NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Sample Answer for NURS 6050 Politics and the Patient Protection and Affordable Care Act  Included After Question

By Day 3 of Week 3

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

By Day 6 of Week 3

Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.

A Sample Answer For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

The Patient Protection and Affordable Care Act of 2010 (ACA) is a revolutionary policy. This Act wanted to address social injustices in the American healthcare system. However, this policy has met stiff opposition from Republican legislators who openly opposed it. When Donald Trump came to power, repealing ACA was one of his number one priorities. They, however, did not get the requisite number to repeal ACA since other legislators felt like many Americans would be affected. Many Republican lawmakers started seeing that they may not get reelected if they continued to support the repeal of ACA.

In May 2017, the House of Representatives passed the American Health Care Act (Jost, 2017). This was the first attempt at repealing ACA. The Trump administration wanted to use this act to repeal ACA.  However, this Act would make millions of Americans lose health insurance coverage. AHCA proposed that tax credit be based on age, which would increase healthcare costs. This Act also created the Patient and State Stability Fund, which would reduce premiums by 25% after 2026 (Jost, 2017). This would increase healthcare costs for Americans with preexisting comorbid conditions.

A cost-benefit analysis by Republican lawmakers revealed that they would not get reelected because of the negative effects of repealing. Repealing ACA would lead to millions of Americans losing insurance coverage (Straw & Aron-Dine, 2020). This was the main reason for implementing ACA. ACA aimed to increase insurance coverage to millions of Americans and reduce healthcare costs (Sommers, 2020). Due to reelection purposes, the Senate Majority Leader McConnell found it hard to garner support for AHCA. To protect their political interest, the US senators came up with another proposal known as the Better Care Reconciliation Act of 2017 (Smith & Gibbs, 2017).

Members of Congress and Senators are elected leaders who must be voted for by the public. Due to this, their positions on policies such as Obamacare are influenced by how their electorates feel. Because of this, their interest is reelection and not ACA.


Jost, T. S. (2017). House passes AHCA; HHS acts on regulations. Health Affairs36(6), 982-983.  

Smith, K., & Gibbs, T. E. (2017). The APHA PHACT campaign in action in Delaware. Delaware Journal of Public Health3(4), 6-11.  

Sommers, B. D. (2020). Health insurance coverage: What comes after the ACA? Health Affairs39(3), 502-508.   Straw, T., & Aron-Dine, A. (2020). Commentary: ACA Repeal Even More Dangerous During Pandemic and Economic Crisis. Center on Budget and Policy Priorities.

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A Sample Answer 2 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

I love that you kept the explanation of the health care acts and attempted repeal short and simple but explained it all perfectly. It is a shame that in recent times, politician’s true colors have shown. They are making it more transparent that some, unfortunately most, do not always have the American people’s best interest in mind. With legislators being driven with the primary goal of being re-elected and not solely for the benefit for its constituents (Milstead & Short, 2019), I am grateful we live in a country that allows us to be a part of a democracy in order to have some control in how our amazing country is ran. According to Dr. Nwogu, “democracy is a system of government with four key elements: a system for choosing and replacing the government through free and fair elections, active participation of the people, as citizens in politics and civic life, protection of the human rights of all citizens and a rule of law in which the laws and procedures apply equally to all citizens” (2015). I genuinely believe, if we allowed these elements to guide our country, the government wouldn’t be viewed as corrupt, and we wouldn’t have to analyze how politicians balance cost vs benefit for their gain instead of the American people like it was originally intended way back when.

NURS 6050 Politics and the Patient Protection and Affordable Care Act 
NURS 6050 Politics and the Patient Protection and Affordable Care Act 


Milstead, J. A., & Short, N. M. (2019. Informing public policy: An important role for registered nurses. In Health Policy and Polictics: A nurse’s guide (6th ed., p. 40). Jones and Bartlett Learning.

