NRS 428 Topic 4 DQ 2 What are the most important elements of the Affordable Care Act in relation to community and public health?
Former President Barack Obama signed the ACA into law in 2010. Sometimes colloquially known as “Obamacare,” this healthcare reform law effectively overhauled the nation’s entire healthcare system. The law’s purpose was to lower insurance costs and ensure that no American went without health insurance. The law expanded eligibility for Medicare and allowed individuals up to age 26 to stay on their parents’ healthcare plan. In addition, the ACA prevented health insurance companies from raising costs or denying coverage to people with preexisting conditions.
The Affordable Care Act (ACA) is the largest expansion of health insurance coverage since the creation of Medicare and Medicaid in 1965. The ACA expanded Medicaid coverage to all qualifying legal residents with income up to 138% of the federal poverty level (FPL). For persons not eligible for Medicaid, the ACA provided federal subsidies for persons with income between 100% and 400% of the FPL to purchase private insurance coverage in regulated state-based exchanges (Health Care, n.d.). The law also supports innovative medical care delivery methods designed to lower the costs of health care generally.
Nurses are integral in sustaining the financing of healthcare concerns through integrated
activities with policy makers, legislators, and administrators because of the need to close the increased gap between funding the Medicare Trust, health related expenditures, and insurance plan instability. Nurses remain uniquely situated to shape healthcare due to their team approach, proximity to the bedside, and understanding of patient care within the hospital and the community (Luther & Hart, 2014). Nurses can support the health of families and communities by serving as sources of much-needed information on how to access the health insurance coverage that the Affordable Care Act (ACA) offers.
The comprehensive health care reform bill and its revisions are often referred to as the “Affordable Care Act” (ACA). The law targets preventive care, health care expenses, and health insurance coverage. Since millions of Americans lacked health insurance before the Affordable Care Act, ACA aims to provide affordable, quality health care for all Americans (Michener, 2020). Pre-Existing conditions prevent some from obtaining health insurance but that all changed with the affordable care act. Because of a pre-existing medical condition, such as pregnancy or a chronic disease like diabetes or cancer, health insurers can no longer increase their rates or refuse to cover someone or their child.
References
Health Care. (n.d.). Affordable Care Act (ACA) – HealthCare.gov Glossary. Retrieved January 16, 2021, from https://www.healthcare.gov/glossary/affordable-care-act/
Luther, B. & Hart, S. (2014). What does the Affordable Care Act mean for nursing? Orthopaedic Nursing, 33(6), 305–309. doi:10.1097/NOR.0000000000000096
Replies
The U.S. Patient Protection and the Affordable Care Act was passed in the year 2010 to expand public health and the prevention programs to support individuals and communities. It helps in reducing costs and improving the quality of the existing healthcare system. The law aimed at ensuring that more uninsured Americans get more health insurance coverage (E., 2016). The law provided increased expansion of Medicaid to cover every person and established a Marketplace for Health Insurance.
Affordable Care Act came in to protect vulnerable Americans who could not afford affordable healthcare services. Insurance companies are not in a position to deny coverage to individuals due to pre-existing conditions. It involves plans to capture a list of real health benefits. Families with lower income can qualify for extra savings on insurance plans via cost-sharing discounts and premium tax credits.
In the United States, healthcare is a fundamental human right. The Affordable Care Act has ensured that all Americans have the chance of receiving the health care they need. Nurses are on the frontline in the advancement of healthcare delivery. They are the leading players in providing direct care to patients and evaluating the safety and quality of care offered to patients (Stimpfel A. W., 2019). Thus, nurses play a significant role in implementing the ACA law. Nurses are required to participate in healthcare reform at a personal, public, and nation-wide level. The nurses are also needed to be aware of the ACA law to educate patients regarding the provisions of ACA and elaborate the new aids to the patients to have access to health services and insurance coverage.
References
E., U. N. (2016). Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Health insurance coverage and the Affordable Care Act, 2010-2016.
