NU506 Critique the Role of Nursing Advocacy in the Implementation of Health Policy

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Purdue University Globle 

NU506 Health Policy, Ethical, and Legal Perspectives of the Health Care System

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Critique the Role of Nursing Advocacy in the Implementation of Health Policy:

Nursing advocacy plays a vital role in protecting evidence-based healthcare policies, improving access to preventive services, and reducing health disparities. In the context of Kelley v. Becerra, nurses and advanced practice registered nurses (APRNs) are essential advocates because the case directly challenges preventive healthcare coverage requirements established under the Affordable Care Act (ACA). The outcome of this legal debate could influence whether millions of patients continue receiving preventive screenings, vaccinations, counseling services, and wellness visits without financial barriers. By combining clinical expertise, patient education, and policy engagement, nurses help ensure that healthcare decisions prioritize population health outcomes rather than solely economic considerations.

Preventive healthcare is a foundation of nursing practice because early identification and intervention can reduce complications, improve quality of life, and lower healthcare costs. Family nurse practitioners (FNPs), clinical nurse specialists (CNSs), and other APRNs are often the first healthcare professionals to recognize how policy changes affect patients at the community level. Their direct experience with individuals and families provides critical insight into the consequences of healthcare legislation and strengthens their ability to advocate for equitable policies.

Preventive healthcare policies supported by nursing advocacy improve patient access, promote early disease detection, and reduce healthcare inequities. The Kelley v. Becerra case demonstrates why nurses must actively participate in health policy discussions to protect evidence-based preventive services.

Understanding Kelley v. Becerra and Its Connection to the Affordable Care Act

The Affordable Care Act (ACA), enacted in 2010, introduced major healthcare reforms designed to increase insurance coverage, improve healthcare affordability, and expand access to preventive services. One of its most significant provisions requires many private health insurance plans to cover recommended preventive services without charging patients copayments, deductibles, or coinsurance.

These preventive services are based on recommendations from organizations such as the U.S. Preventive Services Task Force (USPSTF), which evaluates scientific evidence to determine whether specific screenings and interventions improve health outcomes.

Examples of ACA-covered preventive services include:

• Routine health screenings for conditions such as hypertension, diabetes, and cancer

• Immunizations recommended by public health authorities

• Preventive care visits for children and adolescents

• Prenatal and maternal health services

• Contraceptive counseling and services

• Wellness examinations and risk assessments

The preventive service requirement was created to remove financial barriers that often prevent individuals from seeking healthcare before symptoms appear. Research indicates that reducing cost-sharing improves access to preventive care, particularly among populations who may delay medical services because of financial concerns (Skopec & Banthin, 2022).

Legal Background of Kelley v. Becerra

Kelley v. Becerra challenges the federal government’s authority to require insurance coverage for certain preventive services recommended by expert advisory organizations. The plaintiffs argue that the government improperly assigned decision-making authority to independent organizations and that mandatory preventive coverage requirements create financial burdens for insurers.

The case raises important questions regarding:

• The authority of federal agencies in establishing healthcare requirements

• The role of expert medical organizations in determining preventive care standards

• The balance between healthcare regulation and insurance market flexibility

Supporters of the challenge argue that insurers should have greater control over benefit design and that federal requirements may increase healthcare expenses. However, opponents argue that eliminating guaranteed preventive coverage could create significant barriers for patients who depend on affordable access to screenings and early interventions.

A major concern is that reduced access to preventive services could lead to delayed diagnoses, increased disease severity, and higher healthcare expenditures over time. Preventive care often reduces the need for costly emergency interventions by identifying health risks before they become serious medical conditions.

Why Kelley v. Becerra Matters for Healthcare Policy

Health policy decisions influence how patients access care, how providers deliver services, and how healthcare systems allocate resources. The Kelley v. Becerra case demonstrates the connection between legal decisions and everyday clinical practice.

If preventive service coverage requirements are weakened, potential consequences may include:

• Increased patient out-of-pocket expenses

• Lower participation in routine screenings

• Delayed identification of chronic diseases

• Greater healthcare disparities among vulnerable populations

• Increased reliance on emergency healthcare services

Patients who may experience the greatest impact include:

• Low-income individuals and families

• Older adults requiring routine screenings

• Pregnant individuals needing prenatal services

• Children needing preventive wellness visits

• Patients at risk for chronic illnesses

For advanced practice nurses, these policy changes directly affect clinical responsibilities. APRNs frequently provide preventive services that depend on insurance accessibility, including health assessments, disease prevention counseling, and early intervention strategies.

