23rd March 2010 was the hilarious date that then-President Barack Obama signed into law the Affordable Care Act (ACA). ACA and the Patient protection act put into law various health insurance reforms such as Medicare and Medicaid. Medicare covered the elderly and disabled Americans, while Medicaid covered low-income adults, children, and pregnant women. However, in 10years, the Republican legislators have tremendously made concerted efforts to repeal/replace the ACA.
Legislators make decisions after comparing the estimated cost and opportunities associated with a certain policy and how it makes sense from a business perspective. The government expenditure on the ACA stood at $43billion for just helping the middle-income citizens to get covered in 2016. The federal cost incurred to expand Medicaid programs to residents living below 138% poverty level stood at $74billion in 2016 in just 31 states and Washington DC (Glied et al., 2018). By a cost analysis calculation, the combined government expenditure on the Affordable Care Act supersedes the net revenue provided by the program. The Republican legislators have vowed to repeal ACA and replace the program with a substitute.
Under the full influence of the cost-benefit analysis politics, legislators examined, estimated, and compared these costs and their economic impacts and decided to replace ACA. The politics of cost-benefit analysis has tragic consequences in that legislators have to choose who will live and who will die (Wildavsky et al., 2018). For example, by repealing the ACA, health coverage and access will be reduced since only those on good payroll will afford healthcare. The poor will have to die while the rich survive. On the other hand, legislators do benefit a lot in terms of policy development and implementation. Despite the cost-benefit analysis, as long as the policy favors them, it will be implemented no matter the cost. The reality of the issue is that ACA has helped many, if not all, to cheaply access healthcare, despite the availability of other problems such as longer waiting hours. From a business perspective and cost-benefit analysis, the legislators aimed at returning the health coverage to the previous versions, where private institutions offered health coverage with unregulated prices. Most legislators own these private institutions. To be re-elected, they would like to monopolize the economy, control the costs and convince the public that they deliver more than anticipated.
However, voters’ views have always affected these legislator’s decisions when positioning the national policies. Maneuvering through the repealing of the ACA has been a standstill debate, with conflict being witnessed between the legislator’s views and the views of the people.
Dassonneville, R., Blais, A., Sevi, S., & Daoust, J. F. (2021). How citizens want their legislators to vote. Legislative Studies Quarterly, 46(2), 297-321.
Glied, S., & Jackson, A. (2017). The future of the Affordable Care Act and insurance coverage. American journal of public health, 107(4), 538-540.
Wildavsky, A., & Horowitz, I. L. (2018). The political economy of efficiency: cost-benefit analysis, systems analysis, and program budgeting (pp. 183-209). Routledge.