If legislators’ number one job is to be re-elected regarding certain proposals to promote or not promote certain laws or bills, they would have to monitor their crowd at the time to see who they would be pleasing in majority. A primary example of a cost-benefit analysis (CBA) for a legislator to be re-elected on or not if they support the affordable care act (ACA) or not. During former President Trumps election, Republican, the legislators would increase their odds of reelection if they were republicans as they would support each other to pass bills/laws versus a democratic legislator. That being said, a Republican legislator would vote to repeal the ACA in hopes the president and other members would re-elect them. Whereas the Democratic party would be the opposite. They would be paying more for their campaign and would most like not focus primarily on repealing the ACA, but going about it in a different way, like recreating certain portions over time. This party would most likely reach out to the medical team contributors, such as the Cooperative of American Physicians, American Association of Orthopedic Surgeons, and several others (Milstead & Short, 2019) for funding and knowledge. As Milstead & Short (2019, p. 51) stated, “Deciding which of several policy options will lead to greatest benefits and the fewest costs, in a world where re-election is a key considerations and media are a relentless presence, means the best solution may not be the path ultimately chosen.” Politics and the Patient Protection and Affordable Care Act
Repealing of the ACA would have saved an estimate of $1.55 trillions dollars through 2027 if only the ACAs coverage provisions (leaving ACAs Medicare reduction and tax) were repealed (Health Care, 2017), which would leave funds available to replace the ACA. Although, repealing the ACA entirely would cost approximately $355 billion through 2027. The government would have saved a ton of money per year, except we would be increasing the uninsured dramatically, by approximately 23 million (Health Care, 2017). The pitfall is an entire repeal of the ACA would leave zero funds to ‘replace’ the ACA. It would actually aquire a deficit if it were to be done. With this knowledge Trump did repeal some of the requirements such as removing the mandate of everyone to have health care.
As a legislator one should express these costs and adjustments that would be affected in the repeal and replace of the ACA to the citizens during elections. As Lambrew (2018) even states that candidates’ views on health care policy can affect the exit polls during election time. People want to know that they are protected, but do not want to be paying a fortune to be protected. They also want to know what that tax money is going towards. Voters typically lean left or right, republican or democratic, so they are most likely to support their alike thinkers, although policymakers get focused on what looks and sounds good on paper versus how affecting the ACA/Medicare and Medicaid would actually affect the people. This is when people, citizens, speak out and the voice of nurses assist in making changes (Milstead & Short, 2019). When this happens the decisions by legislators can and should be affected, as it may affect their re-election. Though it may be cheaper to do one thing, it may not be the best option for the majority, such as repealing the ACA with no real plan in line with a replacement. This is why there is always a time and place when to speak up, especially as a nurse, and you have to figure out when that time is especially since “…healthcare professionals are traditionally the largest source of federal campaign contributions… (Milstead & Short, 2019, p. 48)”. Politics and the Patient Protection and Affordable Care Act
Health Care. (2017, January 26). The cost of full repeal of the Affordable Care Act. Committee for a responsible Federal budget. Retrieved March 17, 2021, from https://www.crfb.org/papers/cost-full-repeal-affordable-care-act#:~:text=According%20to%20our%20latest%20estimates,%24150%20billion%20using%20dynamic%20scoring.&text=Repealing%20ACA%20would%20increase%20the%20number%20of%20uninsured%20people%20by%2023%20million.
Lambrew, J. M. (2018, June). Getting ready for health reform 2020: What past Presidential campaigns can teach us (Rep.). Retrieved March 14, 2021, from The Commonwealth Fund website: https://www.commonwealthfund.org/sites/default/files/2018-06/Lambrew_getting_ready_hlt_reform_2020_presidential_0.pdf
Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed., pp. 36-55). Burlington, MA: Jones & Bartlett Learning.
Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
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. Politics and the Patient Protection and Affordable Care Act
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.
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. Politics and the Patient Protection and Affordable Care Act
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.
I found the information you included about President Trump interesting. What may have been a strategic campaigning advertisement in 2016, could have been what cost him his seat in 2020. You also discuss how politicians support or opposition of the Affordable Care Act (ACA), specifically Republicans, could affect their status after the election. I found an article that supports this theory. In a study by Bussing et al. (2020), it was found that Congress members who voted to repeal the ACA had a smaller chance of being reelected. However, the same study discusses how the public are more likely to vote for members who match their own views. It makes me wonder if the moderate Republicans voiced their concerns of repealing the ACA because they truly believed it, or if they did so for the votes. The public was also divided on the subject of repealing the ACA. Our textbook by Milstead and Short (2019) has a graph on page 177. It shows how 51% of the public did not the repeal voted on, 24% wanted to see a replacement plan before repealing, and 19% wanted the vote to repeal to happen before a replacement plan was shared. I agree with your claim that politicians should consider information like this, given that the largest group wishes to see the ACA go unchanged. I am also interested to see what the next 4 years hold for the ACA under the current administration. Politics and the Patient Protection and Affordable Care Act
Bussing, A., Patton, W., Roberts, J. M., & Treul, S. A. (2020, May). The Electoral Consequences of Roll Call Voting: Health Care and the 2018 Election. Political Behavior. https://doi.org/10.1007/s11109-020-09615-4
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