The Role of Nursing Advocacy in Health Policy Implementation

Nursing advocacy extends beyond direct patient care. Nurses influence healthcare policy by using clinical knowledge, research evidence, and patient experiences to support decisions that improve health outcomes.

Unlike many healthcare professionals, nurses spend significant time interacting with patients, families, and communities. This continuous interaction allows nurses to recognize how healthcare policies affect real-world access, affordability, and quality of care.

Nursing advocacy in health policy involves:

• Promoting policies based on scientific evidence

• Supporting healthcare equity and accessibility

• Educating patients about available healthcare resources

• Communicating patient needs to policymakers

• Participating in professional nursing organizations

• Supporting legislation that improves population health outcomes

Advanced practice nurses are especially influential because they combine advanced clinical training with leadership responsibilities. Their ability to interpret research evidence and understand healthcare delivery systems allows them to contribute meaningfully to policy discussions.

How Advanced Practice Nurses Influence Preventive Healthcare Policy

Advanced practice registered nurses, including nurse practitioners, frequently serve as advocates for preventive healthcare because prevention is central to their scope of practice.

Nurse practitioners commonly provide:

• Blood pressure screening and cardiovascular risk assessments

• Diabetes prevention and management services

• Cancer screening recommendations

• Immunization counseling

• Reproductive healthcare services

• Health education and lifestyle counseling

• Chronic disease prevention strategies

When policies limit access to preventive services, APRNs often observe the consequences first-hand. Patients may postpone screenings, avoid follow-up appointments, or delay treatment because of increased costs.

For example, a patient who cannot afford a routine screening may receive a diagnosis only after symptoms become severe. This creates avoidable healthcare complications and increases treatment expenses. Nursing advocacy helps address these challenges by promoting policies that support early intervention.

Summary

Preventive healthcare coverage under the Affordable Care Act improves access to essential screenings, vaccinations, and wellness services by eliminating many financial barriers for patients. Nursing advocacy is critical in protecting these policies because nurses directly observe how healthcare regulations influence patient outcomes, healthcare equity, and community health.

How Kelley v. Becerra Could Affect Advanced Practice Nurses

Advanced practice nurses play a central role in preventive healthcare delivery, making them directly connected to the potential outcomes of Kelley v. Becerra. Nurse practitioners and other APRNs frequently provide services affected by preventive coverage policies, including screenings, health assessments, counseling, and disease prevention interventions.

If preventive service requirements established under the Affordable Care Act are weakened, patients may face increased financial barriers when accessing routine healthcare. These barriers could influence patient behaviors, healthcare utilization patterns, and overall population health outcomes.

For advanced practice nurses, potential impacts may include:

• Reduced patient participation in preventive screenings

• Increased rates of delayed diagnosis

• Greater difficulty managing chronic disease risks

• More healthcare visits related to preventable complications

• Increased challenges in addressing health disparities

Preventive care allows nurses to identify health concerns before they progress into complex conditions. For example, routine blood pressure screening can identify hypertension early, diabetes screening can detect metabolic risks before complications develop, and cancer screenings can improve early detection and treatment outcomes.

When patients avoid preventive services because of cost concerns, healthcare providers often encounter more advanced disease conditions requiring intensive treatment. This shift can increase healthcare costs while negatively affecting patient quality of life.

Impact on Population Health and Health Equity

One of the most significant concerns surrounding Kelley v. Becerra is the potential effect on healthcare equity. Preventive services are particularly important for populations that already experience healthcare access challenges.

Healthcare disparities often result from multiple factors, including:

• Income limitations

• Limited healthcare availability

• Transportation barriers

• Lack of health insurance coverage

• Lower access to health education resources

Removing protections that allow patients to receive preventive services without cost-sharing may disproportionately affect individuals who are least able to absorb additional healthcare expenses.

Nurses frequently work with vulnerable populations and understand how financial barriers influence healthcare decisions. Their advocacy helps ensure that health policies consider the needs of underserved communities rather than focusing only on economic outcomes.

