Affordable Care Act (ACA) Population Health Policy Analysis

Affordable Care Act (ACA) Population Health Policy Analysis

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.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

 

Affordable Care Act (ACA) Population Health Policy Analysis

Population Health Policy Analysis

Introduction

Access to quality, comprehensive health services care is crucial to health promotion and maintenance,   disease management, and prevention of illnesses and the reduction of preventable disability and untimely deaths and the achievement of health equality for all people in the United States. The paper discusses a current health care policy intended to improve a particular population’s access to cost-effective and quality health care.

An explanation of the Policy

The Affordable Care Act (ACA) is a monumental health care legislation that was signed that was enacted in 2010.   The legislation intended to ensure more Americans had health insurance coverage and regulate the costs of health care services and improve the quality of the Country’s health care system.  The ACA majorly aimed at increasing coverage, and thus improving access to health care and at the end y improving health and reducing health disparities (Serakos & Wolfe, 2016).

How the Policy is Designed to Improve Cost-effectiveness and Health Equity for the Population

The ACA has several strategies to target diverse populations and make sure that more got covered. Young people can now stay on the insurance plans of their parents until they attain the age of 26.  Bigger employers are needed to provide comprehensive, affordable health time to employees who work full time. People without employer-sponsored insured are required to buy insurance individually or face a tax penalty. To help low-income families and individuals, the ACA expanded Medicaid eligibility to nonelderly individuals with a yearly income of 133% of FPL. These provisions aim to increase insurance coverage and also make insurance plans more affordable (French et al., 2016; Mclntyre & Song, 2019).

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The ACA has also reformed private insurance by imposing novel regulations on insurance firms and their policies. For instance, the ACA bans insurance firms from increasing the price of premiums for or decline to provide coverage to individuals with pre-existing medical conditions. Additionally, insurance policies are required to offer a bare minimum of preventive services without the requirement of cost-share (French et al, 2016) Affordable Care Act (ACA) Population Health Policy Analysis.

Is the Policy Financially Sound?

The ACA has led to increased coverage of millions of individuals and change the way health care is delivered. However, the policy seems not to be financially sound because it has led millions of people without coverage. According to Machikanti et al (2017), the majority of expansion under the ACA was based on the Medicaid expansion, which has not been working in favor of the middle and working-class who get less support, especially those earning over 400 percent of FPL. AS a result, enrollment to exchanges has been low, with the fraction of the employees getting health benefits from employers decreasing steadily.   These individuals are exposed to high premiums and huge out of cost expenses.

How the Policy Accounts for political and Legal Factors

The ACA accounts for numerous legal as well as political factors.  The legislation has endured numerous legislative challenges since it was passed. The House of Representatives has advanced more than fifty bills to revoke the entire ACA or some of its provisions, with the Senate voting in favor of some of them. The Trump administration has been undermining the law by making proposals to terminate financing or cost-sharing reductions and cutting funds directed towards enrollment outreach and education.  Also, the current government has given authority to states to modify their Medicaid programs in manners that could lead to reduced enrollment, for instance, by making it mandatory for disabled beneficiaries to work for them to be eligible for benefits (Mclntyre & Song, 2019).

The health policy has also faced legal battles, particularly concerning state Medicaid expansion. A key requirement of the ACA is for states to expand Medicaid to low-income individuals, which were seen as unconstitutional.  The 2012 ruling by the Supreme Court abates the power of the law to coerce states to expand Medicaid by offering states the choice of expanding Medicaid without the risk of losing federal funding (Callaghan & Jacobs, 2016; Mclntyre & Song, 2019). Another legal battle involves rolling back subsidies on the marketplaces.  Also, there is another ongoing litigation regarding regulations linked to contraceptive coverage (Mclntyre, & Song, 2019).

The Nursing Perceptive One Must Consider when Implementing the Policy

When implementing the ACA, nurses must provide quality and improve patient outcomes through care coordination. According to Cleveland et al (2019), in 2012, the hospital readmission reduction program was established under the ACA. The programs mandate hospitals to gather and file a report of the fraction of patients rehospitalized within thirty days following the discharge. It is deemed that lack of or poor coordinated care transitions and provision of poor quality care is the cause of high rates of readmission. Nurses can increase quality by assessing the healthcare resources and goals of the patient and recognizing the requirement for consultations and referrals with other specialists. As care coordinators or through direct care, nurses are essential in implementing the ACA and maximizing financial return Affordable Care Act (ACA) Population Health Policy Analysis.

The State, Federal and Global Goals the Policy is Related

The ACA is related to the federal, state, and global goals of enabling individuals to access health care services by expanding coverage and lessening of coverage and costs of health care services. Because the capability of a person to have access to health care services partly dependent on the accessibility of resources, insurance coverage immensely contributes to the accessibility as well as affordability of health care. The ACA increases the accessibility to health care by increasing the availability and affordability of health insurance and supporting states to expand their Medicaid programs by providing federal subsidies (Ruskin et al., 2016).

