D223 Task 2 Final: Analyzing the Affordable Care Act and Its Impact

Student Name

Western Governors University

D223 Healthcare Policy and Economics

Prof. Name

Date

A1. Federal and State Public Healthcare Policy

What is a key federal healthcare policy affecting patient care and healthcare delivery?

A significant federal policy shaping healthcare delivery across the United States is the Affordable Care Act (ACA), enacted in 2010 during the Obama administration. Often referred to as “Obamacare,” this landmark legislation aims to improve healthcare accessibility, affordability, and quality nationwide. It introduced several transformative changes, such as expanding Medicaid eligibility for low-income populations, creating health insurance marketplaces, and mandating essential health benefits that insurance plans must cover.

The ACA also marked a pivotal shift away from traditional fee-for-service payment models toward value-based care, emphasizing preventive services, coordinated healthcare delivery, and better population health outcomes. These reforms strive to reduce disparities in healthcare access, lower overall costs, and ensure comprehensive, affordable coverage for all Americans.

What is an important Nevada state healthcare policy that impacts healthcare delivery?

At the state level, Nevada’s key healthcare policy initiative is Nevada Health Link, the state’s official health insurance marketplace established under the ACA framework. This online platform facilitates residents’ ability to compare, select, and enroll in health insurance plans tailored to their needs. It also offers income-based subsidies to make coverage affordable for low- and middle-income individuals and families.

Nevada Health Link’s objectives include lowering the uninsured rate, encouraging preventive health behaviors, and improving overall public health outcomes by making healthcare coverage more accessible and understandable. This marketplace aligns with Nevada’s broader mission to promote equitable and affordable healthcare for all residents.

A2. How Does Each Policy Work?

Affordable Care Act (ACA)

The ACA operates through a variety of integrated provisions designed to broaden coverage and improve healthcare quality. These mechanisms work collectively to create a more inclusive and patient-centered system.

Provision	Description
Individual Mandate	Initially required most Americans to have health insurance or pay a penalty; repealed in 2017.
Health Insurance Marketplaces	Created platforms for purchasing plans with income-based subsidies to make insurance affordable.
Medicaid Expansion	Broadened Medicaid eligibility to include more low-income adults.
Essential Health Benefits	Mandated coverage for services like preventive care, mental health, maternity, and prescriptions.
Pre-existing Condition Protections	Prevented insurance denial or premium increases based on health history.
Dependent Coverage Extension	Allowed young adults to stay on parents’ insurance until age 26.

These combined elements shift healthcare toward a preventive, coordinated, and equitable system focused on patient outcomes and access.

Nevada Health Link

Nevada Health Link simplifies access to ACA-compliant insurance plans for residents through an easy-to-use portal.

Feature	Function
Plan Comparison and Enrollment	Enables residents to compare plans based on price, benefits, and coverage levels.
Financial Assistance	Offers subsidies and tax credits to help reduce premium costs for eligible users.
Medicaid Screening	Assists in determining eligibility for Medicaid and other assistance programs.
Support Services	Provides navigators and call centers to guide users through plan selection and enrollment.

While participation in Nevada Health Link is voluntary, it plays a critical role in increasing insurance coverage by making enrollment straightforward and accessible.

A3. What Are the Impacts of Each Policy on Different Populations?

The ACA and Nevada Health Link affect various population groups in diverse ways. The table below summarizes key benefits, impacts, and challenges faced by these groups.

Population	Benefits from ACA and Nevada Health Link	How They Benefit	Potential Negative Impact	How They Are Impacted
Low-income individuals/families	Expanded Medicaid and subsidies increase affordable insurance access.	Lower premiums and access to preventive and chronic care.	In non-expansion states, many remain uninsured.	Experience gaps in coverage and limited affordable options.
Young adults	Coverage extended on parents’ plans until age 26.	Continuous insurance during education/career start.	Premiums may rise due to risk pool balancing.	Some forgo coverage due to costs or perceived lack of need.
Individuals with pre-existing conditions	Guaranteed insurance access without discrimination.	Stable treatment access and financial protection.	Premiums may increase to offset higher coverage costs.	Healthier individuals face slight cost increases.
Small employers	Incentives to offer employee insurance coverage.	Improved workforce retention and productivity.	Compliance and cost burdens can challenge small businesses.	May face financial strain or administrative challenges.
Vulnerable populations	Outreach promotes participation and reduces disparities.	Better health literacy and access to care.	Language, cultural, or technological barriers persist.	Difficulty navigating or effectively using benefits.