Preventive Healthcare and Improved Patient Outcomes

Evidence-based preventive services contribute significantly to disease prevention and early intervention. The ACA preventive care requirements were designed to encourage patients to seek healthcare before serious conditions develop.

Examples of preventive services that support improved health outcomes include:

Research has demonstrated that removing financial barriers increases preventive healthcare utilization and supports better long-term health outcomes (Skopec & Banthin, 2022).

Reproductive Healthcare Implications

Preventive coverage requirements have also influenced access to reproductive healthcare services. Contraceptive services included under ACA preventive care provisions have contributed to improved access to family planning resources.

MacCallum-Bridges and Margerison (2020) found that expanded contraceptive access following ACA implementation was associated with changes in contraceptive use patterns and unintended pregnancy outcomes among women of reproductive age.

For nurse practitioners and women’s health providers, maintaining access to preventive reproductive healthcare services is essential for supporting:

• Healthy pregnancy planning

• Maternal health outcomes

• Patient autonomy

• Family health decision-making

Changes to preventive coverage policies could create additional barriers for patients seeking reproductive healthcare services.

Advantages and Disadvantages of the Kelley v. Becerra Outcome

Potential Advantages of Challenging Preventive Coverage Requirements

Supporters of Kelley v. Becerra argue that limiting federal preventive coverage requirements may provide greater flexibility within the healthcare system.

Potential advantages identified by supporters include:

• Increased flexibility for insurance companies when designing healthcare plans

• Reduced federal regulatory requirements

• Potential decreases in insurance-related administrative costs

From this perspective, insurers may have greater ability to determine which services they cover and how healthcare benefits are structured.

However, these potential benefits must be evaluated alongside the possible effects on patients, healthcare providers, and public health outcomes.

Potential Disadvantages for Patients and Healthcare Systems

Critics of weakening preventive coverage requirements argue that the negative consequences could outweigh potential financial benefits.

Possible disadvantages include:

• Increased healthcare expenses for patients

• Reduced use of preventive screenings

• Delayed identification of chronic illnesses

• Increased healthcare disparities

• Higher long-term medical costs

Although preventive services require upfront investment, they often reduce expensive healthcare interventions later. For example, identifying hypertension early can prevent complications such as stroke, kidney disease, and cardiovascular events.

Why Nursing Advocacy Is Essential in Health Policy Decisions

Nurses serve as a bridge between healthcare systems, patients, communities, and policymakers. Their clinical experiences provide valuable evidence about how healthcare policies influence patient outcomes.

Nursing advocacy is essential because nurses:

Support Evidence-Based Healthcare Policies

Healthcare decisions should be guided by scientific research and clinical evidence. Nurses advocate for policies that promote interventions proven to improve health outcomes.

Evidence-based preventive care helps reduce preventable illnesses, improve patient safety, and support healthier communities.

Protect Vulnerable Patient Populations

Nurses often care for populations most affected by healthcare access barriers. Advocacy allows nurses to represent patients who may have limited ability to influence policy decisions themselves.

Populations requiring strong preventive healthcare protections include:

• Children

• Older adults

• Pregnant individuals

• Patients with chronic disease risks

• Low-income communities

Promote Healthcare Equity

Health equity means ensuring individuals have fair opportunities to achieve optimal health outcomes. Affordable preventive care is a major component of reducing healthcare disparities.

Nurses contribute to health equity by advocating for policies that remove unnecessary barriers to healthcare access.

Improve Patient Health Literacy

Nurses educate patients about:

• Preventive screenings

• Vaccination benefits

• Disease prevention strategies

• Available healthcare resources

• Healthy lifestyle practices

Improved health literacy allows patients to make informed healthcare decisions and participate actively in their own care.

Summary

Advanced practice nurses are significantly affected by healthcare policies involving preventive services because their clinical practice depends on patients having access to screenings, vaccinations, counseling, and early interventions. Kelley v. Becerra highlights the importance of nursing advocacy in ensuring healthcare policies protect evidence-based preventive care and promote health equity.

Nursing Advocacy Strategies Related to Kelley v. Becerra

Nurses can influence healthcare policy through individual, organizational, and legislative advocacy efforts. Effective advocacy requires healthcare professionals to communicate evidence, share patient experiences, and participate in policy discussions.