Nwogu, G. A. I. (2015). Democracy: Its Meaning and Dissenting Opinions of the Political Class in Nigeria: A Philosophical Approach . Journal of Education and Practice6(4). Retrieved 2021, from

A Sample Answer 3 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

One of Trump’s main priorities was to repeal the ACA.  Trump issued anti-ACA order shortly after the inauguration directing federal agencies to use their administrative powers to dismantle the Affordable Care Act “to the maximum extent permitted by law” (Center on Budget and Policy Priorities, n.d.). Trump’s agenda included temporary blocking grant exemptions and, if possible, delaying some protocols of the ACA while Congress worked to repeal the ACA. Although House and Senate officials should generally do what is best for the people, many officials prioritize self-agenda first, including doing all they can to get reelected. Many Americans depend on ACA for health insurance and Medicaid for health expenses. If Trump successfully repealed the ACA, many Americans would lose health insurance and join millions of uninsured health care citizens. Both perspectives had decent debates depending on what side is looking at repeal vs. reform, but some outcomes identified were too risky or too costly than benefit.


Center on Budget and Policy Priorities. (2021). Sabotage Watch: Tracking efforts to undermine the ACA.

A Sample Answer 4 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Legislators Influence On Health Care

The Affordable Care Act, also known as ACA or “ObamaCare”, was enacted in March 2010 by the Obama Administration. According to, the health care reform law has three primary goals; “make affordable health insurance available to more people, expand the Medicaid program to cover all adults with income below 138% of the federal poverty level, and support innovative medical care delivery methods designed to lower the costs of health care generally” (“Affordable Care Act (ACA)”, n.d.). This health care law was enacted in order to move towards the end goal of universal health care and provided as a right vs a privilege (Teitelbaum, 2018).

According to Economic Policy Institute, approximately 29.8 million people would lose their health insurance and approximately 1.2 million would lose their jobs (“Repealing the ACA”, n.d.). With the repeal prospectively affecting that many Americans, you would assume this would play a large role in the legislative leader’s position in congress. We as a democracy, can influence those in the position to place laws and policies that impact our day to day lives. With the impact this repeal would have, I think it would be safe to say, the legislative leaders would have to rebuttal in order to save face and protect their position within congress. Once legislators found how many Americans would be affected by the repeal, the Trump Administration proposed the Better Care Reconciliation Act in 2017.

This act would provide more help to cover out-of-pocket costs, health savings accounts, allocating additional resources to combat the opioid epidemic, providing more options for Americans to buy lower premium plans, as well as tax and Medicaid revisions (Senate Budget Committee, 2017). By providing these alterations to the Affordable Care Act, I feel that the legislative leaders were able to secure their position in congress and I can only hope their intentions are to continue to implement laws, policies and acts to better American lives across the nation.


Discussion draft – better care reconciliation act (BCRA). U.S. Senate Committee On The Budget. (n.d.). Retrieved December 13, 2021, from (n.d.). Affordable care act (ACA). Affordable Care Act ACA. Retrieved December 13, 2021, from

How would repealing the Affordable Care Act Affect Health Care and jobs in your state? Economic Policy Institute. (n.d.). Retrieved December 13, 2021, from

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author

A Sample Answer 5 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

The cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA (Obama Care) is a very interesting topic in healthcare. The impact can either help or hurt some of us. The goal for the legislator is to be reelected, so the decision must be supported throughout society. From my point of view, making ACA affordable, having access to healthcare, and making sure those without insurance are insured. Repealing the ACA keeps health insurance which make it appealing for some of us, while on the other hand, replacing the ACA can make it unappealing. This far, ACA has been very effective, and affordable, so let’s just keep it. On the other hand, if the ACA was replaced, many Americans would pay millions for prescription drugs, like medications that could save lives. According to the NCBI, the public debate focuses not on such important and difficult questions as how to discount future benefits or how to estimate cancer rates but on whether it is proper (or, as some contend, sinful) to “put a price tag on human life (National Research Council (US) Steering Committee on Valuing Health Risks et al., 1990).