The ACA was well designed to achieve the aforementioned goals.  The ACA requires all people in the United States to possess health insurance and provides financial aid via cost-sharing reductions and tax credits and safeguards against medical bankruptcy. Also, the ACA imposes penalties for insurance firms who discriminate against individuals based on pre-existing conditions. The ACA created health insurance marketplaces that permit consumers to make comparisons of insurance options based on quality, benefits, and price. Also, the ACA seeks to ensure high-quality care ensuring accountability, promoting efficiency, and improving quality outcomes by emphasizing safety and prevention across healthcare settings (Ruskin et al., 2016).

According to Willison and Singer (2017), the ACA upgraded the scope and quality of coverage through making improvements in benefit design, entailing the implementation of the essential health benefits (EBHS). EHBS are minimum health benefits comprising of ten groupings of care, which must be covered by all small group and individuals plans, as well as marketplaces.

Around twenty million previously individuals have attained health insurance since the ACA was signed into law. This has in turn increased demand for health care services amid the surging shortage of health care providers in the country, including physicians and nurses. According to Potter et al (2017), the ACA impacts where and how nursing care is offered. More nursing services are required in community-based care settings.  Consequently, more nurses are required to practice in senior centers, schools, and community care centers. This requires nurses to be able to identify service gaps, assess for resources, and assist clients to receive care.

The Advocacy Strategies I would Employ on Behalf of My Population to ensure they have access to the Benefits of the Policy

As an advanced registered nurse, I can advocate for the training and employment of more nurses to increase the supply of nurses to ensure populations can benefit from the ACA.  I would also advocate for nurses to be allowed to practice autonomously because they can provide safe and quality care, and be acknowledged as full partners with doctors, Cleveland et al (2019) assert that eliminating obstacles to practice for nurse practitioners have enabled nurses to fully partner with doctors and other providers in most states.

From the Christian perspective, advanced registered nurses are morally and professionally obligated to engage in patient advocacy, promote health, and prevent diseases among diverse groups of individuals. Nurses have the responsibility can advocate the implementation of novel directions that will result in the promotion of health and prevention of disease among diverse populations regardless of their age, ethnicity, socioeconomic status, gender, and religion.  Nurses are inspired by the Bible to advocate as a scheme of fulfilling God’s command for them to seek justice. In Isaiah 1:17, the Bible directs individuals to seek justice and to break yokes of injustices (Isaiah, 58:6).  According to Cleveland et al (2019), Nurses constantly advocate for and offer life-sustaining and lifesaving care for fragile and vulnerable populations.  Nurses advocate for access to efficient, effective, and consistent health care for all individuals in society.

Conclusion

The ACA is an influential health care policy that expanded insurance coverage for Americans and reduced the costs of health care. designed with the key goal of increasing insurance coverage for vulnerable populations, the health policy has led to coverage of millions of Americans who were previously uninsured, including low-income individuals and people with chronic conditions as well as young adults Affordable Care Act (ACA) Population Health Policy Analysis. The ACA has increased availability and affordability of health insurance by supporting states to expand their Medicaid programs by providing federal subsidies The policy has also improved the quality of care by  establishing health care marketplaces which permit health care consumers to make comparisons of insurance options based on quality, benefits, and price

References

Callaghan, T., & Jacobs, L. R. (2016). Interest Group Conflict Over Medicaid Expansion: The Surprising Impact of Public Advocates.
American Journal of Public Health, 106
(2), 308-313. doi: 
10.2105/AJPH.2015.302943

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable Care: Harnessing Power of Nurses.
The Online Journal of Issues in Nursing, 24
(2), Manuscript 2.

French, M. T., Homer, J., Gumus, G., & Hickling, L. (2016). Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings
. Health Services   Research, 51
(5), 1735-1771. doi: 
10.1111/1475-6773.12511

Machikanti, L., Helm, S., Beyamin, R. M., & Hirsch, J. A. (2017). A Critical Analysis of Obamacare: Affordable Care or Insurance for Many and Coverage for Few. 
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(3), 111-138.

Mclntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and Directions at the close of a decade.
PLoS Medicine, 16
(2), e1002752. doi: 
10.1371/journal.pmed.1002752

Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2017).
Fundamentals of Nursing -E-BooK
.  New York: Elsevier Health Sciences.

Ruskin, K. J., Rosenbaum, S. H., & Stiegler, M. P. (2016).
Quality and Safety in Anesthesia and Perioperative Care.
  New York: Oxford University Press.

Serakos, M., & Wolfe, B. (2016). The ACA: Impacts on Health, Access, and Employment
.  Forum for Health Economics & Policy, 19
(2), 201-259. doi: 
10.1515/fhep-2015-0027

Willison, C. E., & Singer, P. M. (2017). Repealing the Affordable Care Act Essential Health benefits: Threats and Obstacles.
American Journal of Public Health, 107
(8), 1225-1226. doi: 
10.2105/AJPH.2017.303888
  Affordable Care Act (ACA) Population Health Policy Analysis