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Politics and the Patient Protection and Affordable Care Act

Politics and the Patient Protection and Affordable Care Act

Legislators’ reelection will significantly impact whether the Affordable Care Act (ACA) will be kept, repealed, or replaced. The ACA provides regulations that affect the structuring of Medicare and Medicaid, which aim to reduce the cost of healthcare coverage for lower-income households and ban the exclusion of preexisting diseases (Himmelstein et al., 2019). This has improved the costs and accessibility of healthcare services for low-income Americans. However, the issues around the ACA have been incredibly politicized. Legislators are divided based on political alignment in either supporting or opposing the replacement or appealing the ACA. The proponents of the ACA view it as beneficial to Americans and economically viable. However, its opposers view it as burdensome, and others argue against it based on its link to Barack Obama’s administration (Thompson et al., 2018).

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The legislators focus on the politics around the ACA as they campaign to be reelected. All sides, whether the proponents or opposers of the ACA, will try to lure the electorate based on politics rather than the provisions of the ACA. As the main focus of the legislators is reelection first, the ACA proponents will utilize the economic and healthcare benefits of the act to push for their reelection. Currently, the United States has a very divisive and polarized political environment. The reelection of the legislators will be based on the political the electorate is aligned with. Therefore, the electorate will define the outcomes of the ACA. If more proponents are reelected, the ACA will be kept. However, if more opposers are reelected, the ACA will be repealed or replaced, and Americans will lose the benefits of the ACA. Therefore, it is more beneficial to reelect those who support the ACA than those opposing it.


Himmelstein, D. U., Woolhandler, S., Lawless, R. M., Thorne, D., & Foohey, P. (2019). Medical bankruptcy: Still common despite the Affordable Care Act. American Journal of Public Health, 109(3), 431–433.

Thompson, F. J., Gusmano, M. K., & Shinohara, S. (2018). Trump and the Affordable Care Act: Congressional Repeal Efforts, Executive Federalism, and Program Durability. Publius: The Journal of Federalism, 48(3), 396–424.


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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 those that benefit society.

Politics and the Patient Protection and Affordable Care Act

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 essential to consider the legislator’s perspective on promoting or not promoting a specific initiative in the political landscape.

To Prepare:

  • Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
  • Consider who benefits the most when policy is developed and in the context of policy implementation.

By Day 3 of Week 3

Post an explanation for how you think the cost-benefit analysis regarding legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voter’s 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 reelected. Please check your discussion grading rubric to ensure your responses meet the criteria.

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