The Affordable Care Act has been one of the most divisive health issues in our society

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The Affordable Care Act has been one of the most divisive health issues in our society. And as a very well discussed topic, it plays a huge role in political campaigns for election and re-election. Depending on the political party, the cost-benefit analysis changes, with the Democrats as supporters who focus on the health coverage it provides to millions of people with pre-existing conditions; and the Republicans as the opposition that points out the huge cost it relies on. Each represents people that are against or in favor of it. Over the years, the legislators have used it as a campaign promise, whether to keep/expand it for Democrats; or to repeal/replace it for Republicans. One example is Donald Trump, who was firmly against the ACA and promised to invalidate it during his Presidential campaign.

The ACA has a great weight within the public, and legislators have used it on their interests. The politician looks beyond the issue itself and considers other factors that affect what is likely to work and has no chance of success. As stated by Milstead and Short, "Deciding which of several policy options will lead to the greatest benefits and the fewest costs, in a world where re-election is a key consideration and media are a relentless presence, means the best solution may not be the path ultimately chosen" (2019, p. 51).

Therefore, politicians organize their agenda and plan their policies from what the people they are aiming for wants. According to a survey conducted by KKF, nowadays, "half of the public (53%) hold a favorable opinion of the ACA while about one-third (34%) hold a negative opinion of the law" (Hamel, 2021, p. 1). Furthermore, within the political parties, 86% of Democrats are in favor, in contrast to the 76% of the Republicans that want to see it overturned (Hamel, 2021). Each party can plan how its next campaign will be and which policies it will position from these statistics.

For example, as most Republicans do not want the law, Trump and the Republicans tried to repeal it with the "skinny repeal" proposal, which had no plan to replace the ACA and "was deeply unpopular" among the public opinion (Davis & Montanaro, 2017). Additionally, other Republican proposals to invalidate it had more planning behind them, such as the "A Better Way" plan developed by the House Republicans. Contrary to Trump's proposal, it offered different policies to handle health coverages (Blackburn, 2017).

On the other hand, as most Democrats are in favor of the ACA, President Joe Biden and the Democrat party have supported it and expanded it. Even though research shows that the ACA has doubled the cost of individual health insurance (Haislmaier & Slagle, 2021), and the only clear path to expanding health insurance remains yet more government subsidies for commercial health plans, Biden has pushed through a two-year expansion of the Affordable Care Act in the COVID-19 relief bill, which will make health insurance more affordable for more Americans (Levey, 2021).

In conclusion, legislators and politicians act on behalf of what their voters want, with the necessity of being re-elected in mind. Regarding the ACA, each party will continue to support or oppose it, as long as the majority of people they aim to retain stay in favor or against it.