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  Both parties have asked that the ACA be repealed or replaced for multiple reasons.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 The federal government would spend $90.9 billion less on health care for the nonelderly in 2021 if the ACA were repealed (Buettgens & Blumberg, 2016). State governments as a whole would spend $5.2 billion more on health care for the nonelderly in 2021 if the ACA were repealed (Buettgens & Blumberg, 2016).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

1. 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

2. 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.

3. References
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/81296/200
0806-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

4. 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

5. 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.
References

6. 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