Policy Issue Analysis: The Affordable Care Act and Nursing

Policy Issue Analysis: The Affordable Care Act and Nursing

Problem Identification

Healthcare costs are soaring in the United States today. More people than ever before are uninsured or underinsured. In 2006-07, there were 46 million people uninsured (Gulley, Rasch, & Chan, 2011), and 9 million children also did not have health insurance (Coddington & Sands, 2008). A change in how healthcare is managed and financed is greatly needed to avoid worsening of this situation.

Background

The cost of healthcare and the number of uninsured individuals has become a critical issue today. Healthcare spending in the U. S. has grown faster than the economy, by about two to three percent per year since the end of World War II (Brown, 2009, p. 1). If nothing changes, Medicare will cost as much as the sum of all federal income taxes in about 75 years (Brown, 2009, p. 2). Healthcare premiums have become so unaffordable, that many families do without. The lack of insurance has a direct effect on poor health outcomes, increasing morbidity and mortality, which also contributes to increased healthcare costs (Coddington & Sands, 2008, p. 1).

The Patient Protection and Affordable Care Act (PPACA), also known as Obamacare, was signed into law on March 23, 2010, and the Supreme Court made a final decision to uphold the law on June 28, 2012 (U. S. Department of Health and Human Services). The PPACA is an attempt at healthcare reform by expanding public coverage programs and strengthening protection for consumers in public and private insurance plans (American Nurses Association, 2010). The plan aims to give more people access to affordable healthcare and offer nurses more opportunities to lead and contribute to the delivery of healthcare with a focus on wellness and prevention rather than sick care (American Nurses Association, 2012).

Stakeholders

There are many stakeholders affected by this policy, including hospitals and healthcare patients and their families. They are all affected by the Affordable Care Act because it has the potential to decrease the cost of care, create affordable options for healthcare insurance, and improve overall access to care.

Issue Statement

How does the federal government get healthcare costs under control, provide more people with better quality care, and strengthen the healthcare workforce?

Policy Objectives

The objectives of the Patient Protection and Affordable Care Act are to improve access to affordable, high quality healthcare for all U.S. citizens, reduce the cost of healthcare, and support reinforcement of Title VIII of the Public Health Service Act (American Nurses Association, 2010). The PPACA expands Medicare and Medicaid so that more people have access to healthcare insurance, and provides higher reimbursements for primary and preventative care. Healthcare costs are reduced by decreased insurance premiums and elimination of deductibles or co-pays for recommended preventative care for Medicare, Medicaid, and "qualified" plans (American Nurses Association, 2010).

Reinforcement of Title VIII promotes models of care delivery that emphasize primary care and wellness services, and supports education and development of nurses through training grants and financial incentives (American Nurses Association, 2010). Nurses have a significant role to play as leaders in primary and evidenced-based healthcare, and the PPACA increases funding for nurse-led health centers and federally qualified health centers