Response posts to two peers

Elizabeth Linton

Hi Class!

I hope everyone is doing well in this course, it seems a little overwhelming at times but we are almost halfway there!!!!!

This week I am required to discuss the Affordable Healthcare Act regarding why it was such a monumental act for the healthcare field and what would happen if the mandate went away. That is, what would happen if people were no longer being required to pay fines if they chose not to comply with the regulation.

First, the Affordable Care Act (ACA) was such a big deal in 2010 because President Obama, who was new to office at that time, passed a bill stating that all Americans were required to have health insurance, or be punished with financial responsibilities. As I have explained in the past, I am not big into politics and do not have any real opinion of any value…in no way am I trying to offend anyone…I’m simply doing the homework you guys! This was a big deal to many American’s because while some loved the ACA for allowing healthcare coverage to be more accessible to everyone for a cheaper cost, others found it to be unconstitutional. While my opinion is nearly here nor there, the ACA was an overwhelming policy change. The lower class that had been unable to pay for healthcare was suddenly covered and able to receive care that they desperately needed. While the middle class was paying a bit more money, the funds they contributed allowed the ACA to ensure that proper healthcare was distributed to all. The penalties of refusing to comply with ACA do more than just fund the program. They ensure several things are in place for this program to operate as it was intended. If the penalties subside, three major things would change. One, the funding would be lost. This means that the fines collected that help cover the other people would be decreased and there would be a struggle to maintain healthcare coverage to all across the board. Another issue would be that the people who are likely to become ill or have several comorbidities would almost always opt in for the insurance, and those who are healthier will opt out. This creates a very expensive environment for healthcare insurance, as they would be covering a pool of people who are at a higher risk and need more coverage. Lastly, those who opt out of the insurance and are not required to pay fines will benefit from the ACA when they need it at their convenience. While others who opt in are paying all these fees for insurance, the “free rider” will reap the benefits without paying their dues.

Wilensky, S. E., & Teitelbaum, J. B., Affordable Care Act (ACA) reframed and uncertain. In D. M. Nickitas, D. J. Middaugh, & V. D. Feeg (Eds.), Policy and politics for nurses and other health professionals: Advocacy in action (3rd ed., pp. 137-160). Jones and Bartlett Learning.

POST # 2

A-J: Both Democrats and Republicans have used reconciliation bills to act on healthcare reform legislation and more recently to facilitate passage of major COVID relief policies. These initiatives prevent the filibuster rule from interfering with their legislative efforts. What is the political advantage of using reconciliation as an approach to pass major policy reform?

Allison Church

(A-J) For a bill to become law it needs to pass the Senate and the House. In the house a bill passes by majority. But in the Senate under normal circumstances, a bill needs a 60-vote majority to pass which means bi-partisan support is usually needed. Reconciliation is a special process that makes partisan legislation easier to pass in the Senate by skipping over time consuming hold-ups (House Budget Committee Staff, 2021). It was originally meant to help Congress to pass budget bills. A reconciliation bill only needs a simple majority to pass, cannot be stalled by filibuster, and does not require the president’s signature. Reconciliation provides an expedited process to bill consideration and thus policy implementation (House Budget Committee Staff, 2021). The reconciliation restricts time for debate to 20 hours. The political advantage to using reconciliation is the ability for the majority party to pass bills that would not otherwise pass due to the filibuster requirement (House Budget Committee Staff, 2021). In the event of a 50-50 divide, the vice president holds the swaying vote (House Budget Committee Staff, 2021). The provisions within the bill must somehow affect federal spending or revenue (House Budget Committee Staff, 2021). This is known as the Byrd rule and helps to protect the process from abuse of power. It can also normally be only used once a year, and cannot increase the deficit after 10 years, and has more financial restrictions (House Budget Committee Staff, 2021). One example of a financial restriction is that the change in spending or revenue cannot be a by-product of another bill. The Byrd rule is what the Republican party is citing in their argument for the basis of the Affordable Care Act (ACA) being repealed. In this example the Republicans do have a valid argument. The ACA often presents a gray area for the Byrd Rule. For example, the ACA effects Medicaid and Tax benefits and thus does affect the federal spending or revenue. But the restrictions of requiring individual coverage and the regulation on business lies on more of a gray area that could be argued break the Byrd Rule and gives a basis for possible future repeals (Wilensky & Teitelbaum, 2016, 2018, as cited in Nickitas, Middaugh, & Feeg, 2020, p. 139).

References

House Budget Committee Staff (2021) Budget Reconciliation: The Basics. Retrieved from https://budget.house.gov/publications/fact-sheet/budget-reconciliation-basics (Links to an external site.)

Nickitas, D.M., Middaugh, D.J., & Feeg, V.D. (2020). Policy and politics for nurses and other health professionals: Advocacy and action (3rd ed.). Jones and Bartlett Learning.