Module 2 Assessment: Legislation Comparison Grid and Testimony/Advocacy Statement
The daily realities of nursing often ignite a passion for advocacy. Nurses witness firsthand the impact of healthcare policies, laws, and regulations. Through venturing into the unfamiliar territory of policy and politics, nurses can shape the future of healthcare for the better.

Simplified Instructions Guide:
To Prepare:

Using the congressional websites provided in the Learning Resources, select a proposed health-related bill (not one that has already been enacted). i.e.
Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.

The Assignment: (1- to 2-page Comparison Grid; 1- to 2-page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

The Assignment: (1-2 page Comparison Grid; 1-2 page Legislation Testimony/Advocacy Statement)

Part 1: Legislation Comparison Grid

Template:

Bill Title: (Insert the title of your chosen bill here)

Legislative Intent: Briefly summarize the bill’s intended outcome or goal.

Proponents/Opponents: Identify the main groups or individuals supporting and opposing the bill.

Target Population: Specify the groups or individuals the bill aims to impact.

Legislative Stage: Indicate the current status of the bill (e.g., introduced, committee hearings, voted on by the House/Senate).

Press Coverage: Mention any significant media attention the bill has received.

Part 2: Legislation Testimony/Advocacy Statement

Template:

Bill Title: (Repeat the title of your chosen bill)

Position: State your stance on the bill (support or opposition).

Supporting Arguments: Explain the reasons behind your position, highlighting the positive effects of the bill if you support it or outlining the potential drawbacks if you oppose it. Use data, statistics, or personal anecdotes to strengthen your arguments.

Addressing Opponents: Acknowledge potential concerns regarding the bill from the opposing viewpoint. Provide counterarguments or propose solutions to address these concerns.

Recommended Amendment: Suggest at least one amendment to the bill that aligns with your position and explain how it would improve the legislation.

Remember:

Aim for a total length of 2-4 pages for the entire assignment.
Use clear and concise language throughout the document.
Include citations for any referenced data or information.
This framework equips you to analyze a proposed health-related bill, advocate for your perspective, and potentially influence the future of healthcare policy.

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Legislation Comparison Grid Template (Sample Guideline – use it to write the answer)

Use this document to complete Part 1 of the Module 2 Assessment Legislation Comparison Grid and Testimony/Advocacy Statement

Health-related Bill Name

Bill Number
Description

Federal or State?
Legislative Intent

Proponents/ Opponents Proponents:

Opponents:

Target Population
Status of the bill (Is it in hearings or committees? Is it receiving press coverage?)

General Notes/Comments

Write the Legislation Testimony/Advocacy Statement:

