Assignment: Legislation Comparison Grid And Testimony/Advocacy Statement

Based on the health-related bill you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

• Determine the legislative intent of the bill you have reviewed.
• Identify the proponents/opponents of the bill.
• Identify the target populations addressed by the bill.
• Where in the process is the bill currently? Is it in hearings or committees?
• Is it receiving press coverage?

Thank you, Ayeshia, for your CBA of the repeal of the ACA.  Do you think the stigma of the nickname “Obamacare” contributes to its unpopularity with some voters and increases the drive of Republicans to repeal without a viable option to replace it with? You discussed the potential costs related to the Government budget, but the health costs to the population could be more catastrophic. With a repeal, 54 million people with conditions severe enough to be denied could be denied healthcare outright. (Abelson & Goodnough, 2020) Not to mention that if the ACA were to be repealed and previous systems were put in place, the number of uninsured Americans would increase by 19.9 million. (Blumberg et al., 2019) this is due to many Americans receiving coverage due to Medicaid expansion created by ACA; if it is repealed, that group of people no longer would be covered.  For the Government s budget, it does not make sense, as you pointed out. But also for the overall health and well-being of the population, it is not the best option. Yet many politicians are making repeated attempts to challenge the constitutionality of the ACA in court.

References

Abelson, R., & Goodnough, A. (2020, September 21). If the supreme court ends obamacare, here’s what it would mean. The New York Times. 

Blumberg, L. J., Buettgens, M., Holahan, J., & Pan, C. (2019, March). State-by-state estimates of the coverage and funding consequences of full repeal of the aca [PDF]. Urban institute. 

Legislators Influence On Health Care

            The Affordable Care Act, also known as ACA or “ObamaCare”, was enacted in March 2010 by the Obama Administration. According to HealthCare.gov, the health care reform law has three primary goals; “make affordable health insurance available to more people, expand the Medicaid program to cover all adults with income below 138% of the federal poverty level, and support innovative medical care delivery methods designed to lower the costs of health care generally” (“Affordable Care Act (ACA)”, n.d.). This health care law was enacted in order to move towards the end goal of universal health care and provided as a right vs a privilege (Teitelbaum, 2018). According to Economic Policy Institute, approximately 29.8 million people would lose their health insurance and approximately 1.2 million would lose their jobs (“Repealing the ACA”, n.d.). With the repeal prospectively affecting that many Americans, you would assume this would play a large role in the legislative leader’s position in congress. We as a democracy, can influence those in the position to place laws and policies that impact our day to day lives. With the impact this repeal would have, I think it would be safe to say, the legislative leaders would have to rebuttal in order to save face and protect their position within congress. Once legislators found how many Americans would be affected by the repeal, the Trump Administration proposed the Better Care Reconciliation Act in 2017. This act would provide more help to cover out-of-pocket costs, health savings accounts, allocating additional resources to combat the opioid epidemic, providing more options for Americans to buy lower premium plans, as well as tax and Medicaid revisions (Senate Budget Committee, 2017). By providing these alterations to the Affordable Care Act, I feel that the legislative leaders were able to secure their position in congress and I can only hope their intentions are to continue to implement laws, policies and acts to better American lives across the nation.

References

Discussion draft – better care reconciliation act (BCRA). U.S. Senate Committee On The Budget. (n.d.). Retrieved December 13, 2021, from .

HealthCare.gov. (n.d.). Affordable care act (ACA). Affordable Care Act ACA. Retrieved December 13, 2021, from .

How would repealing the Affordable Care Act Affect Health Care and jobs in your state? Economic Policy Institute. (n.d.). Retrieved December 13, 2021, from .

Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

1 Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

• Chapter 3, “Government Response: Legislation” (pp. 37–56)
• Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)

2

3 Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003

Note: You will access this article from the Walden Library databases.

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Testimony/Advocacy Statement

            Good afternoon.  My name is Erin Littlepage, and today I will be discussing the importance of passing the H.R.4769 bill, also known as the Medicare Prescription Drug Savings and Choice Act of 2019.  Compared to other highly developed countries with decent healthcare, the United States has substantially higher prices for the cost of drugs.  There are many bills that have been introduced to the House of Representatives in order to combat these high prices that we as Americans face every day, and the Medicare Prescription Drug Savings and Choice Act of 2019 bill is especially important.

