Posted by anderc8 on Monday, January 30, 2017 in News, The Nation's Health.

Written by Alexandra Blair, Vanderbilt University Graduate Student (Medicine, Health & Society)

What better way to learn about the current landscape of the ACA, including the repeal and replace legislation on the table and the various stakeholders involved, than through a healthy, competitive debate? In “The Nation’s Health” we did just that as our class of 27 students gathered into small teams representing various stakeholder groups, including doctors, hospitals, insurance companies, Congressional Democrats, Congressional Republicans, and American healthcare consumers. Graduate students led the teams; and being a graduate student, I welcomed the opportunity to hone my leadership, communication, and teamwork skills. We were charged with representing our assigned stakeholder’s interests, and both conveying and defending those positions to our classmates – should the ACA be repealed? Should any pieces be retained? Does our constituency have specific interests in a replacement plan?

Each team prepared and presented an opening statement, which included a general position statement and key concerns for our constituency regarding the ACA. Throughout the debate, teams had the opportunity to provide justifications for and against key provisions of the ACA, as well as engage fellow stakeholders on their positions. This encouraged us to not only understand our group’s interests and concerns, but also research and anticipate those of other constituencies. As our skillful professors planned, this exercise encouraged us to look at the ACA from all angles—not just from the stance of pro or against, but also from the standpoint of understanding the many stakeholders involved. Moreover, this exercise encouraged us to look at both current events surrounding the ACA, as well as understand the history behind how and why various stakeholders came to hold their positions on healthcare policy.

For me, this exercise was illuminating on many levels. On a more direct level, this exercise revealed the many actors involved in health policy legislation, and the back work that went into the creation and implementation of the ACA. The total number of clients lobbying health care bills—over 1,500 in 2009—spent more than $1 billion on federal lobbying and hired more than 5,300 lobbyists for their work. Thus, comprehending the role of stakeholders, interests groups, and lobbyists is incredibly crucial to understanding the past, present and future landscape of the ACA. On a more general level, being from Washington, D.C., I’ve grown up around the political scene. However, this class, and this exercise in particular, provided me with a chance to academically engage with and research the things I grew up hearing about. Learning about these timely, complex topics in an academic setting has provided me with an open space to ask questions, engage my professors and peers in robust conversation, and develop my personal political voice.

Our next assignment for this class involves contacting our state representative to express our opinions on important topics in health policy, and this in-class debate thoroughly prepared us with the perfect preparation. Not only did this exercise expose us to the current ACA provisions, the proposed repeal and replacement legislation, and the many stakeholders involved in the process, it also gave us a chance to realize and reflect on issues we may feel most personally passionate about. After this debate, I feel much more confident in my ability to engage in conversation about the ACA, as well as the specific aspects I plan to advocate for and speak to my state representative about. I look forward to remaining an active participant in this ongoing legislative conversation, and sharing the information I’ve learned from this exercise.