Overall, both policies advance health equity and preventive care, though ongoing efforts are necessary to address remaining gaps and barriers.

A4. What Evidence Supports These Policies?

The ACA was grounded in extensive evidence highlighting millions of uninsured Americans who deferred or lacked necessary care. Jacobson and Pilch (2019) confirm that ACA marketplace provisions effectively expanded affordable coverage, especially benefiting those with pre-existing conditions.

Nevada Health Link complements the ACA by tailoring access to the state’s specific demographic and economic context. The 2021 Senate Bill 420 (SB420) introduced a public insurance option to offer more affordable plans to residents ineligible for Medicaid or federal subsidies (Beerman, 2021).

Kelly (2019) further notes that increased insurance coverage correlates with improved chronic disease management, higher preventive service utilization, and overall public health gains, reinforcing the ethical imperative of universal healthcare access.

Do the Evidences Suggest Policy Modifications?

Despite successes, evidence points to persistent coverage gaps, especially among moderate-income individuals above Medicaid eligibility. Suggested policy enhancements include:

Expanding subsidy eligibility to cover moderate-income groups.
Increasing financial assistance for out-of-pocket costs.
Strengthening incentives for preventive care participation.
Addressing social determinants of health (e.g., housing, education).
Implementing robust cost-control measures to maintain affordability.

These reforms would bolster health equity, cost efficiency, and population health outcomes.

B. The Role of Nurses in Policy Development and Administration

Nurses play an essential role in shaping and administering healthcare policy, leveraging their clinical expertise and patient advocacy experience to influence healthcare reform.

Advocacy: Nurses promote equitable healthcare policies, uphold patient rights, and seek to improve care quality.
Expert Consultation: Their clinical insights inform policymakers about practical healthcare challenges.
Research and Evidence: Nurses contribute to policy by generating and interpreting relevant healthcare data.
Collaboration: Working with interdisciplinary teams strengthens policy impact and community outreach.
Education: Nurses educate legislators, patients, and the public about health policies and reforms.

At the federal level, nurses participate through national organizations, advisory boards, and advocacy campaigns. At the state level, nursing associations and professional networks engage with lawmakers to influence healthcare legislation.

B1. What Barriers Do Nurses Face in Policy Engagement?

Policy Area	Barriers
Development	Heavy workloads, limited policy education, and scarce access to legislative resources.
Administration	Organizational resistance, restricted authority, staffing shortages, and financial limits.
Revision	Political opposition, institutional inertia, and limited inclusion in policymaking.

B2. How Will I Engage with Healthcare Policy in My Future Nursing Practice?

Policy Area	Planned Engagement Strategies
Development	Advocate for nurse representation in policymaking, collaborate with advocacy groups, and utilize evidence to support fair healthcare policies.
Administration	Lead policy implementation efforts, monitor adherence, and foster interprofessional teamwork to ensure quality outcomes.
Revision	Encourage ongoing policy improvement through evidence-based advocacy, active stakeholder involvement, and education initiatives.

References

Beerman, L. (2021). Nevada’s public option continues healthcare’s cost versus coverage debate. Healthcare Leadership Review, 40(8), 6–8.

Jacobson, G. P., & Pilch, S. (2019). The Affordable Care Act (ACA): It gets personal, very quickly. Journal of the American Academy of Audiology, 30(8), 656–658. https://doi.org/10.3766/jaaa.30.8.1

D223 Task 2 Final: Analyzing the Affordable Care Act and Its Impact

Kelly, D. (2019). Why we need insurance coverage for all Americans. Journal of Oncology Navigation & Survivorship, 10(6), 244–246.