The Affordable Care Act (ACA) that was enacted in 2010 and proposed making healthcare affordable to all Americans. While the debate in society is still present, the role of the ACA on Advanced Practice Registered Nurses (APRN) is another controversial point. On the one hand, they are encouraged to practice their knowledge and skills to the extent that should help patients to recover. On the other hand, they should follow the federal policies in their practice. In general, the ACA makes a positive impact on the role of APRNs by increasing their education funding and supporting their development as professionals.
The rapidly growing population morbidity and physical shortage caused an increasing demand for APRNs. Therefore, Congress accepted the idea of primary care to be provided by nurses. One of the main benefits of such a decision was the Medicare Graduate Nurse Education (GNE) Demonstration to support training and education to equip nurse practitioners with relevant professional skills (Fisher, 2019). The Centers for Medicare and Medicaid Services also launched additional funding. The other useful provision of the ACA was the National Health Services Corps (NHSCs) program that offers scholarship and loyal repayment. In addition, there are nurse-managed health centers (NMHCs) and federally qualified health centers (FQHCs) that provide affordable and systematic care (Robert Wood Johnson Foundation, 2015). In other words, the ACA created more well-paid employment and education opportunities for APRNs.
If the ACA repealed, the US healthcare system would change dramatically. In particular, many patients with low income will turn out to be uninsured, without the opportunity to receive necessary care. As stated by Nuzum, Coleman, and McIntosh (2019), the level of uninsured persons decreased by nine percent from 2010 to 2014. Moreover, some states expanded the ACA to up to 138 percent of poverty rate at the federal level (Nuzum et al., 2019). The abolition of the ACA will also significantly increase unemployment rates among APRNs since their services would not be required. Considering that the groups that are covered by the ACA include people with disabilities, pregnant women, and patients with chronic diseases, the costs of care are higher for them. In this connection, the expansion of ACA will lead to considerable state savings. In their turn, nurse practitioners will also benefit from increased funding that will be allocated for educational, equipment, and a comprehensive care approach.
The contemporary debates regarding the ACA expansion and repeal are also associated with considering healthcare as a right or privilege. On the one hand, it is evident that the current format of ACA cannot ensure that all the people receive timely and proper care. On the other hand, it allowed for transforming the previous state of the national healthcare system. According to the health transformation proposed by the American Nurses Association (ANA), there is a need to provide universal access to a standard package of services, offering community-based and preventive services (“Health system transformation”, 2019). Consistent with this proposal, every person in the US should have a right to receive this package and maintain his or her health. O’Rourke (2017) mentions that healthcare should be regarded as a societal responsibility, and the principle of primum non nocere should be applied, which means that patients’ well-being is of primary importance. Thus, healthcare should be recognized as a fundamental human right, which can be based on a new Medicare for All program to be cost-effective and affordable.
References
Fisher, S. (2019). Medicare for all: Definition and pros and cons.
Health system transformation. (2019).
Nuzum, R., Coleman, A., & McIntosh, A. (2019). Medicaid expansion in Florida: Budget buster or deal of the century?
O’Rourke, T. W. (2017). Lost in the health care reform discussion: Health care as a right or privilege. American Journal of Health Education, 48(3), 138-141.
Robert Wood Johnson Foundation. (2015). Study explores impact of ACA on nurse practitioners.