The Affordable Care Act (ACA) was mainly created to provide a solution to the healthcare system in the U.S. It is almost reaching its full implementations after several amendments. This paper summarizes thoughts about the Affordable Care Act (ACA) reflecting on what makes it a divisive issue both economically and politically and whether ACA is achieving its intended goal as passed in 2010. The paper also discusses three new nursing roles and opportunities that are evolving under the healthcare reform including ways in which nurses can position themselves to improve healthcare and drive policy. Lastly, the paper fully discusses the legislator’s position on the ACA and healthcare reform, the challenges involved in healthcare reform, and shares new information regarding new proposals to replace or amend Obama Care.
ACA, its Political and Economic issues
The ACA, also known as Obama Care, was created in 2010 by President Barrack Obama to reduce the number of uninsured people in the U.S. and expand people’s access to healthcare by making medical coverage more affordable (Courtemanche et al., 2017). Hilliard et al. (2018) further point out that the Act expanded the Medicaid program and formed new market places allowing people who lack employer coverage to buy policies direct from insurers. The ACA also approved new techniques aimed at improving healthcare quality and reducing costs through ways like less hospital payments to some Medicare services.
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Apart from that, the Act experimented new delivery and payment models aimed at providing affordable healthcare services to all Americans. However, the Act has made several political and economic impacts (Frazier, 2016). Political issues of the ACA include the idea that most people do not trust the government to control healthcare provision for the entire country since they prefer seeking medical attention from the private faculties which they trust in terms of quality delivery (Hilliard et al., 2018). According to Brown (2018), economic issues of the initiative include the funding extent to which the initiative has gone to provide healthcare services to low-income families as most people think that it still needs more efforts.
Goals of the ACA since 2010
The main aim of ACA as was formed in 2010 was to provide medical coverage to more Americans especially those in low-income families. Since 2010, Frazier (2016) states that more than 20 million American citizens are insured thanks to the law. The Act has also managed to make most Americans more secure financially especially when it comes to health-related financial shocks (Berkowitz, 2017). However the mission to enhance the affordability of health care in the U.S. has not been fully successful. Affordability the healthcare in the U.S. is still expensive compared to that of other countries globally hence out for reach for most American citizens.
New Nursing roles and opportunities evolving with the Healthcare Reform
The healthcare reform has led to the need for nurses to shift from provider-based and episodic context to patient-centered and team-based care focusing on quality and affordable healthcare (Courtemanche et al., 2017). First, attending registered nurses (ARN) have been created and their role involves building a relationship with the patient and ensuring that every health care team members of the patient follows the shared care plan (Frazier, 2016). Advance practice registered nurses (APRN) were also created and their roles include independent opening and operation of primary care clinics that are nurse-led without supervision from physicians (Combe et al., 2015). Moreover, Patient Alienated Care Teams (PACT) have also been created and it involves a team of nurses aimed at conducting in person long term car.
Ways in which nurses can position themselves to improve healthcare and drive policy
Nurses play a big role in implementing any healthcare policy since they are always in direct contact with patients in the healthcare system. They can position themselves to drive change in several ways. In the first place, nurses should ensure that patient outcomes in the healthcare system are improved (Berkowitz, 2017). This improvement in patient outcome is mainly related to the nurse’s professional and communication skills practiced during service delivery hence improving patient health and healthcare at large (Combe et al., 2015). Nurses can also effectively engage in the transition process in efforts to drive the policy. Nurses can take the new roles and responsibility effectively and make great efforts to implement the policy under the new roles.
Todd Young’s s position on healthcare reform and the ACA as Indiana Senator
Legislators are important in implementing the health reform policy and enhancing its progress. Todd Young is my senator and his position on health reform and the ACA involves implementation of the Act which can be done through creation of delivery systems and Health Insurance Marketplaces for purchase by state members (Courtemanche et al., 2017). Young and his office is also responsible for modifying the rates paid by patients receiving the ACA program including the provision of services relating to Medicare services at low costs within the state. Young’s position also mandates him to modify the Affordable Care Act provisions appropriately to enhance healthcare delivery to state members basing on rational measures and regulations that are at per with the requirements of state members.
Challenges of the Healthcare Reform
The implementation of healthcare reforms has faced several challenges since it was formed in 2010. Up to date, the healthcare reform is yet to fully materialize since insurance costs are still rising in some markets (Berkowitz, 2017). This is a huge challenge since the primary aim of the Act was to reduce the costs for healthcare coverage. This has led to several debates regarding the feasibility of the initiative by Republicans who view it as expensive and wasteful.
Apart from lack of full materialization, the healthcare reform also lacks transparency in pricing hence making it hard for patients to effectively bargain during end-of-life situations. According to Combe et al. (2015), the lack of transparency in pricing is mainly attributed to the creation of the free market allowing the research and development of new medical products by independent bodies that conceal the general prices.
Lastly, early policies led to construction of many hospitals which are now empty. According to Berkowitz (2017), the hospitals need the beds to be filled to cover employee costs by generating payments from insurers. This creates room for underserved markets and the government will have to most of the hospitals and move the care to clinics near community centers (Courtemanche et al., 2017). This may be challenging and may spark debates on the effective feasibility of the policy.
New proposals to amend Obama Care
To amend Obama Care, tax credit subsidies will have to be modified to allow more people to access health services at affordable prices. The market regulations should also be revisited since allowing a free market in the healthcare system will bring in more confusion similar to what it was before the Affordable Care Act (Hilliard et al., 2018). Lastly, Medicaid expansion should be modified to carter for more Americans especially those from low-income families (Courtemanche et al., 2017). When the given proposals are followed to the latter, the Obama Care will be in a good position to offer quality and affordable healthcare programs to more Americans.
Conclusion
Generally speaking, the Affordable Care Act was formed in 2010 by President Barack Obama to provide healthcare coverage to more Americans. Its implementation has since sparked economic and political debated regarding its feasibility. However, several amendments such as modifying of Medicaid expansion can help in addressing issues regarding the number of people it covers.
References
Berkowitz, E. (2017). Getting to the Affordable Care Act. Journal of Policy History , 29 (4), 519–542. https://doi.org/10.1017/S0898030617000252
Brown, E. C. F. (2018). Health Reform and Theories of Cost Control. Journal of Law, Medicine & Ethics , 46 (4), 846–856. https://doi.org/10.1177/1073110518821978
Combe, L. G., Sharpe, S., Feeser, C. J., Ondeck, L., Fekaris, N., & National Association of School Nurses. (2015). The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement . National Association of School Nurses (NASN) . National Association of School Nurses (NASN).
Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2017). Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States. Journal of Policy Analysis & Management , 36 (1), 178–210. https://doi.org/10.1002/pam.21961
Frazier, L. A. (2016). More than the Affordable Care Act: Topics and Themes in Health Policy Research. Policy Studies Journal , 44 , S70–S97. https://doi.org/10.1111/psj.12160
Hilliard, J. I., Liebenberg, A. P., Liebenberg, I. A., & Ruhland, J. (2018). The Market Impact of the Supreme Court Decision Regarding the Patient Protection and Affordable Care Act: Evidence from the Health Insurance Industry. Journal of Insurance Issues , 41 (2), 135–167.
