Agenda Comparison Grid

Healthcare Issue Flexibility and affordability to American health insurance
Description The impact of the Affordable Care Act on health insurance is massive, especially for the patients.  Notably, health insurance is a significant problem that most citizens face. The root cause of the problem is that patients pay a lot of money and do not get quality treatment (Milstead & Short, 2019). The healthcare policy is ineffective, and this has affected the access and quality to care. Patients lack affordable, flexible and transparent insurance because the business model used by insurance companies works against it.


Administration (President Name) Bush Administration Obama Administration Trump Administration
Describe the administrative  agenda focus related to this issue The Bush administration on healthcare policy has a series of incentives that complement the proposal in the Affordable Care Act. In signing the Medicare drug bill, President Bush proposes for a limited expansion of government health programs to make coverage more affordable. The new Bush healthcare agenda is to reinforce the private sector’s ability to expand healthcare coverage.









The Obama Administration carries out healthcare reforms by signing the Patient Protection and Affordable Act popularly known as Obama Care. In signing this act, the president’s objective is to lower healthcare costs and improve quality of life for those who could not obtain health insurance from their jobs. Notably, it makes coverage affordable to most people and allows them to get preventive care to reduce the cost of emergency care (O’Rourke, Crawford,  Morris, & Pulcini, 2017).  The Trump Admiration seeks to repeal the ACA by reducing the funding of healthcare programs. The president budget proposes cuts to health coverage, Medicaid cuts, and other health programs. The administration seeks to create an individual health coverage market that is different from the ACA. Through the Health Saving Account, the administration aims to help customers have more power in the healthcare markets thereby reducing the cost of insurance (Lamb et al., 2015).
Allocation of financial and other resources to this issue The new Medicare Modernization Act signed by President Bush would cost 534 billion over in 10 years. An incremental federal expenditure of 227.5 billion over the ten years.









The Healthcare Reform plan signed by President Obama would cost 894 Billion over ten years. An incremental federal expenditure of 40 billion. The Cheap Short-term Health Plan (CSHP) by President Trump would cost 1.3 trillion over ten years. There is no federal expenditure as their role has been reduced to service provision.
Notes on Administration’s approach to the issue The health care plan proposes for refundable health tax credits, promotion of health savings accounts and significant changes to the health insurance market through the inclusion of better health plans.










The health care plan ensures that a private health insurer covers the pre-existing conditions of their clients. It puts the health insurance industry under the federal anti-trust law ending state-led regulations.  It expanded coverage This healthcare plan offers insurers the opportunity to start selling short term coverage that is cheaper and less comprehensive. The coverage period is increased from 12 months to 26 months.
General Notes/Comments











Medicare offers the private sector with the capacity to expand its health coverage and improve on the quality and access to medical services. It helps to increase control of health insurance policies. Obamacare offers direct subsidies  to the uninsured by providing the option of buying them through exchanges, The CSHP by President Trump is to provide cheap and affordable insurance cover.

Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?         The Agency of Health Care Administration (HCA) will help me to deal with the problems of health care insurance. This agency is responsible for administering Medicaid programs and advocate for long term care services.

How does the healthcare issue get on the agenda and how does it stay there?

A health issue such as affordable health insurance gets on the agency of the administrative agency such as HCA through a report known as policy brief. The purpose of a policy brief is to create a short document that provides findings and recommendation to an audience that is an expert in the area of interest. After this, the concerned stakeholders debate on the issue and decide on the implementation. The duration of the execution will be based on the complexity of the health issue.

Who was the entrepreneur/champion/sponsor of the healthcare issue you selected?

The sponsor of the health care issue selected is Karen Davis, who works at the Hopkins School of Public Health. She is an analyst of various health care insurance plans.



Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Lamb, G., Newhouse, R., Beverly, C., Toney, D. A., Cropley, S., Weaver, C. A., Kurtzman, E., Peterson, C. (2015). Policy agenda for nurse-led care coordination. Nursing Outlook, 63(4), 521–530. doi:10.1016/j.outlook.2015.06.003

O’Rourke, N. C., Crawford, S. L., Morris, N. S., & Pulcini, J. (2017). Political efficacy and participation of nurse practitioners. Policy, Politics, and Nursing Practice, 18(3), 135–148. doi:10.1177/1527154417728514

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