Politics and the Patient Protection and Affordable Care Act

The Affordable Care Act (ACA) is among one of the most impactful healthcare legislations in the history of the state. Yet, numerous efforts have been made to either repeal or replace it by challenging its constitutionality in federal courts. Among the most notable lawsuits challenging ACA was the National Federation of Independent Business v. Sebelius which initially sought to restrict the act’s influence through its individual mandate (Kinney, 2016). Similarly, state governments opposed to the legislation have expressed concern over regional sovereignty and subsequent future implications stemming from its operationalization. Others have responded by proposing that certain sections of the legislation be nullified or amended to avoid a scenario where the legislation infringes upon citizen’s human rights and the possibility of an unfair financial burden on the taxpayers. The individual mandate requiring eligible adults to be insured or else face penalties has been strongly criticized by ACA detractors. In particular, this clause is regarded as a precarious precedent likely to set the stage for similar violations in coming years analogous with the one currently involving the Original Clause. Two major perspectives stand out in relation to repealing or replacing ACA;   the emerging cost-benefit analysis  of legislators being reelected and the impact of voter’s views on decisions made by leaders when proposing and positioning national policies.

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Legislators are essentially charged with the critical task of making prudent choices, mostly from an egalitarian standpoint. Such decisions, therefore, rely greatly on their ability to conduct an in-depth and accurate cost-benefit analysis with the intention of evaluating the suitability of any proposed change (Selker, 2013, p.5). In this regard, they would focus on ensuring that the public get the deserved legislative benefits from the ACA but still focusing on ensuring they remain popular among the electorate. However, the reality today is that a sizeable majority of legislators are mainly interested in maintaining their elective seats through re-election; a complex process that often requires a great deal of political support to achieve political support. The cost-benefit calculations may, therefore, become a priority for legislators when confronted with demands from the electorate (Job, 2018, p. 150). However, demands made by the public may be unmet resulting in the introduction of changes implemented without thoroughly considering the implications of failing to conduct an elaborate cost-benefit analysis. Political leaders who choose to conduct cost-benefit analyses before the final implementation of changes to the ACA provisions are also likely to enjoy renewed political support from the populace based on the perception that they are the embodiment competence.

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Voter’s views on matters of national interest have a direct impact on the decision making process, especially when proposing and positioning national policies. The initial introduction of ACA back in 2010 was a carefully orchestrated strategy to provide affordable care to all Americans while garnering a level of political support from this particular legislation (Nowak et al., 2017). Its enactment was soon hailed by political pundits as a milestone in policymaking since it sought to directly address healthcare concerns raised by the public. Healthcare is an issue of great significance for American voters today.  President Obama’s aim of expanding healthcare coverage to all citizens, reducing healthcare disparities, and focusing on affordable healthcare coverage influenced public opinion, influencing his successful bid for re-election.

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Recent calls to repeal the Affordable Care Act (ACA) may have far-reaching implications for its future primarily since such proposals have been made by voters. Although liberal have proposed repealing contentious sections in the legislation, replacing the legislation altogether cannot be ruled out. Voters are quite capable of voting for legislators promising to institute change through the introduction of new policies which seemingly serve the interests of the majority. Nevertheless, it will also be noteworthy to still note that such a change would require between $90.9 and $927 billion to fully implemented (Cutler, 2015, p. 337). Voters should, therefore, consider the financial cost monumental undertakings and changes in policy to determine whether commensurate benefits will be realized.

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The ACA remains one of the most divisive and controversial pieces of legislation enacted in the United States. Local, state, and federal governments were all expected to participate directly in the scheme to guarantee Americans of the level of healthcare deserves while paying less on Medicaid. However, the overall implementation of ACA has proved problematic given an increase in dissenting voices calling for its replacement or the repealing of certain identified sections. Yet, this has been overshadowed by claims that the act infringes upon the fundamental rights held by American citizens and should, therefore, be removed. Nevertheless, instituting such actions first require a thorough cost-benefit analysis to ascertain whether proposed changes are warranted. Such actions will also be informed by voter’s sentiments since they are often considered necessary during the decision-making process.

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