NURS 6003 Discussion: Politics and the Patient Protection and Affordable Care Act

The Affordable Care Act (ACA) or Obamacare enacted in March 2010, was the most significant reform of the American healthcare system in recent history. The ACA was enacted during President Obama’s term with the following goals: Making affordable healthcare available to more people, to expand the Medicaid group, and to support medical care delivery methods to lower the costs of health care (Healthcare.gov, n.d.). The “affordable care” part of the ACA included Medicaid expansion, dependents remaining on their parent’s insurance until age 26, and creation of an insurance marketplace for individuals to compare cost rates. The “patient protection” portion included guaranteed issue, no exclusion of pre-existing conditions, and coverage of essential health benefits (Campbell & Shore-Shepard, 2020). A primary focus of the law was to extend insurance coverage to approximately 49 million non-elderly individuals (Campbell & Shore-Shepard, 2020). Many Americans believe it is the closest resemblance to universal healthcare offered in other countries by allowing healthcare to be accessible to most Americans.

Struggling to meet your deadline ?

Get assistance on

NURS 6003 Discussion: Politics and the Patient Protection and Affordable Care Act

done on time by medical experts. Don’t wait – ORDER NOW!

Meet My Deadline

Since enactment, The ACA has been a major part of political legislation. Democrats in favor of protecting and improving the ACA, while Republicans in favor of repealing most provisions of the law. When President Trump took office, the Republican agenda was to “repeal and replace” the ACA. However, Republicans quickly realized it would be difficult to repeal provisions in the law and were essentially unsuccessful. Implementing changes would run up against the next election cycle in 2018. According to Milstead and Short (2019), “it demonstrates not just that election results do matter but also that even the threat of an upcoming election cycle affects what policymakers are willing or able to do” (pg. 40).

As of June 2021, a record 31 million Americans have health coverage through the Affordable Care Act (U.S. Department of Health and Human Services, 2021). I believe the ACA has been instrumental in providing affordable healthcare to Americans that would otherwise be uninsured, including those with pre-existing conditions. With so many constituents covered by this law, it inevitably makes it difficult for legislators to repeal or change many parts of it. Constituents voices do have an affect on legislation. As nurses, we recognize the issues associated with the uninsured and underinsured. We have the opportunity to continue to make our voices heard for government to continue affordable healthcare for all, regardless of political affiliation.

References

 Campbell, A. & Shore-Sheppard, L. (2020). The Social, Political, and Economic Effects of the

Affordable Care Act: Introduction to the Issue. RSF: The Russell Sage Foundation Journal of the Social Sciences. 6. 1-40. 10.7758/RSF.2020.6.2.01.

Healthcare.gov (n.d.) Affordable Care Act (ACA). Retrieved December 14, 2021, from

https://www.healthcare.gov/glossary/affordable-care-act/#:~:text=The%20comprehensive%20health%20care%20reform,insurance%20available%20to%20more%20people.

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

Burlington, MA: Jones & Bartlett Learning.

U.S. Department of Health and Human Services. (2021, June 5). New HHS Data Show More

Americans than Ever Have Health Coverage through the Affordable Care Act. HHS.gov. https://www.hhs.gov/about/news/2021/06/05/new-hhs-data-show-more-americans-than-ever-have-health-coverage-through-affordable-care-act.html

The Affordable Care Act (ACA) had a tremendous impact on extending healthcare coverage to many, especially those with pre-existing conditions. This extension largely affected those with chronic illnesses or disabilities. We may be facing in the near future whether or not COVID-19 will qualify as a pre-existing condition. Many who have had the virus are now suffering from long-lasting symptoms. If the ACA were repealed, it would raise the question of how these patients could be treated affordably if their side effects weren’t covered by their insurance. This may discourage individuals from getting tested, potentially furthering the spread of COVID (Mason, 2020). That being said, the ACA dramatically affects the lives of many and their abilities to access affordable healthcare, so efforts to repeal the act would negatively impact the working class.

Despite many citizens’ disagreements on repealing or replacing the ACA, many attempts have been made to do so. Approximately 80% of nonelderly adults are in favor of the ACA, with 70% in favor of keeping the premium subsidies. If the voters’ opinions show more variability, legislators’ stances on the ACA may reflect the voters’ preferences (Karpman & Long, 2017). The views of the voters do matter despite what many may think. As nurses, we are in a position to make a difference in healthcare policy, and it is critical to advocate for what would provide the best outcomes for our patients.

References

Karpman, M. S., & Long, S. (2017, October 16). ACA repeal votes defy preferences of Constituents. Health Affairs. Retrieved December 15, 2021, from https://www.healthaffairs.org/do/10.1377/hblog20171022.190658/full/

Mason, M. (2020, December 2). The ACA and the importance of protecting people with pre-existing conditions. National Health Council. Retrieved December 15, 2021, from https://nationalhealthcouncil.org/blog/the-affordable-care-act-aca-and-the-importance-of-protecting-people-with-pre-existing-conditions/

Thanks for your response Marissa. I completely agree, as nurses, we have a responsibility to be an advocate for your patients. Especially, with so many newer health challenges such as COVID-19.

Great post, Tamisha.

