Respond to ?two of your peers by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their

Peer 1

Jerri-Ann Rowell

RE: Discussion – Week 3

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The Affordable Care Act (ACA) expanded and improved health insurance coverage in two primary ways (Willison & Singer, 2017). First, the number of individuals receiving insurance coverage expanded by increasing access to coverage through Medicaid expansion and providing subsidies to purchase private insurance on the health care exchanges (Willison & Singer, 2017). The first way provides an outlook as to how ACA helped those who have Medicaid and those who have private insurance. However we were all soon to learn how most do not benefit from ACA.  Second, the ACA upgraded the quality and scope of coverage by improving benefit design, including implementing the essential health benefits (EHBs) (Willison & Singer, 2017). Essential health benefits are minimum insurance benefits encompassing 10 categories of care, which the ACA required all individual and small-group market plans, as well as all plans sold on the health care exchanges, to cover (Willison & Singer, 2017). Mandating benefits for individual and small-group markets was a historic step, improving population health by providing access to crucial health care services for millions of Americans (Willison & Singer, 2017). Although some components of the ACA are popular with Republican policymakers, including coverage for preexisting conditions and Medicaid expansion, the EHBs’ future is in doubt (Willison & Singer, 2017). “Be careful what you wish for” could be directed towards those who pushed aggressively for the passage of the Affordable Care Act (Blackburn, 2018). Even though the failings of the law are now apparent, the administration continues to peddle untrue promises to the American public with false hopes such as: “If you like your doctor, you can keep your doctor,” and “if you like your plan you can keep your plan” or “it is affordable once you get the subsidy” (Blackburn, 2018). Even prior to the passage, Republicans correctly predicted none of those pledges would hold true and sadly, Americans are seeing the devastating consequences of this government-run approach to health coverage (Blackburn, 2018). In regard to this, it is making it easier for the people to vote for those opposed to ACA (Blackburn, 2018). No one will vote for someone who is advocating for something they cannot afford and has clearly been shown that it is not in the people’s best interest.  It’s important to highlight not only the failures of Obamacare, but the work being done by the House GOP to repeal and replace it as well. (Blackburn, 2018). We recently learned, via Health and Human Services, that premiums for 2017 will rise by an average of 25% (Blackburn, 2018).  In many states, those increases will be much higher; Arizona (116%), Oklahoma (69%), Minnesota (59%), and in my state of Tennessee, 63% (Blackburn, 2018). After this news, you would think President Obama and the administration would show humility and admit Obamacare is too expensive to afford and is simply imploding (Blackburn, 2018). Instead, the president has said “The bottom line is most people are going to be pleasantly surprised by just how affordable their options are, if we can just get them to see for themselves” (Blackburn, 2018). Just like in 2010 when he signed Obamacare into law, the president is ignoring the facts. (Blackburn, 2018). The truth is people tried it and they do not like it (Blackburn, 2018).

            Legislators are constantly being asked to make decisions; decisions on how to vote, who to support, and what causes to champion (Ames, 2020). Understanding a legislator's decision-making process can make a difference as a group seeks to influence the legislator toward their argument (Ames, 2020). Voters vote according to their views and beliefs.  Therefore, candidates may alter their agenda and policies to receive more votes. Voters have easier access to agenda and polices of their candidates now more than ever before due to most having direct access to internet. With the ease of access, it is more important to the candidate’s beliefs and intent while in office to coincide with their voters.

References

Ames, K. (2020). How legislators make decisions. Social Studies. Retrieved June 8, 2022, from https://www.socialstudies.org/advocacy/how-legislators-make-decisions

Blackburn, R. M. (2018, July 9). The ACA is a disaster. we're offering a better way. gop.gov. Retrieved June 8, 2022, from https://www.gop.gov/aca-disaster-offering-better-way/

Willison, C. E., & Singer, P. M. (2017, August). Repealing the affordable care act essential health benefits: Threats and obstacles. American journal of public health. Retrieved June 8, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508159/#bib1

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Peer 2

Christina Bradford 

RE: Discussion – Week 3 Main Post

Top of Form

Discussion: Politics and the Patient Protection and Affordable Care Act

With the goal of the legislator to be reelected to the following term, the cost of winning yields not only votes, but a large price tag. Legislators are asked to vote and make decisions constantly. “Laws put into place begin as ideas” (United State House of Representatives, n.d.). To remain in office, most elected officials must be aware of how their opinions and votes on policies will affect the ability to remain in office (National Council for the Social Studies, n.d.).   The Affordable Care Act has been a hot election topic for years.  Cost benefit analysis “allows you to consider all costs and benefits over time, even beyond the length of the intervention”(Centers for Disease Control and Prevention [CDC], 2021). Politics are so diverse and those running for reelection use the current healthcare issues to their advantage. The cost on getting reelected means during elections a politician must focus on raising money. “The return on the investment must be beneficial, if not the money invested in political campaigns would not continue to increase” (Milstead & Short, 2017, p. 48).

The Affordable Care Act has been highly controversial over the past few years. It was put into place in hopes to provide affordable health insurance to all Americans and to those with preexisting illnesses, but not without a price tag.  Medicaid cost continue to rise in the United States with more Americans living in poverty. During the Obama presidency, he made many promises about Obamacare that were not upheld. Patients were not allowed to keep the same physician, as many of them left the private sector. Businesses were also hit as they were forced to provide insurance to employees creating more expenses for small companies and a strain on the companies. Penalties were also put in place initially for those not signed up for a qualified health plan.  What most studies saw is that those that even had insurance did not seek medical care, which is not what they wanted to happen.

In 2017, the Trump administration tried to repeal and replace the entire law. The bill got through the House of Representatives and failed at the Senate.  During his presidency the ACA was continuously under fire and many opportunities were lost to rebuild the plan.   The repeal would cost millions to replace and will leave millions without insurance. Many plans propose to replace Medicaid expansion with unspecified block grants. This would leave a large number without insurance.  Another option is to eliminate subsidies and retain reductions in payments to hospitals and providers.  Replacing the ACA’s subsidies with fair tax credits could lead to a collapse of the health care market. The ACA is not perfect, and the alternative designs may generate improvements, but the details are critical.  Many advocates of the ACA repeal promise to replace the ACA with an alternative health reform design and vast improvements. I am not sure what the answer is, but I know that American healthcare is at stake.

References

Centers for Disease Control and Prevention. (2021). Cost-Benefit Analysis.  https://www.cdc.gov

Milstead, J. A., & Short, N. M. (2017). Government response: Legislation. In Health policy and politics: A nurse's guide (6th ed., p. 48). Jones & Bartlett Learning.

National Council for the Social Studies. (n.d.). How legislators make decisions.  https://www.socialstudies.org

United State House of Representatives. (n.d.). The legislative process.  https://www.house.gov

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