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Affordable Care Act and Its Future Paradigm


Access to affordable healthcare has been an ongoing problem for the United States health system. Coverage options were expected to improve as a result of the Patient Protection and Affordable Care Act of 2011 (ACHE, 2016). Initially, the Affordable Care Act coverage was expected to extend Medicaid to thirty-two millions of uninsured people. However, the decision by the Supreme Court has reduced the number of newly covered individuals by stating that Medicaid is a state option.

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Healthcare reform has now reduced the number of uninsured and defined mandated benefits. The problem at this point is that access to affordable care is exacerbated by the limited community-based resources that provide preventative services, primary care access, and ongoing care for patients with chronic conditions (Orentlicher, 2014). With more people with coverage, expectations of what is covered and what is not are not clearly defined.

Lack of medical education and experience may lead to expectations that are not reasonable or possible medically. As discussed in Orentlicher (2014), outcomes may lead families and patients to have unreasonable expectations and false hopes of what the system can offer. The future paradigm of The Affordable Care Act intends to address the remaining issues to extend affordable medical help to all (Hood, 2012). The following paper will identify the main aspects of the issue of unaffordable healthcare based on the latest evidence provided in the scholarly sources and provide a position statement to support the proposed policy solution to the existing problem.

Identification of the Health Care Issue

The problem of unaffordable healthcare remains one of the most complicated ethical and legal issues in the U.S. healthcare system. Healthcare services in the USA are quite expensive compared to other countries around the globe, and according to the opinion stated by multiple specialists in the area, the prices are unjustifiably high (Sommers, Buchmueller, Decker, Carey, & Kronick, 2013).

The outcome is quite sad for millions of Americans, which can be seen from the following comment by ACHE (2016), “the U.S. Census Bureau report noted approximately 49 million Americans did not have healthcare coverage in 2011” (para. 1). In reality, these sad statistics means that millions of people go to the healthcare facility only when it is too late, and few chances to achieve the positive outcomes remain (Sommers et al., 2013).

Controversies in the legislative system make the problem more complicated because despite the efforts of the government to cover around 32 million of uninsured people more with the provisions made by the Affordable Care Act of 2011, the Supreme Court decision regarding assigning the state status for Medicaid has minimized the benefits of this historic decision made by Obama (Hood, 2012).

However, the scale of the problem of healthcare affordability is so large that even full implementation of the Affordable Care Act of 2011 will not cover the existing gaps. Addressing my position as for this complex issue, I fully agree with the vision expressed by ACHE (2016) in the following statement, “no person should be denied necessary healthcare services because of an inability to pay or a lack of accessible services” (para. 5). In addition, I support the point of view stated by ACHE that healthcare executives have a key role in helping the vulnerable populations acquire the healthcare assistance they need.

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Position Statement

The Universal Health Coverage Statement from the WHO declares the objective of over 500 leading health institutions around the globe to provide affordable and high-quality care for all (WHO, 2014). This view is not only consistent with medical ethics principles (Bodenheimer & Grumbach, 2012), its significance is also supported by the experience of vaccination, which can lead to the eradication of diseases like smallpox (Henderson, 2011) and generally creates a healthier population and safer environment (Andre et al., 2008; Davis & Walter, 2011).

Only high-quality care that is accessible for nearly everyone can yield such positive results, and the U.S. government is striving to share the vision of healthcare for all in the federal law regulating the health care affordability. Reflecting upon the situation in the U. S. healthcare, the definition of the Universal Health Coverage has much in common with the Affordable Healthcare Act objectives. However, evaluation of this act as well as other federal and state legislative norms regulating patients’ access to care along with the coverage issues demonstrates that the exalted objective of quality care for all is not yet realized in the U.S. Still, the situation definitely improved to a certain degree with the Affordable Healthcare Act of 2011 (Sommers et al., 2013).

Unfortunately, the success of the legislation is moderate because there are multiple issues still left. The remaining issues mostly relate to the vulnerable layers of the population without insurance coverage. In particular, the 1990s vaccination in the US that was aimed at combating measles outbreaks covered about 50% of the population, but resulted in noticeable disparities by race (with differences amounting to 8% coverage) and income (11%) (Davis & Walter, 2011, p. 873).

Evaluation of facts demonstrates that our society still has the room to improve in this area, and, of course, the health care professionals have a weighty role in these changes because they need to become its leaders. An example of such a successful health care agenda is the Vaccines for Children Program. Although its activities and the general governmental course for disparity reduction, in 2010, no more than 4% of disparities existed between racial minorities and economically disadvantaged children (Davis & Walter, 2011, p. 873).

Healthcare providers can also contribute to the policy-making as well as the direct improvement of healthcare. It is true that healthcare professionals do not have the legislative power to remove the disparities from the U.S. healthcare system. Nevertheless, they can make a change by becoming the leaders of change and participating in the legislative process as consultants, initiators of change, and active citizens who are not indifferent to the nation’s future (Sommers et al., 2013).