Under the current administration, as of December 18, 2019, Donald Trump has announced plans to allow states to purchase prescription medications from Canada to help lower the costs of Americans purchasing their medications.   The fact that our medications are so expensive, we must go to another country to purchase prescription drugs is a disturbing fact.  However, if the plan goes into action, the Medicare expenses will be lowered from state to state which would be a huge push in the right direction of lowering our prescription drug costs (Williams, 2019).

There are opponents to the bill, unfortunately.  Large drug companies must increase the prices of medications in order to make a profit for themselves.  This does not benefit the American consumer, however.  So many Americans fail to take their medications as prescribed by their provider because they do not have the money to pay for them.  I have worked on Medical Surgical units for my entire nursing career, and the amount of admissions and readmissions based on the mere fact that the patient cannot afford their drugs, and come in with acute symptoms that could be regulated with medication administration, is astounding.  While it appears as if the pharmaceutical companies will just continue increasing their drug prices, I think the only way to address these opponents is to have this bill and other bills related to drug pricing passed to Congress and have them take strong action to manage the issue.

An amendment I would propose in regard to this bill, is laid out in the Medicare Drug Price Negotiation act, which would allow the secretary of Health and Human Services to negotiate drug prices for drugs under Medicare.  This in turn, would lower drug prices.  Currently, the secretary of HHS is not permitted to negotiate on pricing so they must accept the numbers given by the pharmaceutical company.

In conclusion, the high prices of medications will continue to be an issue nationwide as long as Congress sits back and allows pharmaceutical companies to take advantage of innocent Americans.  The Medicare Prescription Drug Savings and Choice Act of 2019 will allow the Center for Medicare and Medicaid Services to negotiate with pharmaceutical companies to keep pricing reasonable for drugs and offer alternatives medications that are of equal value, but of lower price.  These companies have time and time again shown their greed, and that a profit is more important than the life of American citizens.  This issue is long overdue to be solved and will continue until Congress takes a stand, starting with the passing of this bill and others related to the issue.

References

Pear, R. (2018, October 25). Trump Proposes to Lower Drug Prices by Basing Them on Other Countries’ Costs. Retrieved December 20, 2019, from https://www.nytimes.com/2018/10/25/us/politics/medicare-prescription-drug-costs-trump.html.

Prescription drug prices rising despite Trump pressure on Big Pharma. (2018, September 24). Retrieved December 20, 2019, from https://www.cbsnews.com/news/prescription-drug-prices-rising-despite-trump-pressure-on-big-pharma/.

Schakowsky, J. D. (2019, October 21). H.R.4769 – 116th Congress (2019-2020): Medicare Prescription Drug Savings and Choice Act of 2019. Retrieved from https://www.congress.gov/bill/116th-congress/house-bill/4769?q={“search”:[“prescription+drugs”]}&s=7&r=5.

Williams, L. (2019, December 18). Trump Plan Would Allow States To Buy Cheaper Prescription Drugs From Canada. Retrieved December 20, 2019, from https://www.ibtimes.com/trump-plan-would-allow-states-buy-cheaper-prescription-drugs-canada-2888113.

An Introduction to Health Policy and Law Program Transcript

JOEL TEITELBAUM: Politics plays a huge role in the development and implementation of health policy.

NARRATOR: Joel Teitelbaum is the associate professor and vice chair for academic affairs in the Department of Health Policy at the George Washington University. He’s also the school’s director of the Hirsch Health Law and Policy program. Professor Teitelbaum co-authored The Essentials of Health Policy and Law for students studying law and policy as a component of their public health studies.

As a university professor and an academic lawyer, Joel has influenced health policy and the policymaking process.

JOEL TEITELBAUM: Two of the three branches of government are by intent by design political. So the executive branch and the legislative branch, the two branches of government that are tasked with designing and implementing health policy and laws, are by their design political, because we elect them. They’re imbued with power as a result of federal and state elections.

So you from that starting point, you have to understand that anything that goes in the policy making and the legal process is going to be political. The Affordable Care Act, for example, passed without any Republicans signatures. And you can see, after it was passed and it’s being implemented that fully half of the states, most of them led by either Republican governors or legislatures, are actively challenging or ignoring the law.

