Class Response 2 America is supposed to be a place where people have a say in their rules and regulation. Public policy is a difficult and challenging process that involves a lot of different players with all different interest. The people involved vary from individuals, interest groups, religious groups, nongovernmental organizations, and businesses. They all use different tactics to push their agenda forward through sensitization of the public, lobbying, and donating to political leaders’ campaign (Todd, 2013).  All these groups tend to drag the policies in different directions. If the policy does not favor a particular group; they try to block it instead of changing or improving it. Also, all these parties involved cost policy making to be along in slow process.  In healthcare, affordability is a big concern when it comes to health coverage in this country. The affordable care act (ACA) was passed in 2010 by Obama which allowed every American access to affordable health care (Brown, 2018). At first many were pleased because they could have healthcare that was once out of reach, or they could not afford. However, this did not ensure that they were guaranteed access to quality care. That is one of the reasons why the ACA has had a lot of controversy from the Republican Party. The suppliers of legislative benefits are legislators, and their primary goal is to be re-elected. Thus, legislators need to maximize their chances for re-election, which requires political support. Majority of the legislative members act on self-interest, they fight to achieve their goal of re-election and their legislative decisions are based on factors that would contribute to their re-election and not for the benefit of the citizens who they serve (Milstead and Short, 2019). The decision of our legislators is driven by the excitement and power the legislative position brings to them and not primarily on what benefits the people. These have affected efforts to repeal/replace the ACA. Even though the republican legislators understand the benefits of ACA to the citizens, good number of them still support to have it replaced or repealed because of the consequences it will have on their chances of getting re-elected if allowed to continue. The decision of legislators is driven by their desire to achieve their goal of re-election and not on the primary need of the voters who elected them. Voters views may affect decisions by legislative leaders in recommending or positioning national policies as elections have the effect of bringing about some degree of policy compromise. Competing political candidates have incentives to adopt positions that reflect the preferences of the electorate because doing so raises the chances they will win the election (Andy, 2012). That is, voters can affect the policy choices of politicians. The Affordable Care Act has been a touchy subject since it was passed. It will continue to be a topic of disagreement between people. There are pros and c ...

1. Class Response 2
America is supposed to be a place where people have a say in
their rules and regulation. Public policy is a difficult and
challenging process that involves a lot of different players with
all different interest. The people involved vary from
individuals, interest groups, religious groups, nongovernmental
organizations, and businesses. They all use different tactics to
push their agenda forward through sensitization of the public,
lobbying, and donating to political leaders’ campaign (Todd,
2013). All these groups tend to drag the policies in different
directions. If the policy does not favor a particular group; they
try to block it instead of changing or improving it. Also, all
these parties involved cost policy making to be along in slow
process.
In healthcare, affordability is a big concern when it comes to
health coverage in this country. The affordable care act (ACA)
was passed in 2010 by Obama which allowed every American
access to affordable health care (Brown, 2018). At first many
were pleased because they could have healthcare that was once
out of reach, or they could not afford. However, this did not
ensure that they were guaranteed access to quality care. That is
one of the reasons why the ACA has had a lot of controversy
from the Republican Party. The suppliers of legislative benefits
are legislators, and their primary goal is to be re-elected. Thus,
legislators need to maximize their chances for re-election,
which requires political support. Majority of the legislative
members act on self-interest, they fight to achieve their goal of
re-election and their legislative decisions are based on factors
that would contribute to their re-election and not for the benefit
of the citizens who they serve (Milstead and Short, 2019). The
decision of our legislators is driven by the excitement and
power the legislative position brings to them and not primarily
on what benefits the people. These have affected efforts to

2. repeal/replace the ACA. Even though the republican legislators
understand the benefits of ACA to the citizens, good number of
them still support to have it replaced or repealed because of the
consequences it will have on their chances of getting re-elected
if allowed to continue.
The decision of legislators is driven by their desire to achieve
their goal of re-election and not on the primary need of the
voters who elected them. Voters views may affect decisions by
legislative leaders in recommending or positioning national
policies as elections have the effect of bringing about some
degree of policy compromise. Competing political candidates
have incentives to adopt positions that reflect the preferences of
the electorate because doing so raises the chances they will win
the election (Andy, 2012). That is, voters can affect the policy
choices of politicians. The Affordable Care Act has been a
touchy subject since it was passed. It will continue to be a topic
of disagreement between people. There are pros and cons for the
act, but there will need to be a replacement if the act is
repealed. Horror of what could potentially be worse than what is
already established continues but on history; legislation will
continue to hold the power and put their needs first.
References
Andy, S. (2012). Factors that influence public policy.
Journal of health politics, policy, and law, 39(2),441-
465
Brown E. C. (2018) Health reform and theories of cost.
Journal of law and medicine ethics. Vol 47, Issue 18
Milstead. J.A. & Short, N.M. (2019).
Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones &Bartlett learning.
Todd P. (2013). How was 91 percent of congress re-elected
despite a 10 percent approval rating? Retrieved from:
https://www.huffpost.com/entry/congress-election-

3. results_b_2114947
Class Response 1
Making or implementing policies should ultimately be in the
best interest of the society or community the legislators serve.
Political parties always have a reason behind pursuing or
refusing a political agenda or policy. Therefore, it is pertinent
who will elect to power. The goal of every political party is to
achieve the mandate for which they were elected, even though it
might not be in the best interest of the larger population or the
disadvantaged in society. However, the primary goal of a
healthcare person or nurse participating or getting involved in
politics is to improve patients' health care in all spheres in the
long run (Milstead & Short, 2019).
The reason behind repealing/replacing the affordable care act
differs from one political party to another. Pagel et al. (2017)
noted that "The Republicans prioritize reducing costs and
smaller government over all other goals, whereas Democrats
prioritize improving health and equity and reducing cost"
(para.7). Legislators' policy would always be in favor of the
political party they belong to. The Republicans were pushing
for repealing the affordable care act without having a proper
replacement. There were many attempts to repeal the ACA
during the Obama-led administration, but they were
unsuccessful. However, the Republicans came up with policies
that deterred the full implementation of the ACA instead
(Patashnik & Oberlander, 2018). The cost of repealing or
replacing the ACA was detrimental to people's health. This
meant access to health care was minimized, people with
comorbidities or pre-existing conditions were disadvantaged,
and health care was less affordable in the long run.
It is crucial to establish that the people we elect to power
should be individuals or governments who will pursue the
welfare of the citizens other than for selfish reasons. Voters

4. should be able to determine whom to vote for based on
manifestos, not based on sentiments. In deciding whether a
legislator needs to be re-elected, the questions that need to be
asked is that are the policy makers aware of the pressing needs
of the people, knowledgeable of the subject matters in question,
people-driven or self-driven, and have a past track record of
deliverables (Milstead & Short, 2019).
References
Milstead, J. A., & Short, N. M. (2019).
Health policy and politics: A nurse's guide. Jones &
Bartlett Learning.
Pagel, C., Bates, D. W., Goldmann, D., & Koller, C. F. (2017).
A way forward for bipartisan health reform? Democrat and
Republican state legislator priorities for the goals of health
policy.
American Journal of Public Health,
107(10), 1601–1603.
https://doi.org/10.2105/ajph.2017.304023
Patashnik, E. M., & Oberlander, J. (2018). After defeat:
Conservative postenactment opposition to the ACA in
historical-institutional perspective.
Journal of Health Politics, Policy and Law,
43(4), 651–682. https://doi.org/10.1215/03616878-
6527971