You mentioned that Milstead and Short (2019) expressed the view that even knowing there will be an upcoming election cycle can influence the decisions and behavior of congressmen and women. This is point that I find difficult to swallow as an American citizen. Congressional policy decisions are influenced not only by re-election, but by campaign donations from special interest groups who seek to influence public policy (Foreman, 2018). It makes me realize more than ever how important it is for the nursing profession to try and shape public policy that benefits the American people. There are many reasons nurses have historically stayed out of the political spotlight, including lack of knowledge of how to get involved and limited time balancing busy jobs (Brokaw, 2016). Do you think there is anything that we as nurse leaders can do to try to influence policy even during difficult times, such as election years?

References:

Brokaw, J.. (2016, September 22). The nursing profession’s potential impact on policy and politics. American Nurse.  https://www.myamericannurse.com/nursing-professions-potential-impact-policy-politics/ 

Foreman, C. (2018). Money in Politics: Campaign Finance and Its Influence Over the Political Process and Public Policy. UIC J. Marshall L. Rev. (52)185. https://repository.law.uic.edu/lawreview/vol52/iss1/8

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

Burlington, MA: Jones & Bartlett Learning.

Foreman, C. (2018). Money in Politics: Campaign Finance and Its Influence Over the Political Process and Public Policy. UIC J. Marshall L. Rev. (52)185. https://repository.law.uic.edu/lawreview/vol52/iss1/8

Hi Andrea,

Thank you for your response. In response to your question, I do believe nurses have a responsibility to advocate for our patients and for healthcare improvements. As healthcare professionals, we have the first-hand knowledge and testimony to the detriment some policies, or lack thereof, have on everyday Americans. In today’s political climate, it can be difficult to believe our voice will make a difference on legislation. However, we cannot be complacent. “Each nurse counts, and collectively, nursing is a major actor in the effort to ensure the United States healthy future” (Milstead & Short, 2019, p. 12). Joining nursing political organizations, such as the House Nursing Caucus or Senate Nursing Caucus is one way to ensure our voices are heard.

Reference

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

ed.). Burlington, MA: Jones & Bartlett Learning.

Hi Janelle,

I believe public opinion does not necessarily correlate to election or political outcomes. For example, Trump won the presidential election in 2016. One of the main topics he ran on was to “repeal and replace” the ACA. However, when he got into office, the repeal of the ACA did not happen due to fear by Republicans of negative future election outcomes and backlash from their constituents. Also, many legislators run on issues they feel will appeal to the base of their party. Then when elected, lobbyists and special interests group take precedent over public opinion. Unfortunately, we see this time after time in politics. As nurses, I feel it is important for us to continue to lobby for the best interest of the public, even when politics come before the everyday voter’s best interest.

Tamisha, you have highlighted a pertinent issue concerning the role of an upcoming elections a predictor of policy positions of incumbent legislatures at the floor the house. Hogan (2019) explains that when voters are aware or are made aware by elites of policy differences among candidates, they are likely to vote for candidates closer to their own particular policy position. Cunow et al. (2016) add that when legislators stray too far from the wishes of the constituency, the electorate may take this information into account when making their voting decision. The result may be that policy positions are as important as, or even more important than, what we observe in congressional elections. What is your opinion about the above statement with regards to ACA?

References

Cunow, S., Ames, B., Desposato, S., & Renno, L. (2016). Reelection and legislative power: Surprising results from Brazil. Legislative Studies Quarterly, 37(4), 533–558. https://doi.org/10.1111/j.1939-9162.2012.00061.x

Hogan, R. (2019). Policy responsiveness and incumbent reelection in state legislatures. American Journal of Political Science, 52(4), 39–51. https://doi.org/10.2307/j.ctv8p

Hi Tamisha, thanks for your post. You are right and I agree very well with you when you said the affordable care act (ACA) has been helpful to people in attaining affordable health care. As a home care nurse, I come across people without health insurance all the time and so I know how it is to not have insurance. I have admitted patients who had to sign a paper indicating they are getting only 3 visits and would be discharged afterwards all because of lack of insurance, so I get it. It’s rather unfortunate that our legislators think about their votes, rather than the betterment or well being of the general population. It is true; the only reason why the ACA is still standing is because many voters are benefiting from it, so it’s like whoever touches it will be saying bye to his or her political career, but it shouldn’t be so, because even though ACA  might have its disadvantages, it has been beneficial in so many ways. According to an online article, the Medicaid section of this act has made it possible for diabetic patients and patients with trauma to receive the care they need. It has also reduced inpatient hospitalizations which in turn has saved the US health care system in terms of cost. Young adults who are diagnosed with cancer have also received health insurance through another part of ACA called “Dependent Care Provision” among other (Isola & Reddivari, 2021).

Also as you mentioned, as nurses, we are out there, we see what goes on it our patients and since we are their voices, we have to advocate for them by making our voices heard on issues like this. As it is stated in our textbook, “the ultimate point in participating in policymaking is to improve patient outcomes” (Milstead & Short, 2019). Again, according to the same Milstead & Short, bills will not become laws without the input of lobbyists (pg. 45). This means that, as nurses we have the upper hand, and that is why need to join our professional organizations, get closer to our legislators and through that we can make our voices heard on issues that concern our patients and health care as a whole.

References

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

Isola, S., & Reddivari, R. K. A. (2021). Affordable care act. Statpearls (Internet). https://www.ncbi.nlm.nih.gov/books/NBK549767/