Greetings Everyone, 
The Patient Protection and Affordable Care Act (ACA), also known as Obamacare, was passed in 2010 (Silberman, 2020). ACA aimed to decrease the cost of health insurance, expand Medicaid, and improve health care outcomes (Silberman, 2020).
Healthcare system reform has been central to the presidential campaigns since the 1940s and continues to be a crucial issue today (Milstead & Short, 2019). According to Milstead and Short (2019), the evaluation of ACA started before it even became the law; the cost-benefit analysis of ACA was performed at both state and federal levels. The ACA continues to have a massive impact on politics which is evident through news, political debates, and social media (Milstead & Short, 2019). Since its implementation, politicians have talked openly about their views on the ACA bill and its effects.
The legislators primary goal is to get re-elected. During his presidential campaign, President Trump promised to replace the ACA; however, his proposed American Health Care Act did gain enough votes to become the law (Weinstock, 2017). According to Milstead and Short (2019), many Republicans did not support the immediate repealing of the ACA as it would have directly affected the next election. Thus, making it clear that regardless of how change might affect people, legislators re-election is always on the agenda (Milstead & Short, 2019). The ACA has proved to succeed as the uninsured rate decreased by 43%, from 16% in 2010 to 9% in 2015 (Obama, 2016).
Furthermore, Obama (2016) explains that the ACA has helped expand Medicare benefits, improve health care delivery, contain costs, and improve the quality of care. The ACA will continue to remain a hot topic for legislators during election and re-election with the given success. Money also plays a crucial role in politics. Whether to repeal the ACA or not depends on the group represented by the legislator (Milstead & Short, 2019). By going against the represented group values, the legislator can lose election campaign funding which can easily average $1 million for a U.S. Congress House seat (Milstead & Short, 2019).   
Obama (2016) explains that change is always tricky and reluctancy to change is a continuous obstacle. Even though legislators aim for re-election, they need to understand the voters perspectives and concerns. To remain in power, legislators must comprehend voters points of view and influence policies accordingly (Milstead & Short, 2019). Proposed bills are directly related to voters, and to get re-elected, legislators must address these issues. Correspondingly, repeal of the ACA was a failure, as republicans considered re-election long before it was due. Now more than ever, it is crucial for nurses as voters and healthcare workers to participate in the policymaking process. Healthcare continues to be an integral part of any election process, and it is significant for healthcare workers to take the initiative to educate politicians and influence healthcare policies.
References:
Milstead, J. A., & Short, N. M. (2019). Health Policy and Politics: A Nurses Guide (6 ed.). Burlington, MA: Jones & Bartlett Learning.
Obama, B. (2016). United States health care reform: Progress to date and next steps. JAMA. 316(5):525“532. doi:10.1001/jama.2016.9797
Silberman, P. (2020). The Affordable Care Act: Against the odds, its working. North Carolina Medical Journal, 81(6), 364“369. https://doi-org.ezp.waldenulibrary.org/10.18043/ncm.81.6.364
Weinstock, M. (2017). Trumps first 100 days marred by failed ACA repeal effort. Modern Healthcare, 47(18), 7.
 Thank you