Affordable Care Act

Impact of Affordable Care Act on Health reforms and Nursing Practice
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Abstract
Lack of appropriate health insurance increases the risk and complications of various diseases. The “Affordable Care Act of 2010” (ACA) is one such provision for facilitating health insurance amongst U.S. citizens. The present article evaluated the benefits of ACA on healthcare reform and its implications on nursing practice. ACA has the potential to increase healthcare access and coverage amongst uninsured individuals. Hence, it would be helpful in reducing the incidence and complications of chronic diseases in uninsured individuals in the near future. ACA has kept enough provisions for advancing the roles and responsibilities of nurses. Nurses are recognized as key leaders in the reform of healthcare delivery under the ACA. ACA endorses that nurses should be ethically engaged in improving health and healthcare delivery amongst concerned stakeholders. Hence, nurses should be aware in accessing the opportunities provided in the Affordable Care Act of 2010. However, ACA has imposed limitations on financial opportunities for nurses practicing in Accountable Care Organizations (ACOs). Nevertheless, ACA provides adequate opportunities for nurses who are deployed in the U.S Healthcare system.
Introduction
Under the present perspective of rising healthcare costs, health insurance is essential for accessing safe and quality healthcare. Lack of appropriate health insurance increases the risk of different diseases and complications.

The burden of illness and cost burden of certain diseases are so high, which necessitates appropriate financial coverage. “Affordable Care Act of 2010” (ACA) or popularly called Obamacare is one such provision for facilitating health insurance for U.S. citizens. The Affordable Care Act has been recognized as one of the robust healthcare policies for ensuring safe and quality healthcare for U.S. irrespective of their financial background. ACA is estimated to have a deep impact on the healthcare scenario in the United States (Buerhaus et al., 2013).
Healthcare is an important attributed for ensuring optimum health of an individual. However, under the present perspective cost of quality healthcare is on the rise. For meeting the unforeseen healthcare costs, healthcare insurance is a necessity rather than a choice. Healthcare insurance not ensures financial support to healthcare consumers but equally ensures quality healthcare services. The ACA has certainly expanded and broadened the availability of healthcare services to around 32 million Americans. Previously, these individuals were not enrolled under any healthcare insurance scheme. Moreover, a state-based scheme (Health Benefit Exchange) would allow individuals to purchase private health insurances. However, individuals whose income is 400% or less of the FPL would qualify for the cost sharing subsidies. Premium tax credits are also extended to them for ensuring that the health insurance schemes become more affordable. The present article would evaluate the benefits of ACA on ensuring quality healthcare and its implications on nursing practice.
Impact of Affordable Healthcare Act on Healthcare Reform
Budden et al. (2015) evaluated the potential of ACA in improving diabetic care amongst U.S. citizens. The authors examined the demographics, healthcare expenditures, use of healthcare and access to appropriate care of diabetic adults within the age range of 19 years to 64 years. Data was accessed from the Medical Expenditure Panel Survey of 2011 and 2012. The authors compared the data between insured and uninsured individuals based on their income above and below 138% of the FPL (Federal Poverty Level). FPL is the threshold for eligibility for Medicaid under the ACA. The findings indicated that uninsured individuals have poor access to diabetic care than their insured counterparts (69% versus 89.5% at <138% FPL and 77.1% versus 94.6% at >138% of FPL, p <0.001). Insured individuals had significantly higher healthcare expenditures than their uninsured counterparts ($13,706 versus $4367, p<0.001). The authors concluded that ACA has the potential to increase healthcare access and coverage of uninsured individuals. ACA would be helpful in reducing the incidence and complications of diabetes mellitus in uninsured individuals in the near future.
Impact of Affordable Healthcare Act on Nursing Practice: Opportunities and Challenges
Nurses are an integral part of the healthcare delivery system and implementation of ACA would certainly impact their professional practice. Luther and Hart (2014) indicated that ACA provides enough provisions for advancing the roles and responsibilities of nurses. Nurses have been recognized as key leaders in the reform of healthcare delivery under the ACA. The policy endorses that nurses should be ethically engaged in improving health and healthcare delivery towards concerned stakeholders. The authors implicated that such provisions is a sign of Federal government’s recognition to the profession of nursing. However, nurses should be aware in accessing such opportunities in their practice settings (US Department of Health and Human Services health resources and Services administration, 2012).
Community health centers are important healthcare facilities that ensure primary and preventive care amongst U.S. citizens. Approximately, 16000 (including 4300 advanced practice nurses) nurses are deployed in these health centers. Since ACA has endorsed on expanding these facilities, numerous nursing positions (including positions for advanced practice nurses) would be created. The ACA has sanctioned $1.5 billion for the Maternal, Infant and Children home visitation program. Under this program, nurses and social workers are supposed to visit and offer healthcare counseling and interventions to concerned stakeholders for improving health outcomes (Ronnebaum E & Schmer, 2015).
On the other hand, ACA has placed limitations on financial opportunities for nurses practicing in Accountable Care Organizations (ACOs). ACOs are groups of healthcare professionals who act in a coordinated manner in ensuring high quality person-centric care in a cost-effective manner. Approximately, 3.1 million nurses in the United States are deployed in various ACOs. However, ACA recognizes primary care physicians only for ensuring health insurance for the beneficiaries. As a result, nursing practice through ACOs would become challenging under the perspective of ACA (Luther & Hart, 2014). Nevertheless, ACA provides adequate opportunities for nurses who are deployed in the U.S Healthcare system.
Implications of ACA on nursing professionals with DNP qualifications
The ACA endorses on the importance of preventive healthcare. Hence, ACA emphasizes on primary care, funds and supports community health initiatives and promotes safe and quality care. Such framework increases the need for qualified and competent healthcare professionals. The Advanced Practice Registration Nurses (APRN) backed by the DNP (Doctor of Nursing Practice) degree is competent to address such needs. Such professionals need to provide leadership in community health centers and must coordinate with interdisciplinary teams for improving patient outcomes (Lathrop & Hodnicki, 2014). These professionals should also advocate and direct future policy changes that would ensure positive health outcomes in patients. APRNs should partner with physicians and allied healthcare professionals in developing and implementing appropriate healthcare strategies. Such strategies would improve primary care services for ensuring safe and quality healthcare in patients (Lathrop & Hodnicki, 2014). APRNs holding the DNP degree are also required meet primary care services by utilizing technology and healthcare information systems. They would have a major role in improving healthcare delivery systems and measuring the outcomes of such systems (Lathrop & Hodnicki, 2014). Hence, ACA provides adequate opportunities for skilled professionals like APRNs.

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