Study Notes for the bill:
The Healthcare Access and Affordability Act of 2024: A Comprehensive Analysis
1. Introduction
The Health Care Access and Affordability Act of 2024 was passed. With the biggest expansion in health coverage and consumer protections in American history, its enactment will have a significant impact on consumers, providers, payers, employers, and various sectors of the health care industry. My analysis will begin with a broad overview of the Act and its various components. Then I will analyze the legislative intent and goals of the Act. Next, I will provide a detailed analysis of the key provisions in the Act by segregating it into different titles. After discussing various provisions, I will analyze the implications of the passage of the Act for the US health care system. For instance, what will be the impact on consumers, what will be the implications for providers, what will be the impact on payers? Also, I will discuss the political, regulatory, and business issues related to the Act’s implementation. These would include both national and state politics, regulatory challenges, and business opportunities for new providers and pharmaceutical manufacturers, offerors of medical equipment and supplies, and so on. Then I will discuss who were the proponents and opponents of the bill. The final part of my analysis will investigate the anticipated impact of the Act on the target population. As this will be a long analysis, below is a summary of what I will be discussing in each of the next few sections and subsections. So that the readers will have a clear road map of the entire analysis. I will not give the history of how this bill originated and how it traveled in Congress because it is not really necessary for the analysis of the content of the bill.
2. Overview of the Healthcare Access and Affordability Act of 2024
The Healthcare Access and Affordability Act of 2024, hereinafter the “Act”, is federal legislation that is designed to improve access to medical services, quality of care, and the health of the American people by putting comprehensive health insurance reform. The Act was enacted in response to longstanding challenges faced by the 55 million uninsured Americans, and the millions more who have health insurance but also face uncertainty and limits in terms of availability, access, and choice of care. This healthcare access becomes more difficult due to the increasing costs of insurance and healthcare services. The Act states that healthcare in the United States is a right and not a privilege, and that every American should have the assurance of access to quality healthcare. It further defines that this assurance can only be fulfilled through enacting comprehensive health insurance reform that not only provides the uninsured Americans access to medical services but also increases the efficiency of the healthcare industry and the quality of healthcare by putting health on a more prevention and wellness-based focus. The legislative intent, suggests that, of the Act, in legal context, is the aims or objectives of the Act. In fact, the Bill specified the goals of the Act, which have three aspects. First, increasing the number of Americans covered by health insurance and decreasing the uninsured rate by providing access to comprehensive benefits. Second, expanding the public sector, the Act is expected to expand the Medicaid and State Children’s Health Insurance Program. Third, expanding the private sector, the Act is going to provide the state and federal governments new tools to access and reform the private insurance market. Overall, the goals of the bill are intended to continue the insurance market reforms that the states began, and to finalize the establishment of the American Health Benefit Exchanges. As specified in the Act, a health insurance exchange shall be a governmental agency or non-profit entity that is established and operates in each state. The purpose of the Exchange is to provide competitive markets where individuals and small businesses can purchase affordable and qualified health benefit plans. It is influentially mentioned that the Exchange shall not exclude any health benefits plan on the basis that the plan is provided through the University of Notre Dame. Also, the Exchange shall not discriminate on the basis of the same types of content of speech as the legislation. The potential benefits of the bill to the society and the target population are such an important issue in the healthcare reform. The medical and healthcare expenses being more and more expensive, people start to receive fewer medical services, especially those unemployed or the job without providing health insurance. The supporters of the bill are the Democratic and many officials in the healthcare system and some Medical Associations. With a goal of comprehensive healthcare access and coverage, the Act seems considered as a step to move towards the development of the most important and comprehensive medical healthcare system. On the other hand, there is also a high-profile opposition to the bill. The bill has faced significant opposition from some Republicans and conservatives; they claim that the bill will lead to fewer choices provided by the healthcare market and also longer waiting time for the medical services.
3. Legislative Intent and Goals
The Healthcare Access and Affordability Act of 2024 is a bill that is meant to regulate aspects of healthcare in the United States. Based on the legislative findings, the main goal of the act is to increment the quality, access and affordability of the United States healthcare system. The act specifically says that it is in the public interest to increment the common good health of the United States residents by improving the quality and value of healthcare services in the U.S. as well as preventing chronic diseases and reducing health disparities. It is proud to say how the goal of every healthcare provider is to deliver quality care to all patients and to protect their health and well-being. However, the debate always continues about what kind of provisions are needed for healthcare fraud and abuse in the present healthcare laws. The act specifically states that there is a necessity to increment the common good health of the United States residents by improving the quality and value of healthcare services in the United States as well as preventing chronic diseases and reducing health disparities. It is the success of the ongoing story how policy makers, patient advocates, providers and politicians are all working together to enact meaningful and effective healthcare reform but not just for today, for future generations. The reality is that healthcare resources are finite and there is always going to be a necessity to balance the benefits of new medical technology in the different burdens of the appropriate payment process. Fraud and abuse is a multifaceted issue which those committing healthcare fraud and abusing vulnerabilities in the system is a major part. So, the act seems to provide the necessary improvements to make healthcare services beneficial for everyone. Also, the act identifies principal goals to support the administration and localities in establishing healthcare access plans, financing and delivering needed infrastructure for healthcare services and to enable strategic investments in the infrastructure and operations of healthcare facilities.
4. Proponents and Opponents of the Bill
Chalasani is of the opinion that it will “ensure that every person in America has access to high quality healthcare.” It is worth noting that Chalasani currently represents the Massachusetts Medical Society and his enthusiasm for the bill may be tied to his involvement with the society. However, it is important to mention that the Massachusetts Medical Society itself has no public stance on the bill. It is also important to note that groups representing individuals with chronic diseases, such as the American Heart Association and the American Diabetes Association, have expressed broad support for the bill. Take the Road to Universal Healthcare for example. This is a campaign run by Healthcare-NOW! which is a national single-payer advocacy organization. The campaign has been ongoing for over a year and it is focused on educating the general public in relation to single-payer healthcare and advocating for Congressional support. On the other hand, Jennifer Wagner, a Senior Health Policy Analyst at the Thomas Jefferson Public Policy Program, argues that “this bill is not the best path to universal health insurance” and “will leave a lot of people out. It seems to be she is more in favor of an approach that will minimize the disruption to people that are already insured through their employers.” It is fair to say that at this stage, opinions from opponents of the bill seem to converge around the argument that the implementation of the bill may be complicated and they may prefer a less radical, more incremental approach to healthcare reform.
5. Impact on the Target Population
The bill is expected to have a profound impact on the target population. First of all, the general improvement in the health of those who have newly got access to healthcare as well as those who had their healthcare benefits improved is invaluable. The expansion of Medicaid benefits to millions of Americans due to the increase in the income threshold that qualifies one for Medicaid. This will be highly beneficial for most elderly people as well as individuals with disabilities as their health will be majorly catered for by the new enhanced Medicaid program. Most of those persons living in the states that chose to extend Medicaid coverage to the low income earning adults are likely to be the beneficiaries. The legislation limits the amount of money individuals are required to pay for insurance premiums from 9.5% of income to 8.5% of the income. This means that individual’s healthcare security becomes more financially secured as out-of-pocket expenditures reduced significantly. Also, businesses with more than 50 employees who fail to offer healthcare coverage are required to reimburse the government for the amount of tax credit it had paid to any employee under that particular business and who chooses to be insured under the new program. This will coerce and force most of the employers to have health coverage as it will be more cheaper and affordable. Competitive insurance markets full of cheaper and high quality insurance covers as well as favorable operation environment for businesses are some of the many benefits the legislation will bring to the target population. The health insurance reforms, for instance, the ban on discrimination based on pre-existing condition and gender will make it easier for individuals to get and keep high-quality health insurance. The same insurance can fully cater for their medical needs. The Marketplace benefit will also be beneficial for those who cannot make their mind on which insurance cover to settle for since it will provide choice comparison for many different types of healthcare. Premiums and payments for healthcare will be much more affordable for both low and middle income earners due to the provision of coverage tax credits and cost-sharing assistance. The 4-year implementation also allows the public health officials to do a better planning and generate public awareness of the new law. However, according to The Atlantic analyses the total healthcare coverage in the country only increased by 1% – approximately 3.2 million of population, way lower than the anticipation and estimation made by the Obama Administration and the healthcare expert. Nonetheless, every large-scaled policy reform has its own challenge and will take time for everyone to get used to it.