Stimpfel A. W., D. M. (2019). Common predictors of nurse-reported quality of care and patient safety. Health Care Management Review, 57-66.
ACA was passed into law in 2010, with the goals of addressing preventative care, healthcare costs, as well as health insurance coverage. This legislation is composed of the HCER Act and the ACA. These two laws sought to decrease healthcare-related expenditures that impact both the federal government and the consumer, as well as increase American health insurance coverage (Ye & Rodriguez, 2021). In order to expand access to treatment, reduce costs, and enhance health outcomes, hospitals and primary care providers would be able to modify their business models under the ACA on a financial, technical, and clinical level. In 2014 we saw the expansion of Medicaid under the Affordable Care Act.
According to the U.S. DHHS, ACA has given health insurance to 31 million Americans (Ye & Rodriguez, 2021).
The most important elements of the ACA are the following: the removal of out-of-pocket costs for preventive care; the end of insurers’ capacity to reject inclusion to individuals with prior conditions; the raising of the age at which dependents can continue to be covered by their parents’ health insurance to 26; and the removal of lifetime insurance coverage caps.
Nurses must inform, promote, and support illness prevention and health promotion in order to maintain the wellbeing of patients and their families and reduce the cost of medical treatment. One way that nurses may continue to support and contribute to a healthcare system that is developing is via the creation of health policies (Zhang, 2021). Care managers, care coordinators, and informatics specialists are the nursing leadership roles providing direct interaction changes and proof-based mediations critical to assess and unequivocally report quality measures. By additional creating results and convincing structures to move quality and security drives, this results in cost decline.
Nurses consider their patients’ healthcare objectives and resources when considering if referrals to and consultations with other disciplines are required to provide high-quality treatment at an affordable price (Zhang, 2021). The multidisciplinary team, patients, and nurses must work together to create a unique, quality-driven, and patient-centered care plan. Nurses should raise their educational levels and acquire specialist certificates or licenses in order to deliver care that is based on the latest scientific research, improve quality, and lead effectively.
References
Ye, W., & Rodriguez, J. M. (2021). Highly vulnerable communities and the Affordable Care Act: Health insurance coverage effects, 2010-2018. SOCIAL SCIENCE & MEDICINE, 270. https://doiorg.lopes.idm.oclc.org/10.1016/j.socscimed.2021.113670
Zhang, X. (2021). Immigrants’ access to care under the Affordable Care Act: An examination of California. International Journal of Healthcare Management, 14(2), 335–344.
The Affordable Care Act (ACA) was brought into law in 2010. With the U.S. not having a central area to access health insurance, the ACA provided a central site to access standard government-regulated healthcare and private health plans (Green, 2018).
The most important ACA elements for the community and public health are to increase access to affordable healthcare insurance for everyone including those with preexisting chronic conditions and mental health issues, expand Medicaid program for all adults that have an income lower than 138 percent of the federal poverty level and to improve our healthcare delivery system with the goal of decreasing costs (HHS, 2022). With this law, the goal was to improve healthcare in the U.S. for everyone by increasing access, and quality of care. However, not all states have expanded the Medicaid program and costs of healthcare services are continually rising.
Nurses play a key role in implementation of this law by advocating for the public. Nurses have direct patient care experience and therefore can provide insight on what improvements need to be made (Nurse Journal, 2021). As a result, further education for all nurses is needed to improve health outcomes and prepare nurses to use their knowledge to get involved in policy and law making at the state and national level. Through nursing advocacy, the healthcare delivery systems can be improved.
