Week3 discuss 6050 | NURS 6050 – Policy and Advocacy for Improving Population Health | Walden University

Melissa Hinkhouse

Week 3-Original Post

NURS 6050: Policy and Advocacy for Improving Population Health

Walden University

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Both parties have asked that the ACA be repealed or replaced for multiple reasons.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 The federal government would spend $90.9 billion less on health care for the nonelderly in 2021 if the ACA were repealed (Buettgens & Blumberg, 2016). State governments as a whole would spend $5.2 billion more on health care for the nonelderly in 2021 if the ACA were repealed (Buettgens & Blumberg, 2016).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.


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/

Lilia Roy

Discussion Week 3 

Repeal or Replace the Affordable Care Act

Affordable care has been a topic that has a long history of wishing that we can all have medical insurance and be able to have great doctors and excellent services for very little money.  The cost of Medicaid in the United States continues to rise every day.  Many people cannot afford not to have medical insurance, but many cannot afford medical insurance.  The fact that there are so many people that live in poverty lines and must accommodate the use of medical insurance is either by state services such as Medicaid, which has been a good thing since 1960 (Milstead & Short, 2019).  The Obama Administration has tried to implement a reform of insurance for the past eight years of his presidency. Still, many think it was just an expansion to Medicaid services, which many people did not like the idea that they lost their doctors that they wanted.  He promised that people would keep the same plan and doctor, which he did not factor in that many doctors were not going to accept the proposal he offered.  Many doctors left their private sectors due because of this.  They were going to have to see more patients for less money. Another thing it put pressure on small businesses that they had to aid their employees to have medical insurance, which many can pick packages that were not good if they wanted the cost to below so they could stay in business.  Providing this insurance for employees created an extra expense for small companies, and many had to reduce their personal.  What studies saw it was that even people with insurance did not seek medical care which was not what they wanted to see

Politics plays a huge role in selling a need and targets the idea for elections and for them to win. The Obama administration sold the plan of care for all with no evidence data, which millions of Americans enrolled for insurance for the first time in history.  Obama stated that the republicans have not idea how to repeal the ACA with no plan to replace the health care issue (Obama, 2017).  The Trump administration has good intentions, but no plan on how to implement the ideas due to the people that will benefit is business and the wealthy that will not have a problem with the yearly cost of health care.  Trump wants to be able for people to choose their coverage, and some of the same things, such as preexisting medical care, will not be punished or pay more.  His goal is to create a patient health care system that promotes choice and quality (Glied & Jackson, 2017).   They also will keep kids covered until the age of 26, which they complete school.  Most of the repeal is going to cost billions of dollars to replace.  It is going to leave millions of people without insurance and health care.  It’s going to increase the national debt, and we all still have no clue how to fix it.  The idea of creating a socialist system of health care might work, but people that would lose their choice of care providers, doctors, hospitals, and patient care.  We are going to see the care that will diminish due to no incentive if a doctor sees three patients or ten per day he or she will be earning the same amount of money.  I see this in the Tricare system many providers do not perform the same volume of surgeries due to he is going to get the same amount of money he is not paid per case he is paid per salary.  I have both care systems I have Tricare, and I purchase my health care. I have both many people tell me why, but I have to.  My daughter has many needs that sometimes Tricare will not cover or will not have my choice of a doctor, so I prefer to have options for her due to she requires nothing but the best care for her Autism.  I do not want her just to see someone once a month. She needs individual attention to weekly providers such as speech pathology and occupational therapy.  I do not see anything resolved is such a huge debate of who is right and what is fair. 


Glied, S., & Jackson, A. (2017). The future of the affordable care act and insurance coverage. American Journal of Public Health, 107(4), 538–540. Retrieved June 15, 2020, from https://doi.org/10.2105/ajph.2017.303665

Milstead, J. A., & Short, N. M. (2019). Health Policy and Politics (6th ed.). Jones and Barlett Learning books.

Obama, B. H. (2017). Repealing the ACA without a replacement—the risks to American health care. Obstetrical & Gynecological Survey, 72(5), 263–264. Retrieved June 15, 2020, from https://doi.org/10.1097/ogx.0000000000000447

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