The efforts to repeal or replace any legislation are affected by the legislators’ cost-benefit analysis. These political representatives consider the benefit against the cost of major legislative reform. If the benefit (in terms of political support) exceeds the cost, they usually pass the legislation (Feldstein, 2006). Cost-Benefit analysis plays a critical role in the efforts to repeal or replace the ACA, which is a current debate in United States politics. The current government must have analyzed the pros and cons of such a political decision. Therefore, the analysis informs the politics and partial success of Congress in adopting the change (Thompson, Gusmano, & Shinohara, 2018). From a federalism perspective, the lobbying of Congress by governors relates to Feldstein’s analysis. A majority of the Republican governors acted as affiliates of a vertical partisan alliance to support the national party instead of protecting their state’s insurance coverage.
In addition, governors exert pressure on the legislature to create, repeal, or change policies affecting health care. Hence, they lean on the side that is most likely to benefit them politically (Milstead & Short, 2019). Policy processes are political in nature, and the decisions depend on partisan or personal interests of legislators. The cost-benefit analysis affects decisions by legislative leaders in recommending or positioning national policies. Legislators, such as governors, may lobby Congress to make decisions that support their political interests. Historically, they have had considerable advantage over the development of policies that affect Medicaid (Thompson, Gusmano, & Shinohara, 2018). The process reveals a partisan polarization that has affected the Affordable Care Act. One of the political arguments includes the potential for cost-saving by the country after changing the policy.
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