With respect to institutions, healthcare providers can and should be involved in quality improvement programs (Tuan, 2014). Finally, healthcare professionals need to maintain high standards in personal practice and promote the improvement of the quality of healthcare and quality of patients’ lives. For example, educating the patient and their family about care and treatment will continue to be shouldered by the nurses. Orentlicher (2014) has stated that nurses need to help patients clarify perceptions regarding the quality of life, and discuss not only how life might be extended, but also how the quality of life may be affected by various options. To sum up, the role of healthcare professionals in achieving the vision of high-quality care for all is crucial.

The Issue Implications to Nursing Informatics

Finally, addressing the implications of the issue under consideration to nursing informatics, it should be noted that this area of nursing has its exalted objective to optimize the process of using patient information to assist the healthcare providers in achieving the optimal patient outcomes and provision of cost-effective care (Collen & Walker, 2015). The role of nursing informatics professionals in solving the issues related to affordable care for all is in increasing their professional potential to continue to minimize the spending and thus ensure better access to care services by the economically-disadvantaged clients (Collen & Walker, 2015).

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In addition, it has been suggested that the healthcare costs can be dramatically reduced, which will make it affordable to the representatives of the vulnerable social layers, in case patients are kept out of hospitals provided that the wide scope of care services can be offered to them in their very communities with the use of modern informational technologies (Collen & Walker, 2015). At that, physicians and sometimes even family nurse practitioners will not need to travel to remote communities. For instance, follow up visits to the primary care providers to monitor the effectiveness of the proposed treatment regime and consult patients can be done with the use of distant communication technologies (Collen & Walker, 2015).

Finally, the quality, as well as efficiency and safety of healthcare and healthcare information exchange, appear to be able to benefit from the use of nursing informatics. For example, the Omaha System has been implemented in institutions all over the US has successfully fulfilled a number of aims. The latter included specifics ones (for example, the program has been used for the evaluation of home visiting programs and the engagement of senior patients in health promotion activities) as well as the goal of overall improvement of patient and community outcomes in a variety of settings and the improved flow of health information.

These outcomes were proved by a bulk of studies, including recent research and the evaluations that were carried out at the time of the program’s origin several decades ago (Martin, Monsen, & Bowles, 2011).

Given the fact that funding and efficiency are among the key issues that modern healthcare experiences (Bodenheimer & Grumbach, 2012), nursing informatics adoption and development are of primary importance.


In conclusion, it should be pointed out that the problem of unaffordable healthcare continues to be a burning issue for American society that needs effective policy-making in order to provide more people with an opportunity to lead a quality life and engage in health promotion activities. The healthcare reform has reduced the number of uninsured citizens and defined mandated benefits. The problem at this point is that access to affordable care is exacerbated by the limited community resources that provide preventative services, primary care access, and care for patients with chronic conditions.

Moreover, with more people covered, the expectations of what services are actually covered are not clearly defined. It is the task for nursing professionals to work with the community populations they are assigned to work with to educate people regarding the provisions that the Affordable Care Act has made possible for them and help them to benefit from the available resources to the highest possible extent. Healthcare professionals should not remain indifferent to the well-being of patients by active participation in the policy-making process with the purpose to eliminate the existing limitations. Therefore, the future paradigm of the Affordable Care Act is to ensure that there are no vulnerable population categories with little or no access to timely and quality healthcare.


American College of Healthcare Executives (ACHE). (2016). Access to Affordable Healthcare. Web.

Andre, F., Booy, R., Bock, H., Clemens, J., Datta, S., John, T., … Schmitt, T.J. (2008). Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of The World Health Organization, 86(2), 140-146. Web.

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Bodenheimer, T. & Grumbach, K. (2012). Understanding health policy. New York, NY: McGraw-Hill Medical.

Collen, M. F., & Walker, P. H. (2015). The history of medical informatics in the United States. London: Springer.

Davis, M. & Walter, J. (2011). Equality-in-quality in the era of the Affordable Care Act. The Journal Of The American Medical Association, 306(8), 872-873. Web.

Henderson, D. (2011). The eradication of smallpox – An overview of the past, present, and future. Vaccine, 29, 7-9. Web.

Hood, V. (2012). The present and future of the Affordable Care Act. American College of Physicians. Web.

Martin, K., Monsen, K., & Bowles, K. (2011). The Omaha System and Meaningful Use. CIN: Computers, Informatics, Nursing, 29(1), 52-58. Web.

Orentlicher, D. (2014). The future of The Affordable Care Act: Protecting economic health More than physical health? Houston Law Review, 51(4), 1-12.

Sommers, B. D., Buchmueller, T., Decker, S. L., Carey, C., & Kronick, R. (2013). The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Affairs, 32(1), 165-174.

Tuan, L.T. (2014). Clinical governance, corporate social responsibility, health service quality, and brand equity. Clinical Governance: An International Journal, 19(3), 215-234. Web.

World Health Organization (WHO). (2014). The Universal Health Coverage statement. Web.

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