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Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

TASK

Post your initial response to one of the two topics below

The ACA or the AHCA: Imperfect Solutions to Increasing Access to Health Care?

This week’s discussion focuses on the federal government’s role in protecting the public’s health using the ACA and current efforts to “repeal and replace” the ACA. Please note that the government’s role in protecting the public’s health did not begin with the ACA. In the late 1800s, Lilian Wald brought health care to the community. And in 1965, Congress passed bills authorizing Medicare and Medicaid. Since 1965, Congress has expanded government-sponsored health care to pregnant women and children.

Topic 1

  • Compare the current provisions in the ACA with those in the failed first version of the AHCA. 
  • Share your opinions about why the AHCA failed in the first attempt at passage.

Peer 1



The Affordable Care Act is also know as Obamacare.  This act was created with the intent to help get insurance to those that were uninsured.  According to Mason (2016), "the ACA provisions aim to increase access to care; change the culture of health care from one of cure to one of health promotion and illness prevention; mitigate barriers to practice for primary care providers of all disciplines; capitalize on the skill and expertise of nursing in areas of leadership, practice, research, and innovation; and, through these mechanisms, improve population health outcomes" (p. 193).  Many felt that the AHCA would cause many of the previously insured Americans to lose insurance coverage. With many people losing coverage, this would create a problem in the poor community with the ability to have access to health care. The AHCA failed in its first attempt due to lack of proper planning.  Although I feel that there are parts of the ACA that need change, we have to fully analyze the effects that this would have on the consumers.  I personally feel that the government needs to step in on the reimbursement rates that insurance companies have to pay.  I currently work and live in one of the poorest counties in South Carolina.  We have one hospital in the entire county.  I have had to wear many hats working at Williamsburg Regional Hospital.  One of these hats include investigating the reimbursement of insurance versus the cost of the procedure.   We have had to stop performing procedures due to the simple fact that the reimbursement rate does not cover the cost to the hospital.    

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2016). Policy & politics in nursing and health care (Seventh edition.). Elsevier



Peer 2 


Healthcare reform has made several efforts by the federal government earliest date known was 1984, but was not considered successful until 2010.  ACA created the Center for Medicare and Medicaid Innovation that was intended to facilitate value-based approaches to healthcare primarily by creating and piloting alternative payment models (Hirsch, Rosenkrantz, Nicola, Harvey, Duszak, Silva, Barr, Klucznick, Brook & Manchikanti, 2017). ACA has two goals in mind such as increasing the number of insured individuals, and reducing the cost of healthcare. These goals were met by expanding Medicaid and creating the “exchange” marketplace (Hirsch et al., 2017). As this bill was intended to help the uninsured, it actually increased the deductibles and out of pocket expenses for those with the exchange insurance and employer based plans (Hirsch et al., 2017). AHCA has mentioned that individual plans, the premiums would be based on age with a 5% increase for elderly as ACA has a 3% increase. In my opinion, the reason ACHA has failed is because of the increase in the population that lost insurance and had no additional insurance or means to pay. Although, it really seems like both bills want to point the finger at each other and say that it is because of “pre-existing conditions” or “stipulations imposed” in the bill that caused the failure. Regardless of the “why”, we have to figure out some way to benefit each American that is cost effective and provides the much needed healthcare coverage. 

Reference

Hirsch, J. A., Rosenkrantz, A. B., Nicola, G. N., Harvey, H. B., Duszak, R., Silva, E., Barr, R. M., Klucznik, R. P., Brook, A. L., & Manchikanti, L. (2017). Contextualizing the first-round failure of the AHCA: down but not out. Journal of NeuroInterventional Surgery9(6), 595–600. https://doi.org/10.1136/neurintsurg-2017-013136


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