NSG 4068 First Steps on Becoming a Grassroots Lobbyist/Advocate for Health Care Policy

NSG 4068 First Steps on Becoming a Grassroots Lobbyist/Advocate for Health Care Policy

NSG 4068 First Steps on Becoming a Grassroots Lobbyist/Advocate for Health Care Policy

The American Health Care Act (AHCA) is a proposed health care policy that partially repeals and replaces the Affordable Care Act (ACA). It was passed in May 2017 by the House of Representatives and awaits a ruling by the Senate. The Bill was proposed to improve health care equity and cost-effectiveness. The purpose of this assignment will be to discuss my stand on the AHCA and the rationale for supporting or opposing it.

Part 1: Leave Behind

  • The AHCA is a proposed health care policy that seeks to partially repeal and replace the Affordable Care Act (ACA).
  • I do not support the AHCA since it seeks to halt the ACA’s income-based tax credits for buying insurance.
  • It will put an end to the increased federal funding for states that expanded Medicaid.
  • AHCA system of tax credits is based on age instead of income, which will greatly affect low-income families.
  • It introduces penalty in the form of raised premiums for Americans who fail to maintain continuous coverage.
  • The penalty might result in a high number of uninsured Americans.
  • AHCA will eliminate funding for the Prevention and Public Health Fund, which provides for investment in prevention and public health programs.
  • The AHCA will thus halt efforts to improve health and contain the rate of increasing health care costs.
  • It will lower the number of Americans who access preventative care.
  • The AHCA does not appear financially sound compared to the ACA.
  • It will decrease employment and economic activity in the long term. 
  • Even though it will abolish the tax penalty for Americans without health insurance, it will decrease incentives to purchase insurance, thus increasing the number of uninsured.

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Part 2: Rationale for the Position in the “Leave Behind” Page

I oppose the AHCA bill because it does not appear financially sound. Repealing and replacing ACA with AHCA will significantly reduce the number of Americans with insurance coverage, which will reverse the gains made since the ACA was enacted. According to Ku et al. (2017), if the AHCA Act becomes law, predictions show that the overall U.S. economy will have a loss of 924,000 jobs by 2026. A majority of these job losses will be in the health care field, yet it is one of the areas that had the highest job growth in the past years (Ku et al., 2017).  Besides, the AHCA will eliminate almost all of the ACA’s revenue provisions.

NSG 4068 First Steps on Becoming a Grassroots Lobbyist Advocate for Health Care Policy
NSG 4068 First Steps on Becoming a Grassroots Lobbyist Advocate for Health Care Policy

The tax repeal policies such as the repeal of Medicare-related taxes will predominantly help Americans with high incomes or selected businesses. High-income families would enjoy net benefits from the tax and spending changes proposed in the AHCA, while low-income families would face net losses (Blumberg et al., 2017). Higher-income families would benefit the most from the tax cut. On the other hand, cutbacks in federal funding for health benefits would adversely affect low-income families (Blumberg et al., 2017).  If implemented alone, the coverage-related policies may result in steep job losses over time, getting to 1.9 million by 2026, driven by deep Medicaid cut downs (Blumberg et al., 2017). In addition to the major increases in the number of uninsured Americans, AHCA could lead to a period of medical and economic hardship in the U.S.

AHCA seeks to eliminate funding for the Prevention and Public Health Fund, which allocates investment in prevention and public health programs to improve health and contain high health care costs (Ku et al., 2017). Eliminating this funding will halt prevention and public health programs, which have been crucial in improving the health and wellbeing of Americans and improving health outcomes. This might result in increased cases of preventable communicable and non-communicable diseases resulting in increased utilization of healthcare services and high healthcare costs.

Part 3: Scenario Surrounding the Legislative Visit

I presented my stand on the AHCA to the Congress representative in my state, a Republican. The legislator was in support of the AHCA, while I was against it.  Despite the difference in opinions, he granted me the opportunity to argue my case on why I was opposing the AHCA. The Congress representative stated that he supported AHCA because it is designed to improve cost-effectiveness and health care equity. He believes that it will improve cost-effectiveness in healthcare by repealing tax penalties on Americans for failing to maintain health coverage and on employers for failing to offer coverage. Besides, he stated that AHCA is a reconciliation bill, which will only affect the budgetary and fiscal provisions of the ACA. He further explained that the AHCA would eliminate about $900 billion in taxes imposed by the ACA on higher-income taxpayers, health care providers, and insurers.

           In opposition to the representative’s position, I would argue that the exclusion of waivers proposed by the AHCA would decrease health insurance enrollment, and the loss of health insurance would increase in the coming years. For instance, the proposed tax repeal policies, such as the repeal of Medicare-related taxes, will mainly help Americans with high incomes (Ku et al., 2017). High-income families would enjoy net benefits from the tax and spending changes, while low-income families face net losses. Consequently, there would be an increased number of uninsured Americans from low-income families (Ku et al., 2017). The AHCA would reverse the ACA’s impact in increasing the number of insured Americans from low-income families.  

           I would make a case that a majority of adults aged 50 to 64 years and most Americans with incomes below 200% of the federal poverty level will pay more for individual-market insurance under the AHCA than under the ACA. The high costs for older adults, to a degree, reflect that the tax credits proposed by the AHCA do not increase as sharply with age as premiums (Claxton et al., 2017). In addition, I would point out that the AHCA proposal to limit federal regulation and allow states to exercise more regulatory authority would place greater personal responsibility on Americans for their health and the cost of their care.

The Congress representative opposes the ACA, which imposes ten categories of essential health benefits that non-group and small-group policies must cover. The AHCA will permit states to obtain waivers to amend the required benefits to help lower premiums (Claxton et al., 2017). I would argue that reducing the essential health benefits to provide for less expensive insurance options would eliminate access to certain benefits for Americans who need them (Claxton et al., 2017). Besides, the essential benefits are crucial in ensuring that all Americans have the right to access health.

           Working as a nurse before and after the enactment of the ACA made me realize how it significantly reduces the number of uninsured Americans. This resulted in more Americans accessing healthcare services, including specialized diagnostic and treatment services. Consequently, I would oppose any bill that would potentially increase the number of uninsured Americans or reduce access to specialized services.  Besides, I oppose the bill since preventative care is crucial in reducing the number of patients who present with diseases in the advanced stages. In my nursing experience, prevention and public health programs help identify persons with underdiagnosed chronic illnesses and lead to early treatment interventions, promoting better health outcomes.


The AHCA seeks to replace and repeal and replace the ACA. It seeks to repeal the individual and employer mandates, change the ACA’s age-based rate banding, changing income-based subsidies in the individual market to age-based subsidies. It will also allow states to define their essential health benefits rather than using the ten sets from the ACA. I oppose the AHCA because it will reduce the number of insured Americans, especially from low-income families, and result in job loss in healthcare. It will also reduce access to preventative care by halting prevention and public health programs.


Blumberg, L. J., Buettgens, M., Holahan, J., Mermin, G., & Sammartino, F. (2017). Who gains and who loses under the American Health Care Act. Washington, DC.

Claxton, G., Pollitz, K., Semanskee, A., & Levitt, L. (2017). Would States Eliminate Key Benefits If AHCA Waivers Are Enacted?. Kaiser Family Foundation, June14.

Ku, L., Steinmetz, E., Brantley, E., Holla, N., & Bruen, B. K. (2017). The American Health Care Act: Economic and Employment Consequences for States. Issue brief (Commonwealth Fund)17, 1.