So it’s clear that obviously politics is playing a very important role in both the design at the outset and now the implementation of the Affordable Care Act. Over the past century or so, there have been many examples of important health policies that have really changed the delivery of public health services in this country. I think a good starting point is with the Public Health Service Act in 1944, which at that point consolidated a lot of the health policies that were in existence and greatly expanded the role of the Public Health Service.

From there, you can look to the 1960s when we had the passage of Medicare and Medicaid, which of course gave health insurance and really did a lot to improve the public health for the elderly and for the disadvantaged and poor. The Community Health Center program, which has really influenced public health, was passed in 1965, was when the first health center opened.

From there, you can look at the Affordable Care Act of course in 2010. I think the Affordable Care Act has very much influenced the notion of health care as either a right or a privilege. I think it has taken us further away from the idea of health care as a privilege and closer to the idea of health care as a right. Now, the way that the Affordable Care Act mainly did this was through the creation and the regulation of new health insurance markets.

And there is clearly not a one to one correlation between having health insurance and health care as a right, because even with health insurance, there’s no guarantee that someone will get quality health care or any health care at all if they can’t access it. But I do you think that the Affordable Care Act has played a large role in helping the country move toward understanding that what it means to have an equitable and fair health care system means having access to insurance which then in many cases will then lead you to health care access.

Even after implementation of the Affordable Care Act, there’s going to be 10s of millions of people without insurance. So the idea that we’re somehow close even to universal insurance leading towards a right is still pretty far away. My experience in influencing health policy I think I can talk about in two different ways.

The first is what I have learned about what it means to be a health policy advocate or influential health policy maker or someone who can help influence the design of health policy. Broadly speaking, I think you have to have a lot of stamina, you have to be a very good team player understand that no one individual given the multifaceted nature of health policy making can have as great an influence as they can if they’re working with, say, lawyers and economists and others. I think you have to have a fertile political environment, because again, as we’ve seen, something like the Affordable Care Act barely even passed even though it is something we’ve been working toward for many, many decades in this country.

In terms of my own experience, my role in thinking about health policy and law and the research and teaching and writing that I’ve done has spanned several topical areas. I started off working on behavioral health care issues in law and policy– so substance abuse and mental health issues. That transformed into work around managed care law and policy, which then morphed into an interest that I brought the job which was health care civil rights, and after that into health care reform and implementation.

So along the way, I’ve been able I think to influence health policy in each one of those areas through articles, through presentations, I’ve testified before the DC council, I’ve written testimony for Congress. So there have been a lot of different ways I think as a university professor and as an academic lawyer that I’ve been able to influence the policy making process.

So what are some of the pearls and pitfalls of writing a health policy analysis? I’ll give you a handful. The first one is that you should not go into the writing a policy analysis with an outcome in mind. You’ve got to be open minded and be able to really take a look at what the data says, what the literature says, and be thinking creatively about what all the various options are, as opposed to going in with one outcome in mind.

The second thing is that the advice that you give, the final recommendation that you make to the policymaker, whoever that may be, has to be within that policymaker’s power to achieve. There’s no point in giving advice that there is no either political environment for or is within the power of the policymaker to actually carry out. Another one is that you have to address all sides of a policy issue.

When you’re writing a policy analysis, it’s not enough to look at two or three, even if they’re good, options. You have to address all sides of the issue. Otherwise, the policymaker won’t really be able to make an informed decision. You can’t be giving superficial advise. As the policy analyst, as the writer of a policy analysis, you have to be very well informed, oftentimes better informed than the policymaker him or herself.

It’s you they’re going to be relying on. And you have to be incredibly informed. So the giving of superficial advice is really something that you shouldn’t do in crafting a policy analysis. Oftentimes students forget in writing a policy analysis that giving the recommendation to do nothing is an option. In fact, it is an option.

So when what you’re doing is considering a policy question and thinking about what the options are, sometimes doing nothing, leaving things as they are, the status quo, is the best thing to do. A lot of times, students believe that they need to recommend a change just for change sake. I don’t think that’s always the best advice.