The decisions by legislative leaders could affect low-income families currently benefiting from Medicaid expansion would be at grave risk of financial catastrophe and more likely to take out debt in the event of a health emergency if they were to lose their coverage (Cusick Director et al., 2021). Legislatives invests nearly $1 trillion over the 2010–2019 time period aimed at making coverage affordable, the Act more than offsets these expenditures through curbs on Medicare and Medicaid spending, new taxes on high-cost plans, and tax shelters used most heavily by affluent families (Rosenbaum, 2011). Replacing the ACA with (the American Health Care Act – AHCA) can cause significant changes like age of the client, cost, and the lack of coverage. The decision is normally made by voters that have the most votes. The end goal is protecting families and their health.

Cusick Director, J., Cusick, J., Director, Director, S. H. A., Hananel, S., Director, A., Seeberger Director, C., Seeberger, C., Oduyeru Manager, L., Oduyeru, L., Manager, Gordon Director, P., Gordon, P., Shepherd Director, M., Shepherd, M., Director, J. P. D., Parshall, J., Director, D., President, L. R. V., … Simpson, E. (2021, November 7). The chaos of repealing the Affordable Care Act during the coronavirus pandemic. Center for American Progress. Retrieved December 13, 2021, from

National Research Council (US) Steering Committee on Valuing Health Risks, Costs, & Decisions, and B. for E. (1990, January 1). The politics of benefit-cost analysis. Valuing Health Risks, Costs, and Benefits for Environmental Decision Making: Report of a Conference. Retrieved December 13, 2021, from

Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public health reports (Washington, D.C.: 1974). Retrieved December 13, 2021, from

A Sample Answer 6 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

   I found it interesting that the number one goal for a legislator is to get reelected. While that should certainly be on the list of top priorities, I would think that doing a great job and creating positive change should be at the top. I certainly thought more about the ACA repeal in terms of how it will affect all American patients, but I did not realize the impact it could have on nursing as well. Potera (2017) explains the danger of mass nursing job cuts because of so many Americans losing health insurance. The only thing that is clear about ACA repeal/replace is that there is no clear solution. I agree that the use of a cost-benefit analysis (CBA) is an interesting topic. CBA is used by legislators much like it is used by healthcare entities. Ke, Yi, Nurjono, & Ee (2020) show how a CBA can be used in healthcare to determine the efficacy of a program or policy proposal. I continue to be impressed by the importance of nurse involvement in government affairs. I hope you are finding this class equally interesting! Thank you for a great discussion post.


Ke Xin Eh, Yi Han Ang, I., Nurjono, M., & Ee Shiow Toh, S.-A. (2020). Conducting a Cost-Benefit Analysis of Transitional Care Programmes: The Key Challenges and  Recommendations. International Journal of Integrated Care (IJIC)20(1), 1–4.

Potera, C. (2017). Repeal of the ACA Could Lead to RN Job Cuts. AJN, American Journal of Nursing117(12), 15.

A Sample Answer 7 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Costs for Legislators Repealing the ACA

In March 2010, President Barrack Obama founded and signed the comprehensive health care reform law known as, Affordable Care Act (ACA) to help the American people get health insurance coverage. The ACA expanded and improved health insurance coverage in two primary ways. First, the number of individuals receiving health insurance coverage grew by increasing access to range through Medicaid expansion and providing subsidies to purchase private insurance on the health care exchanges. Secondly, the ACA upgraded the quality and scope of coverage by improving benefit design to include implementing the essential health benefits that many Americans missed. (Willison & Singer, 2017)

 President-elect Donald Trump had a mission to eliminate the ACA, referring to “Obama care is a broken mess.” (Simmons-Duffin, 2019) The constant president speech of repealing the current ACA did not come with a solid plan presented to the Representatives, Senators, or the American people. The critical decision-making process to have these changes enacted would rely on the ability of legislators to conduct a cost-benefit analysis of the proposed changes. Legislators are suppliers of benefits, and one of their primary goals is re-election. The cost-benefit investigation revealed that re-election is hindered due to the adverse effects of repealing ACA. (Straw, 2020) The plan fell short when Republican Senators John McCain, Susan Collins, and Lisa Murkowski voted with the Democrats against repealing former President Obama’s signature legislation.  To protect their political interest, restructuring from the original ACA, on July 13, 2017, Senate Republican leaders released the Better Care Reconciliation Act of 2017. The latest bill included several new proposals to help offset costs. (Nicholson & Morgan, 2017) By providing the American people with restructuring as opposed to repealing, the legislative leaders are able to secure their upcoming positions.


