POLITICS, THE PATIENT PROTECTION AND AFFORDABLE CARE ACT The Affordable Care Act

POLITICS, THE PATIENT PROTECTION AND AFFORDABLE CARE ACT The Affordable Care Act (ACA), commonly known as Obamacare, profoundly affects Americans’ political attitudes and behaviors, and it is the most significant social expansion in the United States. The ACA is a federal statute enacted by the 111th Congress and signed into law on March 23, 2010, by President Obama, intending to extend health care coverage to millions of uninsured Americans. The effects affected those who pay for the benefits, those who benefit, those who resent or oppose it, and those who embrace the expansion of insurance access. The ACA required plans to cover essential health benefits, preventing insurance companies from denying coverage to pre-existing health conditions by creating a Health Insurance Marketplace (Investopedia.com, 2019). There have been multiple Republican repel attempts to replace it or degrade it since the ACA enactment. Additionally, legislators provided health insurance coverage change suggestions during re-elections. However, they needed help to figure out how to effectively replace or repeal the act without affecting millions of Americans. It is common knowledge that a legislator’s primary objective is to be reelected. For that to happen, they need to be aware of the political climate in which they compete and maintain their vigilance. Mildstead and Short (2017) contend that politicians must look beyond a particular issue and consider the factors that affect what is likely to succeed or fail. By looking at the number of votes required to pass any particular bill, lawmakers must decide which policies would be most beneficial and least expensive to support during their reelection. During an election year, lawmakers running for reelection always track whether most voters or constituents favor or oppose a particular proposition. However, according to Schechter (2017), during the last ten years, legislators have become more dependent on the political contributions made by those who support them. Moreover, according to Schechter (2017), during the last ten years, legislators have become more dependent on the political contributions made by those who support them. Stated differently, legislative leaders’ decisions about the placement or recommendation of national policies may be affected more by the amount of contributions they get than by the views of their constituents. Since its effect in 2010, the Affordable Care Act (ACA) has been the subject of extensive discussion. There has been much political discussion around attempts to repeal or replace the Affordable Care Act (ACA), with opinions often falling along party lines. Even while the Affordable Care Act (ACA) offers benefits such as more comprehensive coverage for individuals with pre-existing diseases, there are drawbacks, including the perception that it will increase the budget deficit and that premiums will not fall for everyone (Rand Corporation, 2019). Republicans thought the Affordable Care Act was a costly endeavor that would increase the cost of private insurance, increase the deficit in the federal budget, undermine Medicare, and devastate the health care system in the United States. Between 2010 and 2016, the House Republicans introduced more than 50 proposals to abolish the Affordable Care Act (Cohn, 2020). Democratic supporters of the ACA claimed that many people—including those with pre-existing conditions—were covered by it. Because of the way the healthcare industry is set up, health insurance is also reasonably priced. Voter expectations have split the ACA discussion, with lawmakers more likely to propose policies that will appease the majority of their constituents. The Democratic Party lost several House of Representatives seats following the Republicans’ sustained attacks on the 2010 passage of the Affordable Care Act. This demonstrates how public opinion shapes reelection decisions. As a result of their futile attempts to repeal the ACA, the Republicans also lost seats. Four alternatives have emerged from the political discussion around the ACA’s repeal or replacement. These include doing away with the Affordable Care Act and putting in place a single-payer system (the American Health Care Act), the Health Insurance Solution, or the American Health Security Act, which was proposed by Senator Bernie Sanders in 2011. While millions of Americans would be unable to pay the high rates or would lose their coverage, these solutions would only appeal to individuals who are worried about the government deficit (Rand Corporation, 2019). We have to do an overview of the cost-benefit analysis of legislators’ re-election that affected the replacement and repelling of the ACA during the Trump administration and the political period before him. During the Obama administration, the Republican House voted to repeal the ACA multiple times, even though President Obama would veto the bill. Republicans won seats in elections by using the repeal of the Affordable Care Act as their platform. The Republican Party held the majority at the start of the Trump administration and had the power to repeal and replace the ACA. According to Milstead and Short (2017), “Republicans saw their opportunity to finally repeal a law that had long been a thorn in their sides.” Therefore, it was believed that Republicans and lawmakers from swing states who were up for reelection would gain from supporting the dominant party since the Republican push to repeal and replace the Affordable Care Act (ACA) paid off politically during the 2016 election. Republicans’ disputes inside the party, which may have been influenced by their political reelections, inhibited them from repealing the ACA. By the time of the 2018 election, the ACA was well-liked, and Democrats ran their campaigns on preserving and enhancing it. Due to the effort, Democrats managed to retake control of the House. Since supporting or opposing a cause might cost a politician their seat if the idea or problem directly conflicts with their political party or support group, politicians will typically go to any lengths to ensure they are reelected. Given the interdependence of health and politics, nurses ought to engage in legislative advocacy for public health issues (Milstead & Short, 2019). References Cohn, J. (2020, March 6). The ACA, repeal, and the politics of backlash. Health Affairs Blog. Retrieved on June 10, 2022, from https://www.healthaffairs.org/do/10.1377/forefront.20200305.771008. DOI: 10.1377/hblog20200305.771008 Kenton, W. (2019, October 17). Affordable Care Act (ACA). https://www.investopedia.com/terms/a/affordable-care-act.asp Haselswerdt, Jake. 2017. “Expanding Medicaid, Expanding the Electorate: The Affordable Care Act’s Short-Term Impact on Political Participation.” Journal of Health Politics, Policy and Law 42(4): 667–95. Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning. Rand Corporation (2019). The Affordable Care Act. Retrieved on June 11, 2022, from https://www.rand.org/health-care/key-topics/health-policy/aca.html Sances, Michael W. 2019b. “Policy Effects, Partisanship, and Elections: How Medicaid Expansion Affected Opinions of the Affordable Care Act.” Working paper, University of Memphis. Accessed January 22, 2020. Schechter, A. (2017, June 28). Study: Politicians Vote Against the Will of Their Constituents 35 Percent of the Time. Stobierski, T. (2019, September 5). How to do a cost-benefit analysis & why it’s important? Retrieved on June 12, 2022, from https://online.hbs.edu/blog/post/cost-benefit-analysis Understanding affordable care act. https://visclosky.house.gov/issues/understanding-the- affordable-care-act