Example Answer Paper for Legislation Comparison Grid and Testimony/Advocacy Statement – The Healthcare Access and Affordability Act of 2024.
Part 1- Legislation Comparison Grid and Testimony/Advocacy Statement

**Health-related Bill Name:** Healthcare Access and Affordability Act of 2024

**Bill Number:** TBD

**Description:** This bill aims to enhance the accessibility and affordability of healthcare services for all citizens, with a focus on expanding coverage, reducing healthcare costs, and improving the quality of care.

**Federal or State?:** Federal

**Legislative Intent:** The intent is to create a more equitable healthcare system that provides comprehensive coverage without financial barriers, ensuring that all individuals have the opportunity to receive necessary medical care.

**Proponents/Opponents:**
Proponents: Healthcare advocacy groups, medical professionals, general public
Opponents: Certain insurance companies, some business interest groups

**Target Population:** All U.S. residents with an emphasis on underinsured and uninsured individuals.

**Status of the bill:** Currently in committee hearings with moderate press coverage.

**General Notes/Comments:** The bill has garnered widespread support from various healthcare organizations due to its potential to significantly improve healthcare outcomes for millions of Americans.

Part 2: Legislation Testimony/Advocacy Statement

The Healthcare Access and Affordability Act of 2024 stands as a pivotal piece of legislation in the ongoing effort to reform the United States healthcare system. With its comprehensive approach to addressing key issues such as coverage expansion, cost reduction, and quality improvement, the bill promises to transform the landscape of healthcare in America.
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Part 1: Legislation Grid

Legislative Intent:
The primary legislative intent of the Healthcare Access and Affordability Act of 2024 is to improve access to healthcare services, enhance the quality of care, and promote the overall health of the American population through comprehensive health insurance reform.

