Politics and the Patient Protection and Affordable Care

Act
Regardless of political affiliation, individuals often grow concerned when considering
perceived competing interests of government and their impact on topics of interest to
them. The realm of healthcare is no different. Some people feel that local, state, and
federal policies and legislation can be either helped or hindered by interests other than
the benefit to society.

The suppliers of legislative benefits are legislators, and their primary goal is to be re-
elected. Thus, legislators need to maximize their chances for re-election, which requires
political support. Legislators are assumed to be rational and to make cost-benefit
calculations when faced with demands for legislation. However, the legislator’s cost-
benefit calculations are not the cost-benefits to society of enacting particular legislation.
Instead, the benefits are the additional political support the legislator would receive
from supporting legislation and the lost political support they would incur as a result of
their action. When the benefit to legislators (positive political support) exceeds their
costs (negative political support) they will support legislation. (page 27)

Source: Feldstein, P. (2006). The politics of health legislation: An economic perspective (3rd ed.). Chicago, IL:
Health Administration Press.

To Prepare:

 Review the Resources and reflect on efforts to

repeal/replace the Affordable Care Act (ACA).
 Consider who benefits the most when policy is
developed and in the context of policy
implementation.

Post an explanation for how you think the cost-benefit analysis in the statement from
page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain
how analyses such as the one portrayed by the Feldstein statement may affect decisions
by legislative leaders in recommending or positioning national policies (e.g., Congress’
decisions impacting Medicare or Medicaid).