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Green, Sue Z. (Ed). (2018). Community & public health: The future of health care. https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/
Nurse Journal (2021). Nurse Journal: The Nurse’s Guide to The Affordable Care Act. The Affordable Care Act and Nursing | NurseJournal.org
U.S. Department of Health and Human Services, HHS (2022). About the Affordable Care Act. About the ACA | HHS.gov
The Affordable Care Act (ACA) extends access to coverage for millions of Americans. Most research on the Affordable Care Act of 2010 (ACA) has focused on its objectives of reducing the nation’s uninsurance rate and improving access to medical care. The law has been quite successful in accomplishing these objectives: By the third quarter of 2016, the percentage of Americans lacking health coverage was at the lowest level ever recorded, and measures of access to care had improved substantially. Millions of Americans now have greater access to insurance thanks to the Affordable Care Act (ACA). The Affordable Care Act of 2010 (ACA) has received the most attention for its goals of lowering the nation’s uninsured rate and enhancing access to healthcare.
These goals have been pretty successfully attained by the law: By the third quarter of 2016, the proportion of Americans without health insurance had fallen to its lowest level ever seen, and indicators of access to care had significantly improved. Pre-existing condition coverage is a guarantee for people and families buying insurance in the individual market, and their premiums cannot change depending on their gender or medical history. Additionally, there will be subsidies to lower the cost of insurance, and new health insurance exchanges will make it easier for people to shop for the plans that best suit their needs. A law that focuses on eradicating health disparities, and inequities. Enhancing community health is the specific effort and overarching objective of public health (Chait & Glied, 2018).
Extended health care coverage is the most essential and crucial element of the ACA, which increases the demand for community health centers. More people have access to healthcare, which is essential for fostering the community’s health. The nurses in these facilities have a responsibility to deliver high-quality, secure care and to advocate for prevention over treatment. I also want to emphasize how crucial it is to emphasize preventative care. Public health and prevention received significant attention under the ACA. Prevention and Public Health provides public health budgetary flexibility and crucial funding for public health services. The ACA also addressed public health objectives in three different ways: It boosted access to clinical preventive treatments; created new incentives for prevention and wellness programs in the private sector; established new programs and structures that were centered on public health goals; and raised funding for already existing programs.
According to a recent study, the ACA has significantly reduced the coverage gap that had previously existed between U.S. citizens and non-citizen immigrants. Within three years of the Affordable Care Act, naturalized citizens, non-citizens with longer residency in the United States, and non-citizens with less residency in the United States were found to have a lower likelihood of being uninsured by 5.81%, 9.13%, and 8.23%, respectively. Additionally, there were also improvements in other measures of access and utilization (Bustamante et al., 2019).
The role nurses play in implementing the ACA’s preventative initiatives and ensuring improved quality and safety of care is crucial. Furthermore, they are responsible for educating people about the ACA and its provisions to promote the health of the community. Generally, low-income earners and uninsured individuals do not know about this coverage. A nurse’s role is to inform the public and mobilize healthcare providers to implement the law. As nurses, we can help consumers become more self-efficacious and independent in practicing health-promoting behavior by promoting health education and prevention strategies. Registered nurses have traditionally contributed to care coordination as part of their professional standards and competencies. It is what nurses do.
It is what we have always done. It is the nurses’ job to facilitate continuity of care for patients across settings and among providers, whether assisting with the development of care plans based on patients’ needs and preferences or educating patients and their families after discharge. However, public health nursing began with a focus on disease prevention and wellness. Nurses now advocate for ongoing legislative reform and environmental sustainability (Green, 2018). Millions of Americans are uninsured or lack healthcare access because of costs. Through advocacy, navigating care upon discharge to avoid rehospitalization for emergency services, and providing education about the ACA, nurses are in a position to turn health care in the United States from No. 11 to No. 1.
References:
Bustamante, A. V., Chen, J., McKenna, R. M., & Ortega, A. N. (2019). Health Care Access and Utilization Among U.S. Immigrants Before and After the Affordable Care Act. Journal of immigrant and minority health, 21(2), 211–218.
https://doi.org/10.1007/s10903-018-0741-6
Chait, N., & Glied, S. (2018). Promoting prevention under the Affordable Care Act. Annual Review of Public Health, 39(1), 507-524.
