The Affordable Care Act

The Affordable Care Act (ACA) was signed into law in 2010. Its main objectives included enabling more citizens to access healthcare services through affordable insurance coverage. It also sought to expand the Medicaid program by covering more adults that fall within the specified income bracket. In addition, the act was created to assist with reducing healthcare costs through the support of innovative methods designed to deliver care. From a general perspective, the act was intended to ensure fairness, affordable health care, quality, and efficiency and ensure that individuals can access primary care effortlessly. Access to primary health care was designed to initiate long-term changes regarding preventive care (U.S. Centers for Medicare & Medicaid Services, 2021). Based on the intentions of the health care act, the government intended to initiate a positive change in USA’s health care system and ensure long-term effects manifested.

The process of expanding the Medicaid program, which was one of the objectives of ACA, encountered opposition from different quarters. One of the arguments claimed that the expansion was unnecessary as most of the individuals without health insurance overage could still access care. This assumption implied that the ACA could not improve healthcare access further. However, the ACA has effectively improved the number of people with health insurance. Newly insured individuals are more likely to access care faster without being burdened by high costs. By 2018, the ACA managed to reduce the uninsured proportion of the population from 15 to 8.5 percent of the population (Collins & Lambrew, 2019).

Before its implementation, the then president, Barrack Obama, had promoted using the act to reduce annual premiums by at least $2500. The estimate was based on the assumption that the ACA would save at least $200 billion each year. Such savings would be realized through the implementation of policies that would cut down the administrative expenses that insurers incurred and expand the application of information technology in health. In addition, the same policies were expected to expand the programs that were designed to prevent and manage chronic conditions. However, the National health expenditure analysis indicated that these savings were barely realized. On the contrary, healthcare spending increased from $2.6 trillion to $3.65 trillion over a period of eight years (Antos & Capretta, 2020). In relation to the national economy, healthcare allocations increased to 17.7 percent of the Gross Domestic Product over two presidential terms (Maddox, Bauchner, & Fontanarosa, 2019). These increments were attributed to the expansion, which included more families than those that were initially covered. In addition, new treatments and changes in varied factors that affected the health of the population also contributed to the growth in spending. Based on the data, ACA barely reduced health care spending in the country.

The expansion of the Medicaid program and retention of ACA is affected by numerous factors, namely political, legal, and ethical factors. In the same way, the implementation of any program, such as the ACA, affects these aspects. The ACA complies with the utilitarianism principle, which advocates for coverage of more citizens. Ensuring that individuals that are more vulnerable can access care under the ACA promotes beneficence. The program also promotes justice by ensuring that all willing individuals are covered. The promotion of such principles could portray ACA as a program that satisfies most ethical burdens and compromises. However, numerous principles of ethics remain unaddressed. One of these is the lack of equitable distribution of the gains, as the majority of uninsured lack coverage due to financial challenges. In addition, maintenance of the coverage increases the taxpayer’s financial burden, especially in cases of citizens who purchase the coverage but are unqualified for subsidies. In addition, coverage under ACA does not guarantee beneficiaries of access to healthcare. If a patient cannot locate a facility that is willing to offer care, the coverage leaves the patient unassisted. Geographical distance is one of the aspects that lead to this challenge (Field, 2015). The ACA allows access but does not fully facilitate the patients to obtain care from the existing facilities.

The ACA grants both state and federal governments a chance to participate in implementing the program to fulfil their mandate to the people. The federal government is expected to ensure that citizens with preexisting conditions receive protection. Individuals with incomes below 400 percent of the nation’s poverty level are entitled to equal financial assistance. The federal government is also expected to ensure that people receive coverage through their employers or personal mandate. On the other hand, the ACA expects the states to oversee the insurance markets, large or small. They are also expected to manage their Medicaid programs and establish their unique insurance marketplace. They should also ensure that individuals within 138 to 200 percent of the federal poverty level have a basic health plan. These activities should be conducted without increasing federal costs and must ensure affordability and availability for all. Different regulations, court decisions and guidance have further increased the role of state governments in implementing the ACA (Collins & Lambrew, 2019). Such extensions to the state governments are essential in ensuring that the policy attains the intended goals.

Telehealth is one of the strategies that could ensure that minority groups access the benefits of ACA. Telehealth is important because it ensures that patients access care and receive care from healthcare experts. Thus, it eliminates the geographical barriers that interfere with the process of accessing benefits. In addition, monitoring the patients in remote areas ensures that the ACA’s benefits trickle down to all populations. As a result, it maximizes the ACA’s benefits. Most importantly, the health workforce should be expanded to handle the new individuals who are now under the ACA. Some of the strategies to increase the healthcare workforce include the relaxation of immigrant laws and increasing residency opportunities (American Medical Association, 2021).

From a Christian perspective, registered nurses are responsible for ensuring that diverse populations receive care. As the Bible instructs, kindness is a critical virtue in serving others. In addition, healthcare workers are expected to deliver care to all populations who are in need and save lives. Thus, nurses are obliged both morally and professionally to offer preventive and primary care to patients from various populations. Such obligation maximizes the ability of healthcare programs such as the ACA to really benefit the registered population (Field, 2015). To improve the health programs, registered nurses in advanced job levels should advocate for beneficial changes that increase the programs’ efficiency.

References

American Medical Association. (2021). 5 ways to improve access to health care.

Antos, J. R., & Capretta, J. C. (2020). The ACA: Trillions? Yes. A Revolution? No.

Collins, S. R., & Lambrew, J. M. (2019). Federalism, the Affordable Care Act, and Health Reform in the 2020 Election. Retrieved from https://doi.org/10.26099/j3wp-e345

Field, R. I. (2015). The Ethics of Expanding Health Coverage through the Private Market. AMA Journal of Ethics, 17(7), 665-671.

Maddox, K. E., Bauchner, H., & Fontanarosa, P. B. (2019). US Health Policy—2020 and Beyond Introducing a New JAMA Series. Journal of the American Medical Association, 321(17), 1670-1672.

U.S. Centers for Medicare & Medicaid Services. (2021). Affordable Care Act (ACA). Retrieved from HealthCare.gov: https://www.healthcare.gov/glossary/affordable-care-act/

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The Affordable Care Act

Select a current or proposed health care policy that is designed to improve a specific population’s access to quality, cost-effective health care. In a paper of 1,000-1,250 words, include the following:

Explain the policy and how it is designed to improve cost-effectiveness and health care equity for the population. Is the policy financially sound? Why or why not?

How does the policy account for any relevant ethical, legal, and political factors and the nursing perceptive one must consider when implementing it?

To what state, federal, global health policies or goals is this particular policy related? How well do you think the policy is designed to achieve those goals?

Finally, discuss the advocacy strategies you would employ on behalf of your population to ensure they have access to the benefits of the policy.

Explain, from a Christian perspective, the professional and moral obligation of advanced registered nurse to advocate for and promote health and prevent disease among diverse populations.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

The paper should be written in APA format 7th edition