Leave Behind
- The attempt by the Republican Party to modify the existing Affordable Care Act passed under President Obama is incompetent.
- Attempts to bend regulations to benefit health insurance companies and large employers.
- Existing loopholes for state waivers for higher premiums for individuals with pre-existing conditions.
- States have the ability to choose medical benefits coverage, which may lead to politicizing healthcare, with services such as maternity leave no longer covered. This could lead to further health disparities and marginalized populations.
- Comprehensive effort to reduce Medicaid recipients that will greatly affect low-income individuals in desperate need of coverage.
- Potentially increases premiums by as much as 30% annually for lapses in coverage, which creates additional cost barriers.
- Potentially disincentivizes healthy and young people to enroll causing gaps in coverage and declining public and preventive health.
- The AHCA lacks a universal and equitable approach, ideological neutrality, proper funding, and long-term evaluation of national health objectives, with a primary objective to overwrite Obamacare.
Rationale
The Affordable Care Act extended coverage to over 20 million people, introduced new standards, and boosted public health funding. Unarguably, it had its issues which the previous administration was attempting to address. However, Donald Trump’s administration heralds its support and agenda on the public opinion that was prevalent in the 1950s and 1960s with significant civil rights abuses and racism.
Trump vowed to replace ACA for none other than ideological reasons, despite the move being rash and radical, costing coverage to thousands of people. The AHCA offered by Trump maintains a pro-corporate focus by modifying health-related taxation, regulation of employment-based coverage, and cutting funding to oversight by agencies of medications by the Food and Drug Administration. Public health is an extremely complex system that has a profound and long-term impact on the population.
Therefore, it requires a scientific and highly surgical approach to creating change, justified by proven research in the field (Himmelstein & Wooldhandler, 2017). However, Trump’s administration is acting without evaluating potential data, both in impacts and cost, as well as propagating a strong anti-ACA approach to its support base.
The ACHA was inherently flawed and based on fallacies. Without proper preparation and calculations, it was making empty promises regarding cost and expenses. In all consideration, it was a political gamble with the hopes that the Republican majority in Congress will lead to its passing. AHCA fails to consider the critical day-to-day and operational aspects of the national healthcare system.
Furthermore, the Congressional Budget Office estimated an $880 billion cut from Medicaid in the next decade which would lead to 53 million citizens losing access to health insurance, including 14 million in the first year (Collier, 2017). The bill would essentially set back any progress made by ACA and other health initiatives over the last two decades.
Scenario
As a nurse, one is expected to become a leading advocate for the health interests of patients and the community. One’s professional education and duty provide more introspect in the inner workings of the health system and how the policy may affect operational aspects which eventually reflect on the quality and availability of patient care. When a national health policy similar to the AHCA is being debated, it is vital to voice the professional and civil opinion to the Congressional representative which represents and votes in one’s district. The current representative for Miami-Dade’s 25th district is Mario Diaz-Balart of the Republican Party.
Diaz-Balart has historically voted the Republican party line on healthcare. That includes defending corporate interests as well as supporting legislation that would decrease coverage and allow charging for pre-existing conditions (Nicol, 2018). Diaz-Balart voted in favor of replacing ACA with Trump’s AHCA during the House of Representatives vote. He justified the vote by noting the failing condition of the state marketplace, leaving many counties with one or few providers, disrupting the market competition.
When addressing Representative Diaz-Balart, I would attempt to use reason and statistics to disprove his arguments, provide facts on the irrationality of AHCA, and advocate for numerous population groups in Miami-Dade that would be severely affected if the legislation was passed. I would note that the provider issue that he mentioned as his argument is due to a strict regulatory framework that prevents unethical business practices with insurance.
Even a single provider would prevent any monopoly on prices since it is strictly controlled. I would then discuss President Trump’s agenda and how it lacks focus on the broader context when it comes to healthcare. Finally, Miami-Dade has high rates of minority and immigrant populations that rely on ACA coverage and subsidies to receive basic healthcare. With AHCA, they would most likely lose it and it could lead to severe public health issues, as well as political repercussions.
Conclusion
My personal experience as a nurse influences my position since I am exposed to the numerous individuals coming into the hospital as well as in community programs that require healthcare but are only able to afford basic coverage. Many individuals are from minority, immigrant, or marginalized communities who are able to have some access due to ACA’s adoption of regulatory policies for pre-existing conditions. Overall, the condition of the health system requires reform, but the ACA has made significant strides in improving it. Meanwhile, legislation such as the AHCA aimed solely at replacing it is an irresponsible approach to national healthcare reform that affects so many people.
References
Collier, R. (2017). Why Trumpcare failed. CMAJ, 189(17), e645-e646. Web.
Himmelstein, D. U., & Woolhandler, S. (2017). Trumpcare or transformation. AJPH, 107(5), 660-661. Web.
Nicol, R. (2018). Mary Barzee Flores: Mario Diaz-Balart’s health care record is ‘hurting families.’ Web.