Despite the cost of repealing or replacing the Affordable Care Act (ACA) being extremely high and its effect on legislators' re-elections, repealing or replacing it would give insurance companies the freedom to deny coverage or charge a high premium to Americans with pre-existing chronic conditions. The Affordable Care Act was introduced during the Obama administration hence referred to as Obama Care. The primary goal for the ACA was to make health insurance available to more Americans, expand Medicaid coverage and lower the cost of medical care delivery (Willison & Singer, 2017).

The implementation of ACA helped to insure 25 out of 50 million Americans who were previously uninsured, expanded Medicaid coverage to the elderly, individuals with disabilities, and low-income population. (Laurate, 2018). American Progress (2017) indicates that approximately 132 million Americans have pre-existing conditions protected under ACA health care and repealing or replacing it strips their ability to access affordable health insurance through their employers.

In 2010 when the Republicans took over the House of Representatives, they proposed replacing the ACA with the American Health Care Act (AHCA) (Gorin, S. H. 2011). Repealing or replacing ACA would significantly affect the legislators' re-election and the voters' overall well-being, meaning that "25 million Americans insured under ACA would lose their insurance coverage, 14.5 million Americans will lose their Medicaid/Chip coverage…." (Buettgens et al., 2016).

The legislators' position on policy-making is significantly affected by voters' views. Voters elect members of both the House and the Senate, and their position on depriving affordable health insurance would decrease their chances of being re-elected. Public polling on sensitive political issues assists the legislators in making decisions on how to pass said political issues.

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