First Steps on Becoming a Grassroots Lobbyist-Advocate for Health Care Policy
The modern healthcare landscape is an ever-changing field that is not short of challenges. In the wake of competing priorities, divergence in thought processes and subsequent failures to address wider determinants of health often compound these challenges. Responding to these dynamic and complex healthcare priorities often necessitates policy-level changes targeting the determinants of health. The American Health Care Act (AHCA) signifies one of the policy-level changes that can have an impact on the healthcare in the country. This bill was passed by the 115th Congress, passed by the House Congress but not by the Senate, and sought to repeal parts of the Affordable Care Act (ACA). I do not support the bill because I disagree with some of its provisions:
- To begin with, the bill sought to repeal and replace the ACA of 2010. This is despite the proven success of ACA in expanding access to healthcare for many Americans. At the very least, the bill was supposed to improve the deficiencies of the ACA rather than replace it.
- The bill also had specific clauses that would have hurt some populations. An example is the Medicaid Per capita cap clause on the bill. Many arguments reveal that this clause would have been harmful to persons with disabilities.
- The bill would also have increased the number of uninsured Americans, thereby compounding traditional problems such as poor access to healthcare.
- Overall, the bill rolled back some of the gains made by ACA without postulating provisions that would have countered the devastating effects of rolling back the gains. Any bill that can result in diminished access to quality care for millions of Americans is simply unacceptable.
Rationale
Healthcare reforms in the U.S. have mostly been centered on enhancing access to healthcare. The Affordable Care Act was a landmark reform that considerably enhanced access to healthcare for many Americans. This enactment increased the health insurance coverage for many uninsured Americans by implementing drastic reforms to the insurance markets. There is a consensus on the impact of ACA and whether it attained its goal of enhancing access to healthcare. Ercia (2021) notes that ACA improved the health of Americans by strengthening the existing forms of insurance coverage, such as Medicaid and Medicare, and by helping millions of Americans gain insurance coverage. These gains remain significant to the current health of America’s population.
The AHCA, despite having some positive clauses on healthcare access, could have had some negative impacts on America’s population health. To begin with, it rolled back the gains in insurance coverage made by the ACA. By implementing the Medicaid per capita caps, the bill would have prevented the Medicaid program from automatically expanding in response to public health shocks that spike the need for healthcare (Smith, 2021). This would mean restricted access to healthcare and subsequent poor community health for communities that benefited from the program.
The Medicaid per capita caps would also be harmful to Americans living with a disability. The Medicaid program has long benefited persons living with disabilities. The loss of expansion of the Medicaid program accustomed to fund cutting will mean that these populations will no longer be able to benefit from the program fully (Smith, 2021). Collectively, healthcare reforms should be centered on advancing the state of healthcare in a country. These reforms should be targeted at addressing apparent challenges within the healthcare systems rather than compounding these challenges. The American society, which continues to suffer from traditional problems such as health inequity, should be at the forefront of passing reforms that address poor access to healthcare. Hence, I did not support the AHCA because I believed it to be retrogressive in this regard.
Scenario Surrounding the Legislative Visit
The legislative visit is intended to broaden my perspective on the bill. From a point of consensus, the healthcare status in the U.S. is challenging. Traditional problems such as poor access to healthcare persist. This problem is compounded by the skyrocketing cost of healthcare that further jeopardizes the efforts to improve population health. Policy-level changes can help address some of these challenges. As evident in the ACA, federal enactments can be valuable in enhancing access to healthcare. Legislators execute the legislative processes that precede such enactments. Talking to a legislator may help build a consensus on the strategies to address the problem and give insight into counterarguments and the politically-influenced hurdles that may impede the policy formulation processes. In this case, the legislator may detail what informed the bill and the political viewpoint that proceeded the discussion around its implementation.
The legislative members visited was a house democrat. She was not in support of the bill. She retorted that the bill passed in the House on a close vote. The Republican-led bill was introduced to the House based on concerns about health insurance coverage, the quality of the insurance coverage, the impact of the budget deficit annually, and the cost of insurance. Its proponent argued that the bill would reduce the annual budgetary deficit by 1.2 trillion over a decade. The proponents also argued that the proposed bill would increase the quality of insurance by varying insurance premiums. The bill was also expected to increase jobs by up to 924,000.
The legislator expressed her opposition to the bill. She noted that the non-partisan bill was a political move rather than an evidence-based approach to addressing poor access to healthcare. One of the arguments she put forth was that the bill was not cognizant of the plight of vulnerable Americans. This included persons living with disabilities and those with chronic illnesses otherwise covered by the Medicaid program. Per her narration, the cap placed on the Medicaid program would have ended up stalling the program. With the number of Americans meeting the eligibility for Medicaid programs increasing, passing the bill would have jeopardized their ability to access quality healthcare.
The legislator also noted that the bill only favored wealthy Americans. The proposed cut on tax that would have amounted to close to 900 billion dollars favored medical insurance and drug companies. While these groups are players in the American economy, they are contributing to the current plight of the American healthcare system. Passing the bill would mean prioritizing them over the American majority. Moreover, the legislator noted that the bill failed to comprehensively address the real problems Americans face regarding healthcare. Notably, the bill does not address problems, such as the rising cost of essential pharmaceutical products such as insulin.
Further, nursing experiences enhance nurses’ advocacy capacity and skills. As healthcare providers, nurses are better placed to identify pertinent issues affecting populations. Nurses, in this respect, owe it to their professional responsibility and nursing professional ethics to advocate for positive changes in healthcare. Policies that enhance access to care are progressive and a demonstration of nurses’ concurrent with the ethical principles of beneficence, requiring nurses to promote the welfare of their patients. The AHCA was a retrogressive bill that would have diminished access to healthcare and contravened the principle of beneficence, informing my stance on the bill.
References
Ercia, A. (2021). The impact of the Affordable Care Act on patient coverage and access to care: Perspectives from FQHC administrators in Arizona, California, and Texas. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06961-9
Smith, L. E. (2021). Trump and Congress. Policy Studies, 42(5–6), 528–543. https://doi.org/10.1080/01442872.2021.1955849
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Question 
Instructions
First Steps on Becoming a Grassroots Lobbyist/Advocate for Health Care Policy
In a Microsoft Word document of 4-5 pages formatted in APA style, you will imagine you are going to make a visit to your representative in Congress. There are two parts to this assignment.
Address the following topics:
Develop a one-page document that supports your position on the AHCA that you would leave with your representative or his or her aide when you make your visit.
First Steps on Becoming a Grassroots Lobbyist-Advocate for Health Care Policy
。 This one-pager, also called a “leave behind,” should state your position clearly in bullet points and give your reasons why your position is preferred.
。 This “leave behind” should have 1-inch margins and utilize 14-point font throughout.
If you were making this visit in person, you would present your “leave behind” to the person with whom you speak during your visit.
Include a second page that describes your rationale for the position in your “leave behind” page supported by at least two journal articles.
Write a two-page brief to describe the scenario surrounding your legislative visit. Understanding the political affiliation of your representative, include answers to the following:
。 Was your member in support or in opposition to the AHCA?
。 State three points that you would cover in support or opposition to your representative’s position.
• How does your nursing experience influence the advocacy position that you take on the AHCA?
You may find it necessary to search for answers to the questions outside of the assigned reading.