The Nurse’s Guide to the Affordable Care Act
The Affordable Care Act (ACA) brought a big change to healthcare in the United States. This guide discusses how the ACA affects nurses and the nursing shortage. When the ACA became law in 2010, it completely transformed the U.S. healthcare system. This affected how nurses and other healthcare professionals approached their work. This guide gives an overview of the ACA and looks at what it means for nurses. Experienced nurses share insights on how nursing roles are changing due to ongoing shifts in the American healthcare system. We’ll also explore what this means for your nursing career.
What is the Affordable Care Act (ACA)?
The ACA, often called “Obamacare,” was signed into law by former President Barack Obama in 2010. This law changed the entire healthcare system in the country. It aimed to reduce insurance costs and ensure that everyone in the U.S. had health insurance. The initial law required every family to have a healthcare plan, or they would face a penalty. The ACA introduced several other changes as well. It expanded access to Medicare, allowing individuals up to age 26 to remain on their parents’ healthcare plan. The law also provided subsidies to help low-income individuals with healthcare costs. Additionally, it prevented insurance companies from raising costs or denying coverage based on preexisting conditions. The ACA was rolled out over five years due to its complexity.
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The ACA and the 2020 & 2024 Presidential Election
As the 2020 presidential election approached, the fate of the ACA was uncertain. Each major party candidate had a clear stance on the ACA. Democratic candidate Joe Biden supported the ACA. He was Vice President under President Obama when the law was passed. Biden planned to strengthen and expand the ACA if elected. His campaign aimed to provide health insurance coverage for 97% of Americans. Biden’s healthcare proposal included creating a public health insurance option that individuals could choose if they didn’t want their employer’s plan. He also suggested increasing tax credits to lower insurance costs and expanding Medicaid access for low-income Americans, even in states that hadn’t expanded Medicaid.
President Donald Trump, in contrast, opposed the ACA during his presidency. His administration tried to undo the ACA and its policies. For instance, he eliminated the ACA’s individual mandate requirement. Heading into the 2020 election, President Trump continued to push for repealing the ACA. He asked the Supreme Court to overturn it, although the court wouldn’t hear arguments until November.
Impact of the Affordable Care Act on Healthcare
The ACA achieved many of its goals. Federal funding helped states expand Medicare, with 37 states doing so after the ACA passed. Those without employer-based insurance could buy coverage from private marketplaces, and insurance companies couldn’t charge more due to preexisting conditions. The law stabilized premiums and led to reduced costs.
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One contentious aspect of the ACA was the individual mandate, which required people to have insurance or pay a penalty. The idea was that having healthy individuals and those with health risks in the same insurance pool would keep costs lower. This helped prevent significant cost increases for older individuals or those with chronic conditions.
Effects of the Affordable Care Act on Healthcare Quality
With increased access to healthcare due to the ACA, the quality of care has improved. More chronic health conditions, including behavioral and mental health disorders, are covered by health insurance. Preventive care is a significant outcome of the ACA. More people take steps to maintain their health before falling ill. This means fewer emergencies and preventable deaths, easing the burden on healthcare systems. The Medicare payment system also shifted to value-based care. Payments are tied to care quality – better care quality leads to higher payments.
Impact of the Affordable Care Act on Nursing
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The ACA’s focus on outcomes means more pressure on nurses to provide effective care. This has led to a higher demand for advanced practice nurses (APNs) and nurse practitioners (NPs). NPs require advanced education, leading to better patient outcomes compared to other nurses.
Higher education levels also benefit nurses’ work. While individuals can become registered nurses (RNs) with an associate or bachelor’s degree, the Institute of Medicine recommends that at least 80% of nurses hold a bachelor’s degree by 2025.
Growing Demand for Nurses
Even before the ACA, the U.S. faced a nursing shortage – more nurses were needed than available. As the ACA increased the number of people with Medicare coverage, the demand for healthcare grew, increasing the need for nurses. However, this demand also has drawbacks, including nurse burnout due to long hours and inadequate nurse-to-patient ratios. Some propose measures like universal healthcare, but this could worsen the nursing and physician shortage.
The Future of the ACA
Although the ACA has been implemented, it’s a work in progress. While it succeeded in insuring more Americans and reducing insurance premiums, there are challenges beyond the individual mandate’s repeal. About 45% of people remain underinsured, and some progress, such as reducing medical bill struggles, has stalled.
The individual mandate was controversial, requiring citizens to have insurance or pay a penalty. Congress repealed it during the Trump administration. The ACA’s future remains uncertain and may depend on the political party in power.
Nurses’ Role in Shaping Healthcare Reforms
Nurses have a unique view of the healthcare industry, as they care for patients and handle medical records and insurance systems. “Nurses have a special bedside perspective on healthcare and, as a significant healthcare profession, they can make an impact in healthcare politics,” says Deborah Weatherspoon, an advanced practice nurse and nurse educator.
Nursing professionals can advocate and take political action to improve the healthcare industry. Joining state associations or the American Nurses Association, which include political action, can make a difference. These groups hold advocacy events where nurses campaign for their causes in state legislatures.
As a Nurse, Your Vote Matters
Nurses have a distinct perspective on the healthcare system. Voting is a way for nurses to use their knowledge to improve the system. The 2020 election is an opportunity to shape the future of U.S. healthcare. With their numbers, nurses can make a significant impact. “The nursing profession is over three times the number of physicians in the U.S.,” says Weatherspoon. “It’s time our collective voice is heard and respected for our healthcare knowledge.”
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