Nicholson, H., & Morgan, R. (2017, June 23). Overview: Better care reconciliation act of 2017. Overview | Better Care Reconciliation Act of 2017. Retrieved December 13, 2021, from

Simmons-Duffin, S. (2019, October 14). Trump is trying hard to thwart Obamacare. How’s that going? NPR. Retrieved December 13, 2021, from

Straw, T. (2020, October 5). Commentary: Aca repeal even more dangerous during pandemic and economic crisis. Center on Budget and Policy Priorities. Retrieved December 13, 2021, from

Willison, C. E., & Singer, P. M. (2017, August). Repealing the affordable care act essential health benefits: Threats and obstacles. American journal of public health. Retrieved December 13, 2021, from

A Sample Answer 8 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Thank you for a great explanation of the Affordable Care Act (ACA) and the efforts made to repeal/replace it. You explained how the ACA “upgraded the quality and scope of coverage”, but many people do not realize the negative consequences of that aspect of ACA. Buchmueller, Carey, & Levy (2013) discuss the impact that it could have for smaller employers who would not be penalized for not offering insurance to employees. I personally left a job that I loved as a direct result of Obamacare. The insurance my employer was carrying did not meet the new ACA standards, so they stopped offering insurance. Thankfully I ended up in psych and found a new passion, but I wonder how many others struggled because of the new requirements.

   Cost-benefit analysis (CBA) did play an important role in how legislators voted during the Trump administration. The problem with reelection being the primary goal is that voting with the majority does not always equate to voting for what is best in the long run. Thompson, Gusmano, & Shinohara (2018) point out that a Trump administration’s “thin Republican majority in the Senate, and the unanimous opposition of Democratic lawmakers thwarted the attempt” (to replace ACA). I do believe that many Americans were thankful to have the individual mandate penalty removed. I believe that all sides of government want a better healthcare system for the country but do not agree on how to accomplish this feat.

Thank you for a great discussion post!


Buchmueller, T., Carey, C., & Levy, H. (September 2013). Will Employers Drop Health Insurance Coverage Because Of The Affordable Care Act?

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 Federalism48(3), 396–424.

A Sample Answer 9 For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

 The success of a medical project’s implementation is often dependent on understanding the importance of the cost-benefit analysis. In this week’s discussion post, I will explain how cost-benefit analysis relates to legislators working towards reelection.  Additionally, I will detail how this has impacted the efforts to repeal and replace the American Care Act. Furthermore, I will discuss how analyses of the voters’ views may affect decisions by legislative leaders concerning the recommendation of national policies. 

Cost for Legislators Repealing the ACA

 Over the past 20 years, there has been an increase in the number of uninsured Americans. In response, The Affordable Care Act (ACA) was signed into law on March 30, 2010, by President Barack Obama (Health and Human Services, 2021). The main goal of this bill is to extend and expand healthcare access, increase healthcare insurance while decreasing cost, and provide preventative care to all Americans (Health and Human Services, 2021). The ACA aims to expand public and private insurance for all Americans by requiring large business owners to insure their workers. If a business goes against this policy, they are required to pay a hefty penalty. Additionally, the ACA focuses on creating more options for small business owners, such as providing tax credits to assist with covering their employee benefits. Furthermore, the ACA prevents insurance companies from denying insurance to individuals who suffer from pre-existing health conditions. However, the ACA has remained highly controversial among both political parties and Americans. 