Nurses can advocate by:

Participating in Professional Organizations

Membership in organizations such as nursing associations provides opportunities to influence healthcare legislation, participate in advocacy campaigns, and communicate nursing perspectives to policymakers.

Engaging With Policymakers

Nurses can share clinical experiences with elected officials to demonstrate how policy decisions affect patients and healthcare delivery.

Examples include:

• Writing policy letters

• Participating in legislative meetings

• Attending healthcare advocacy events

• Providing expert testimony when appropriate

Educating Patients and Communities

Patient education strengthens public understanding of healthcare policies. Nurses can explain how preventive services improve health outcomes and encourage patients to participate in healthcare advocacy.

Supporting Evidence-Based Research

Nurses contribute to healthcare improvement by conducting research, publishing findings, and sharing evidence related to preventive care effectiveness.

Policy Recommendations for Protecting Preventive Healthcare Access

To maintain access to essential preventive services, several policy approaches may strengthen healthcare protections while addressing legal concerns raised in Kelley v. Becerra.

Recommended strategies include:

• Maintaining coverage requirements for evidence-based preventive services

• Clearly defining federal authority related to preventive healthcare recommendations

• Strengthening collaboration between government agencies and healthcare experts

• Supporting continued investment in public health programs

• Ensuring healthcare policies consider vulnerable populations

Congressional clarification regarding preventive service authority could address legal concerns while preserving access to healthcare services that improve population health.

Conclusion

Kelley v. Becerra demonstrates the significant relationship between healthcare policy, preventive medicine, and nursing advocacy. Preventive services covered under the Affordable Care Act have improved access to screenings, vaccinations, counseling, and early interventions by reducing financial barriers for patients.

Nurses, particularly advanced practice nurses, play an essential role in protecting these healthcare benefits because they directly experience how policy decisions affect individuals and communities. Through advocacy, education, research, and professional engagement, nurses help ensure healthcare policies remain focused on evidence-based practice, patient safety, and health equity.

Protecting preventive healthcare access is not only a policy issue but also a public health priority. Nursing advocacy remains essential for creating healthcare systems that support prevention, improve outcomes, and reduce disparities.

Frequently Asked Questions

What is Kelley v. Becerra?

Kelley v. Becerra is a legal challenge involving the Affordable Care Act’s requirement that many private health insurance plans cover recommended preventive services without patient cost-sharing. The case questions the federal authority involved in establishing preventive healthcare coverage requirements.

Why are preventive services important in healthcare policy?

Preventive services help identify health risks early, prevent disease progression, reduce healthcare costs, and improve population health outcomes. Removing financial barriers encourages individuals to seek care before conditions become more serious.

How could Kelley v. Becerra affect nurse practitioners?

If preventive service coverage requirements are reduced, nurse practitioners may encounter more patients delaying screenings, vaccinations, and preventive visits due to increased costs. This could contribute to delayed diagnoses and worsening health outcomes.

What role do nurses play in healthcare policy advocacy?

Nurses advocate for healthcare policies by educating patients, communicating clinical experiences to policymakers, participating in professional organizations, supporting evidence-based legislation, and promoting healthcare equity.

Who would be most affected if preventive services require patient cost-sharing?

Populations most likely to experience negative effects include low-income individuals, children, pregnant patients, older adults, and individuals managing chronic disease risks because additional healthcare costs may discourage preventive care use.

How does nursing advocacy improve healthcare equity?

Nursing advocacy helps remove barriers to healthcare access by supporting policies that make preventive services affordable, available, and based on scientific evidence.

References

MacCallum-Bridges, C. L., & Margerison, C. E. (2020). The Affordable Care Act contraception mandate and unintended pregnancy in women of reproductive age: An analysis of the National Survey of Family Growth, 2008–2010 vs. 2013–2015. Contraception, 101(1), 34–39. https://doi.org/10.1016/j.contraception.2019.09.003

Patient Protection and Affordable Care Act, Pub. L. No. 111–148, 124 Stat. 119 (2010). https://www.congress.gov/bill/111th-congress/house-bill/3590

Skopec, L., & Banthin, J. (2022). Free preventive services improve access to care. Robert Wood Johnson Foundation. https://www.rwjf.org/en/library/research/2022/07/free-preventive-services-improve-access-to-care.html

U.S. Preventive Services Task Force. (2024). USPSTF A and B recommendations. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations