their constituents.

The ACA’s repeal is a contentious issue, and legislators’ decisions to either repeal or keep the act in place are based on several factors, including their political interests and their constituents’ preferences. Thus, it is essential for legislators to balance the needs and wants of their political party and their constituents when making healthcare-related decisions.


Blendon, R. J., Benson, J. M., & Schneider, E. C. (2021). The Future of Health Policy in a Partisan United States. JAMA, 325(13), 1253.

Brodie, M. (2020, February). The Past, Present, And Possible Future of Public Opinion on the ACA. Health Affairs.

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