D223: Performance Assessment 2

Student Name

Western Governors University 

D223 Healthcare Policy and Economics

Prof. Name

Date

A1: Federal and State Public Healthcare Policy

Federal Policy: Tobacco 21 Act

The Tobacco 21 Act, enacted in December 2019, is a pivotal federal legislation that increases the minimum legal age to purchase tobacco products to 21 years. This law is primarily designed to reduce tobacco use among young people by limiting their access to tobacco products. By raising the purchase age, the act aims to prevent early initiation of smoking and decrease associated health risks, ultimately promoting better public health outcomes (Products, n.d.).

State Policy: Colorado’s Reproductive Health Equity Act (RHEA)

Passed in 2022, Colorado’s Reproductive Health Equity Act (RHEA), also known as House Bill 22-1279, guarantees individuals the right to use contraception and access abortion services without interference or discrimination. The law explicitly clarifies that fertilized eggs, embryos, and fetuses do not have legal rights under Colorado law. This provision is intended to protect reproductive autonomy and ensure equitable healthcare access without judgment or legal barriers related to pregnancy decisions (Reproductive Health Equity Act [RHEA], 2022).

A2: Public Healthcare Policy Process

A3: Policy Impact on Populations

Federal Policy: Tobacco 21 (T21)

Who benefits?
Youth under 21 years old and society as a whole benefit from this legislation.

How do they benefit?
By restricting access to tobacco products, the law helps prevent young people from starting smoking, leading to healthier long-term outcomes and decreased tobacco-related illnesses.

Who is negatively impacted?
Tobacco companies face negative effects due to reduced sales, especially among younger consumers.

How are they impacted?
The restriction decreases the number of new smokers, causing a decline in tobacco industry market growth and revenues.

Impact on health disparities and equity:
The T21 law promotes health equity by reducing tobacco-related diseases and lowering healthcare costs, which particularly benefits underserved and marginalized populations disproportionately affected by tobacco use.

State Policy: Colorado’s Reproductive Health Equity Act (RHEA)

Who benefits?
Women and individuals of reproductive age within Colorado.

How do they benefit?
They gain legal protections ensuring safe and discrimination-free access to contraceptive methods and abortion services.

Who is negatively impacted?
Groups opposing abortion and contraception on moral or religious grounds may find their advocacy efforts challenged.

How are they impacted?
These groups might experience social and political conflicts as their beliefs clash with the law’s provisions.

Impact on health disparities and equity:
RHEA advances reproductive health equity by removing legal, financial, and geographical barriers, facilitating timely and equal healthcare access.

A4: Evidence Informing Policy

Federal Policy: Tobacco 21

The Tobacco 21 Act aims to reduce youth smoking initiation. Evidence from California’s Tobacco Control Program demonstrated a significant drop in high school smoking rates—from 10% in 2016 to 2% in 2018—after similar tobacco age restrictions were implemented (Kim et al., 2021). According to the CDC, smoking remains the leading preventable cause of death in the U.S., contributing to extensive health and economic burdens (Centers for Disease Control and Prevention [CDC], 2021). Limiting tobacco access for youth is crucial for fostering healthier populations and reducing future healthcare costs.

State Policy: Reproductive Health Equity Act

After the 2022 Supreme Court decision overturning Roe v. Wade, states regained authority over abortion regulations (Berg & Woods, 2023). Colorado responded by enacting the RHEA to protect abortion access and reproductive rights within the state, ensuring legal and safe reproductive healthcare (Coen-Sanchez et al., 2022). This legislation reflects a strong commitment to reproductive autonomy in a changing national legal context.

A4A: Evidence Supporting Policy and Suggested Improvements

B: Role of Nurses in Policy Development

Nurses play a critical role in shaping healthcare policy at federal and state levels. Their direct care experience equips them with valuable insights into the healthcare system’s practical challenges. By participating in professional organizations such as the American Nurses Association (ANA), nurses advocate for priorities like safer nurse-to-patient ratios and improved working conditions.

At the state level, groups like the Colorado Nurses Association (CNA) empower nurses to engage in advocacy and policymaking. Through involvement in these organizations, nurses can influence local legislation and help promote policies that enhance both patient care and nursing practice.

B1: Barriers Nurses Face in Policy Development

Despite their importance, nurses face various obstacles when trying to impact healthcare policy:

• Lack of Training: Many nursing education programs inadequately prepare nurses for confident policy engagement.

• Resistance to Change: Some healthcare staff may resist policy changes due to concerns about increased workload or altered duties.

• Resource Limitations: Time constraints, insufficient funding, and staff shortages restrict nurses’ ability to gather evidence and advocate effectively.

• Rapid Healthcare Changes: Constant shifts in healthcare require adaptable policies, but outdated regulations often limit effective responses, underscoring the need for ongoing nurse involvement in policy reform.

B2: Nursing Engagement in Policy

This educational experience has motivated me to actively participate in all aspects of healthcare policy, from development to implementation and evaluation. I plan to join the Colorado Nurses Association to stay updated on legislation and collaborate with colleagues to advocate for positive changes. By working with compliance teams and policy committees, I aim to contribute evidence-based recommendations that enhance patient care and nursing practices. Every nurse’s input is vital, and I am dedicated to using my voice to support impactful healthcare reforms.

References

Berg, J. A., & Woods, N. F. (2023). Overturning Roe v. Wade: consequences for midlife women’s health and well-being. Women’s Midlife Health, 9(1), 2. https://doi.org/10.1186/s40695-022-00085-8

Centers for Disease Control and Prevention. (2021, October 29). Health effects of cigarette smoking. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

Centers for Disease Control and Prevention. (2023, May 26). State System Tobacco MLSA Fact Sheet. https://www.cdc.gov/statesystem/factsheets/mlsa/Minimum-Legal-Sales-Age.html

Coen-Sanchez, K., Ebenso, B., El-Mowafi, I. M., Berghs, M., Idriss-Wheeler, D., & Yaya, S. (2022). Repercussions of overturning Roe v. Wade for women across systems and beyond borders. Reproductive Health, 19(1), 184. https://doi.org/10.1186/s12978-022-01490-y

D223: Performance Assessment 2

Kim, S. C., Martinez, J. E., Liu, Y., & Friedman, T. C. (2021). US Tobacco 21 is paving the way for a tobacco endgame. Tobacco Use Insights, 14. https://doi.org/10.1177/1179173×211050396

Products, C. for T. (n.d.). Tobacco 21. U.S. Food and Drug Administration. https://www.fda.gov/tobacco-products/retail-sales-tobacco-products/tobacco-21

Reproductive Health Equity Act [RHEA]. (2022). Colorado General Assembly.