Legislators Decisions in National Policies

A cost-benefit analysis refers to the comparison of the estimated projected cost of a project with the estimated success or outward benefit of it (Borgschulte & Vogler, 2020). For example, research has shown that the improvement in welfare and mortality rates due to the ACA offsets the total monetary value. From the beginning of the ACA’s proposal, President Obama believed that increasing the number of insured Americans would bridge the gaps in healthcare delivery. He felt that cuts in government spending and allocations from a tax increase would allow him to provide all Americans with health insurance. However, on January 20, 2017, President Trump entered the United States presidential office. Immediately he started to appeal the Affordable Care Act, as he felt it provided funds to help the poor by taxing the rich. 

Like many of us, legislators are seeking job security. Their terms are only secured for a two or six-year period (United States House of Representatives, n.d.). Therefore, their job security comes through being the best representative for a given geographical area. Due to this, they must support committees and laws that their congressional district is in favor of in order to secure their reelection. In regards to the ACA, the response has been largely based on political association. It has been found that Republican opposition increases when a Democratic governor supports an expansion of the policy (Pacheco et al., 2020). If in a given geographical area, the ACA is largely approved of then a cost-benefit analysis would advise a legislator to support the law. On the other hand, if voters’ views tend to be disproving of the ACA then a state legislator may support repealing the law as it would give them greater support at reelection time.  

In conclusion, The ACA has been controversial from the beginning. It is subject to change every year. Changes in healthcare are continuous along with presidential administrations. It remains likely that the ACA will face changes and growth for years to come.


Borgschulte, M., & Vogler, J. (2020). Did the ACA Medicaid expansion save lives?. Journal of Health Economics72, 102333.

Health and Human Services. (2021). The affordable care act. Retrieved from

Pacheco, J., Haselswerdt, J., & Michener, J. (2020). The affordable care act and polarization in the United States. The Russell Sage Foundation Journal of the Social Sciences6(2), 114–130.

United States House of Representatives. (n.d.). House overview. Retrieved from

A Sample Answer For the Assignment: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Title: NURS 6050 Politics and the Patient Protection and Affordable Care Act 

Indeed, the recent global experience can be used to summarize the current crisis in access to mental health services and other healthcare issues; “During the past 2 years, exacerbated by the COVID-19 pandemic, there are more individuals suffering from depression, anxiety, substance abuse, social isolation, and interpersonal conflicts. There are more deaths by accidental drug overdose than ever in our history. More and more people every day cannot access the mental health treatment they so desperately want due to long waits for an evaluation, a lack of resources, and an underfunded mental health infrastructure. We need more psychiatrists, more PMHNPs, more psychotherapists, more mental health clinics, more psychiatric hospital beds, more partial hospitalization programs, more resources for the homeless suffering from mental illness, and more reforms to release individuals with serious mental illnesses from incarceration due to minor offenses, often directly related to the consequences of lack of treatment” (Kuntz, 2022).

Looking at what is happening in the healthcare setting, Nurses at all levels need to promote and educate the masses on the Cost-Benefit Analysis of the Affordable Care Act (ACA) and the need to promote the ACA and support the reelection of any legislators that promote ACA. Yes, I believe your statement that “engaging NPs in political efficacy, they can advocate and influence change in the state rules and regulations which would allow them full practice.” According to our study material, “According to the Federal Elections Commission, as of November 28, 2016, the healthcare sector had contributed $236,399,000 to campaigns during the 2016 election cycle, with approximately 60% of that total going to Republican candidates” (Milstead & Short, 2019). Thus, healthcare providers can influence the legislators and help in campaigning for those legislators that will promote healthcare bills. I remember when Trump’s presidential campaign promised to repeal and replace the ACA but finally made some changes. Indeed, repealing and replacing the ACA will be of negative impact on society. Indeed, if more nurses advance in becoming qualified PMHNPs and functioning at the highest level of their education and scope of practice, in that case, it will go a long way in making healthcare affordable. The quality of care will improve, and legislators will seek opinions from nurses before making any policies that will affect the healthcare sector. Thanks a million for your contribution.


Kuntz, L. (2022). Psychiatric Care in the US. Psychiatric Times39(4), 1–4.

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). 

        Jones & Bartlett Learning. Chapter 3, “Government Response: Legislation” (pp. 37–56)