The Affordable Care Act (ACA) enacted in the year 2010

The Affordable Care Act (ACA) enacted in the year 2010 has had a dramatic effect on
the healthcare system in the United States (Kaestner et al., 2017). The law aimed at reducing the
number of people who are uninsured. The election and reelection of legislators have an impact
on the healthcare regulatory framework. ACA has raised sharp opinions with some legislators
supporting the law, while some believe that it should be replaced. In the year 2017, there were
efforts by Republican legislators to amend the law and pave the way for a replacement of ACA
(Jost, 2017). However, the efforts did not bear fruits since the move was not supported by a
majority of Democrats.
Evidently, ACA has not been debated in a bipartisan way. Legislators have sharply been
divided on the issue with Republicans calling for its replacement while Democrats have
continued to advocate for the full implementation of the law (Jost, 2017). To this end, there lacks
a clear framework that would replace ACA. The reelection of Republicans is likely to result in
legislators opposing the move to implement ACA. The move may affect many Americans
adversely. The number of people who are insured is likely to go down. More than 14.5 million
Americans will be without medical insurance, and this move may result in poor healthcare
outcomes. It may be difficult to offer quality healthcare services to the poor who do not have
medical insurance.
Voters have a huge impact on the decisions made by the legislature. The elected leaders
are the voice of the voters. They, therefore, make decisions based on the views held by voters.
Many voters feel that ACA has positively transformed healthcare in the country (Friedmann et
al., 2017). Further, the view is held by the poor and the middle class who feel that the law has
helped them get access to quality services. Legislators are likely to adopt the same stand on ACA
by rejecting any efforts meant to replace the law. Legislators are likely to support the full

implementation of ACA. However, it is important to note that Democrats predominantly support
ACA, while Republicans mainly oppose ACA. If more Democrats are reelected, the efforts to
replace ACA will likely be unsuccessful. The choice is likely to trickle down to Congress. The
decisions on Medicare and Medicaid are firmly rooted in numbers. The majority has the way,
and this means that the voters have a chance to dictate which policies will be passed through
choices made on the ballot.

References

Friedmann, P. D., Andrews, C. M., & Humphreys, K. (2017). How ACA repeal would worsen
the opioid epidemic. New England Journal of Medicine, 376(10), e16.
Jost, T. (2017). Examining the House Republican ACA repeal and replace legislation. Health
Affairs Blog, 7.x
Kaestner, R., Garrett, B., Chen, J., Gangopadhyaya, A., & Fleming, C. (2017). Effects of ACA
Medicaid expansions on health insurance coverage and labor supply. Journal of Policy
Analysis and Management, 36(3), 608-642.