NURS 6050: Policy and Advocacy for Improving Population Health
In 2010 The Affordable Care Act (ACA) was enacted; the hope was to expand access to medical care, make coverage more affordable, and decrease the number of people without medical insurance. The Affordable Care Act (ACA) expanded and improved health insurance coverage in two primary ways. First, the number of individuals receiving insurance coverage grown by increasing access to coverage through Medicaid expansion and providing subsidies to purchase private insurance on the health care exchanges. Second, the ACA upgraded the quality and scope of coverage by improving benefit design, including implementing the essential health benefits (Willison & Singer, 2017). People who did not have coverage through their employer or Medicaid were required to purchase insurance through the Marketplace. The Marketplace was created as a one-stop-shop for people to view multiple plans and purchase insurance. Just because you have access to health care insurance does not mean you are going to receive quality health care (Teitelbaum, 2018).
Both parties have asked that the ACA be repealed or replaced for multiple reasons. Every Republican presidential candidate for 2016 has called for the repeal of the ACA. Some, but not all, Republican candidates have proposed health policies that they would like to put in place after repeal, but there is no broad agreement on a replacement for the ACA (Buettgens & Blumberg, 2016). The federal government would spend $90.9 billion less on health care for the nonelderly in 2021 if the ACA were repealed (Buettgens & Blumberg, 2016). State governments as a whole would spend $5.2 billion more on health care for the nonelderly in 2021 if the ACA were repealed (Buettgens & Blumberg, 2016). Healthcare is a priority to many Americans for obvious reasons; it was more costly for those with preexisting conditions before the ACA to obtain Medical Insurance. With the ACA the income guidelines for Medicaid where changed so additional people qualified that didn’t prior. As a Behavioral Health Nurse, I am a fan of anyone and everyone having access to Healthcare Services. I have seen to many times my patient not have the money for their medications because insurance was canceled so they go off their medications, they become unstable and ended up in the Emergency Department and admitted Inpatient, costing more money, hurting themselves and their loved ones.
Politicians are aware that election time is the best time to play the tug of war game with the heavy ticket items to capture someone votes. Republicans ran hard on promises to get rid of the law in every election since it passed in 2010. But when the GOP finally got control of the House, the Senate and the White House in 2017, Republicans found they could not reach agreement on how to “repeal and replace” the law (Kaiser Health News, 2018). And political strategists say that, when the dust clears after voting, the numbers in the Senate may not be much different, so change could be hard there too. Republicans, even with a small majority last year, could not pass a repeal bill there (Kaiser Health News, 2018). When it comes to voting, it is hard for some to know the different facts from fiction, political talk, and actual context that can be followed through. It can be frustrating but needed to research why a candidate is saying something and if he has the means to make a change. It can be time consuming to research through the political propaganda, but worth it for the issues at hand.
References
Buettgens, M., Blumberg, L. J., Holahan, J., & Ndwandwe, S. (2016, June). The Cost of
ACA Repeal. Urban Institute | Social and Economic Policy Research. https://www.urban.org/sites/default/files/publication/81296/2000806-The-Cost-of-the-ACA-Repeal.pdf
Kaiser Health News. (2018, November 2). The election’s impact on health care: Some bellwether
races to watch. Health Leaders. https://www.healthleadersmedia.com/elections-impact-health-care-some-bellwether-races-watch
Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel
Teitelbaum [Video file]. Baltimore, MD: Author.
Willison, C. E., & Singer, P. M. (2017, August). Repealing the Affordable Care Act essential
health benefits: Threats and obstacles. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508159/