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Efforts to Repeal 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.



    Required Readings

    • Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide(6th ed.). Jones & Bartlett Learning.
      • Chapter 3, “Government Response: Legislation” (pp. 37–56)
      • Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)
    • govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
    • 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), 346–350Links to an external site..
    • United States House of RepresentativesLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.house.gov/
    • United States SenateLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.senate.gov/
    • United States Senate. (n.d.). Senate organization chart for the 117th CongressLinks to an external site..  https://www.senate.gov/reference/org_chart.htm
    • Document: Legislation Grid Template (Word document)Download Legislation Grid Template (Word document)

Efforts to Repeal Affordable Care Act

The efforts to repeal/replace the Affordable Care Act (ACA) were heavily influenced by the cost-benefit analysis in terms of legislators being reelected. The ACA was a landmark piece of legislation that significantly impacted healthcare in the United States, and its repeal or replacement would have had substantial consequences, both politically and socially.

From a legislator’s perspective, the decision to support or oppose the repeal/replace efforts was largely driven by the perceived impact on their constituents and their own reelection prospects. For some legislators, particularly those in districts or states where the ACA was unpopular, supporting repeal efforts could have been seen as aligning with the preferences of their voter base and potentially increasing their chances of reelection. Conversely, for legislators in areas where the ACA was more popular or where constituents relied heavily on its provisions for healthcare coverage, supporting repeal efforts could have posed significant political risks.

Additionally, the influence of interest groups and lobbyists cannot be overlooked in this context. Healthcare industry stakeholders, including insurance companies, pharmaceutical companies, and healthcare providers, often wield significant influence over legislators through campaign contributions and lobbying efforts. For legislators considering their reelection prospects, the support or opposition of these influential groups could weigh heavily in their decision-making process regarding the ACA.

In terms of voter views, analyses of public opinion on healthcare issues like the ACA can have a significant impact on decisions by legislative leaders. Public opinion polls and surveys can provide insight into how voters perceive healthcare policies and how those perceptions may influence their voting behavior. Legislators who are attuned to the views of their constituents may be more inclined to support or oppose certain policies based on public sentiment.

Furthermore, the ACA’s provisions directly impacted millions of Americans through programs like Medicaid expansion, subsidies for private insurance, and protections for individuals with pre-existing conditions. As such, decisions regarding the ACA could have far-reaching implications for the health and well-being of voters, making it a critical issue in electoral politics.

Overall, the cost-benefit analysis for legislators regarding the ACA repeal/replace efforts was heavily influenced by considerations of reelection prospects, constituent views, and the influence of interest groups. Understanding these dynamics is essential for assessing the political landscape surrounding healthcare policy decisions at the national level.

Example: In the 2018 midterm elections, healthcare emerged as a central issue for voters, with many Democratic candidates campaigning on a platform of protecting the ACA and expanding access to healthcare. This electoral outcome reflected the significance of healthcare policy in shaping voter preferences and highlighted the potential electoral risks for legislators seeking to repeal or undermine the ACA.

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