Discussion: Politics and the Patient Protection and Affordable Care Act

*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.


Politics and the Patient Protection and Affordable Care Act

Cost for Legislators Repealing the ACA

Citizens are often concerned over the competing interest of the leaders in government and their interests. In many cases, the citizens feel that state, local, and federal policies and legislation can either support or hinder their interests other than the benefits to the society (Adida et al., 2021). The legislators need to maximize their chances for re-election, which requires political support. Legislators are assumed to be rational and make the cost-benefit calculations when faced with demands for legislation. Therefore, since ACA benefits most low-income homes, the legislators benefit by ensuring they receive support from their constituents (Milstead & Shortm, 2019). Certain actions will lead them to lose in elections. Therefore, in most locations where the citizens clearly do not support repealing the ACA, leaders had to support the ACA to be re-elected.

Legislators’ Decisions in National Policies

Legislators’ decisions are often influenced by their political careers. Analyzing the voter’s opinions significantly impacts the legislator’s decisions regarding the recommendation of national policies and impact changes of the centers of Medicare and Medicaid services that have been debated for years. Li & Stith (2020) indicate that although ACA did not deliver what it had promised Americans, the voters wanted to have more coverage for the policies that ensure universal coverage for all citizens. Therefore, the legislators have to make policy recommendations that align with the voters’ views to get reelected. Trust is the foundation that legislators build for their elections. They want to appear trustworthy to the voters, which means appearing to support issues that impact them (Adida et al., 2021). The more trusted and credible the individuals appear, the more they can influence their voters to keep them in office.


Adida, C., Gottlieb, J., Kramon, E., & McClendon, G. (2020). When does information influence voters? The joint importance of salience and coordination. Comparative Political Studies53(6), 851-891. https://doi.org/10.1177/0010414019879945

Milstead, J.A., & Shortm, N.M. (2019). Health Policy and Politics: A nurse’s guide (6thEd.) Burlington, MA: Jones & Bartlett Learning.

Li, X., & Stith, S. S. (2020). Health insurance and self‐assessed health: New evidence from Affordable Care Act repeal fear. Health Economics29(9), 1078-1085. https://doi.org/10.1002/hec.4026

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