Evaluating Healthcare Policy through a Political Lens- The Impact of Interests and Re-election on the Affordable Care Act

Introduced in 2010 during President Obama’s tenure, the Affordable Care Act (ACA) is, without a doubt, one of the most controversial health policies of the 21st century. For starters, it is worth noting that ACA had 3 central objectives: first, reforming the private insurance market; second, the expansion of Medicaid to the working poor with household income up to 133% of the national poverty level; and third, transforming the way medical decisions are formulated (Silvers, 2018). However, the ACA was a subject of many debates throughout the nation, as most pundits suggested that it was not as affordable as it was deemed. One example that was widely cited by politicians from both sides of the divide pertained to the fact that it created a liability for Americans to have insurance, such as penalizing those who did not have insurance. This is just one of the demerits of ACA that changed the political discourse of the nation.

The 2016 general election further aggravated the situation as the public became more concerned about the costs of the ACA over the benefits of the policy. Subsequently, this offered a unique platform for politicians to put forth their stance to get re-elected. Instead of caring about the actual future of care accessibility alongside the substantial out-of-pocket expenses that individuals had to part away with, politicians used the ACA as a campaign tool for re-election. Hence, the cost-benefit calculations of the politicians were not the cost-benefit to the greater society of implementing the Act, but the merits were the additional political support that the politician stood to get from supporting the legislation or losing from opposing the Act. For most politicians, their decision was based on what they perceived that will bring them significant success, such as remaining in office.  Any smart politician whose objective was to be re-elected went with the popular vote (Milstead & Short, 2019).

References

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

Silvers J. B. (2018). The Affordable Care Act: objectives and likely results in an imperfect world. Annals of Family Medicine, 11(5), 402–405. https://doi.org/10.1370/