Green, S. Z. (2018). The environment, policy, and health effectiveness. In Community and public health: The future of health care.
https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/#/chapter/4
Embedded in the Affordable Care Act are three important goals. The first is to make health insurance affordable and available to more Americans where the law provides consumers with subsidies at a lower cost for households with income between 100 percent and 400 percent of the federal poverty line (HHS.gov). Second, for Medicaid programs to cover adults whose incomes are below 138 percent of the federal poverty line since not all states have expanded this program (HHS.gov).
Thirdly, to support innovation in medical care delivery methods that are designed to lower health care costs (HHS.gov). According to Jordan & Duckett (2014) in the Northwestern public health review, Affordable Care Act was designed to readjust and encourage the public health and health care systems to collaborate, and it focuses on insurance reform and health system reform with significant implications for public health. Among the important elements of ACA in relation to community and public health is the provision of preventive healthcare services. The Affordable Care Act makes provisions for prevention and public health funding which focuses on behavioral choices for individuals and social determinants of health.
According to Chait and Glied (2018), the ACA provided expansion of public health capacity by allocating funds specifically to improve public health laboratory capacity and this funding was distributed among all health departments in the fifty states.
The Act makes specific provisions for primary and secondary preventive measures such as immunization and regular screening for diseases that most health insurance plans are required to provide at no extra cost to plan members and they are not required to charge copays or coinsurance for these services.
Another provision of the ACA is the mandatory requirement by the Internal Revenue Service for all non-profit hospitals to perform a Community Health Needs Assessment (CHNA) every 3 years and give a report on their assessment and the extent to which they are addressing and meeting the needs of the community (Jordan. & Duckett, 2014).
Reference
Chait, N., & Glied, S. (2018). Promoting prevention under the affordable care act. Annual Review of Public Health, 39, 507-524.
https://www.hhs.gov/healthcare/about-the-aca/index.html
Jordan, N., & Duckett, P. (2014). The Affordable Care Act and Public Health. Public Health.
Topic 4 DQ 2: Affordable Care Act and Public Health
Public health encompasses the interventions individuals, governments, and societies apply to promote health. Optimal public/community health requires populations to be adequately protected from infections. As a result, awareness programs, community visits, and screening programs should be plenty at the community levels. Different populations should also afford and access health care services when needed to reduce illness transmission and mortality rates.
The Affordable Care Act (ACA) is integral to improving community and public health. It has many provisions, but the most relevant to the community and public health is the Prevention and Public Health Fund established under Section 4002 of the ACA. The Prevention and Public Health Fund is dedicated to improving public health by expanding and supporting investments in prevention and public health programs that improve health and restrain the rising health care costs (Centers for Disease Control and Prevention (CDC), 2021).
Such programs include promoting awareness, screening, educating providers, and community health visits. Health programs that support early detection and response to threats are part of the Prevention and Public Health Fund coverage. Prevention programs/preventive care facilitates early diagnosis and treatment and help to eradicate many diseases (Fowler et al., 2020; Levine et al., 2019). An informed populace is vital for the success of such programs hence community awareness.
Nurses can play a critical role in implementing the Prevention and Public Health Fund regulations. For instance, they can collaborate with the CDC on program support functions. Other roles include promoting awareness and helping individuals and communities to prioritize the early detection of illnesses. Nurses can also be involved in community programs that help people to respond to health threats and expand evidence-based care in the communities.
References
CDC. (2021). Prevention and Public Health Fund. https://www.cdc.gov/funding/pphf/index.html#:~:text=The%20Prevention%20and%20Public%20Health,our%20nation’s%20public%20health%20system.
Fowler, T., Garr, D., Mager, N. D. P., & Stanley, J. (2020). Enhancing primary care and preventive services through Interprofessional practice and education. Israel Journal of Health Policy Research, 9(1), 1-5. https://doi.org/10.1186%2Fs13584-020-00371-8
Levine, S., Malone, E., Lekiachvili, A., & Briss, P. (2019). Health care industry insights: why the use of preventive services is still low. Preventing Chronic Disease, 16. http://dx.doi.org/10.5888/pcd16.180625