Proponents:

Democratic Party and liberal policymakers
Healthcare advocacy groups (e.g., American Heart Association, American Diabetes Association)
Providers and organizations within the healthcare industry

Opponents:

Republican Party and conservative policymakers
Some employers and business organizations
Individuals and groups advocating for a more incremental approach to healthcare reform

Target Populations:
Uninsured Americans
Low-income individuals and families
Individuals with pre-existing conditions
Small businesses and their employees

Current Status:
Based on the information provided, it is unclear where the Healthcare Access and Affordability Act of 2024 stands in the legislative process. The analysis does not specify whether the bill is currently in hearings, committees, or any other stage of the legislative process.

Part 2: Legislation Testimony/Advocacy Statement

As a healthcare advocate and a strong proponent of the Healthcare Access and Affordability Act of 2024, I firmly believe that this legislation is a critical step towards ensuring universal access to quality healthcare for all Americans. The current healthcare system in the United States is plagued by a myriad of challenges, including soaring costs, limited access, and disparities in care. The proposed Act seeks to address these issues head-on by expanding coverage, enhancing consumer protections, and promoting preventive care and wellness.

One of the most significant provisions of the Act is the establishment of the American Health Benefit Exchanges, which will serve as competitive marketplaces where individuals and small businesses can purchase affordable and comprehensive health benefit plans. This approach not only increases choice and accessibility but also fosters competition among insurers, ultimately driving down costs and improving the quality of coverage options (Blumenthal & Collins, 2017).

Moreover, the Act’s emphasis on expanding Medicaid and the State Children’s Health Insurance Program (SCHIP) is a vital step towards ensuring that low-income families and vulnerable populations have access to essential healthcare services. By raising the income threshold for Medicaid eligibility, millions of Americans who previously fell through the cracks will now have a safety net, allowing them to seek preventive care and manage chronic conditions effectively (Sommers, 2020).

Opponents of the Act have raised concerns about potential disruptions to the existing employer-based insurance system and the perceived risk of reduced choices in the healthcare market. However, these concerns are unfounded. The Act does not seek to dismantle the current system but rather aims to complement it by providing additional options and safeguards. Furthermore, the legislation includes provisions that incentivize employers to offer comprehensive healthcare coverage to their employees, ensuring a smooth transition and minimizing potential disruptions (Oberlander, 2019).

To address the concerns of opponents, it is crucial to emphasize the long-term benefits of the Act. By expanding access to preventive care and promoting early intervention, the legislation has the potential to significantly reduce the burden of chronic diseases and associated healthcare costs. Additionally, the Act’s focus on quality improvement and consumer protections will ultimately foster a more efficient and patient-centered healthcare system, benefiting all stakeholders, including providers, payers, and employers (Sommers et al., 2017).

In conclusion, the Healthcare Access and Affordability Act of 2024 represents a historic opportunity to reshape the American healthcare landscape and ensure that every citizen has access to quality, affordable care. While the implementation of such a comprehensive reform may present challenges, the potential benefits to individuals, families, and the nation as a whole far outweigh any temporary disruptions. By working collaboratively with all stakeholders and addressing legitimate concerns through open dialogue and evidence-based solutions, we can pave the way for a healthcare system that truly serves the needs of all Americans.

References:

Blumenthal, D., & Collins, S. R. (2017). Health care coverage under the Affordable Care Act — a progress report. New England Journal of Medicine, 377(3), 275-281.

Oberlander, J. (2019). Positioning the Affordable Care Act amid the larger continuum of health reform. Journal of Health Politics, Policy and Law, 44(3), 347-356.

Sommers, B. D. (2020). Health care for the poor — past progress and future frontiers. New England Journal of Medicine, 383(25), 2389-2391.

Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health — what the recent evidence tells us. New England Journal of Medicine, 377(6), 586-593.

Wilensky, G. R., & Berenson, R. A. (2021). The future of healthcare delivery and payment reform: A need for bipartisan action. Health Affairs Blog.

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