Effective evidence-based healthcare policies may improve nursing and patient outcomes by promoting safety and quality of care. As a major health policy, the Affordable Care Act demonstrates how political initiatives can transform healthcare (Laureate Education, 2016). The following discussion post will provide a detailed description of the Affordable Care Act, indicate its supporting and opposing aspects, and analyze its impact on lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) populations. The Affordable Care Act was first introduced on March 23, 2010, to expand health insurance coverage and access to Medicaid to previously uninsured people, including LGBTQ populations (Gaffney & McCormick, 2017). In 2016, the U.S. Department of Health and Human Services Office for Civil Rights issued a new rule guaranteeing nondiscrimination protections and insurance coverage for LGBTQ patients (Baker, 2016). The policy was introduced in response to the lack of affordable medical care for people with preexisting conditions and addresses inequality issues of previously uninsured populations. Additionally, the new rule aims to improve the understanding of the unique needs of diverse minority and LGBTQ patients.
It is important to examine the supporting and opposing aspects of the Affordable Care Act, its implementation, and its impact to understand the value of the policy and detect its deficiencies. On the one hand, the policy’s main supporting aspect is that it promotes healthcare affordability via a cost-effective insurance strategy. The implementation of the policy and the new rule allowed LGBTQ patients to gain access to quality healthcare and resulted in a decreasing number of uninsured LGBTQ adults (Gonzales & Henning-Smith, 2016). On the other hand, there is a considerable opposing aspect of the Affordable Care Act associated with its initiative for maximizing value in healthcare systems. The effect of value-based programs on equality in healthcare is unclear. However, several studies discovered bothering statistics of frequent hospital penalties following the implementation of the Hospital Readmission Reduction Programme (HRRP) and the Hospital Value-Based Purchasing (HVBP) (Gaffney & McCormick, 2017). The negative impact of the programs might be explained by the fact that they penalize safety-net hospitals for elevated readmission rates despite their lower 30-day mortality rates. Safety-net hospitals provide care for diverse patients, including the LGBTQ population, regardless of their insurance or financial status. To support nondiscriminatory healthcare, the policy should be adjusted to ensure fair measurement of hospital performance, especially in safety-net medical facilities.
Policies have a significant influence on clinical practice, as they provide patients with legal protection and nurses with appropriate standards of care. I experienced the impact of the Affordable Care Act during the encounter with a male-to-female transgender patient with a history of reoccurring UTIs, who was admitted to the emergency department and diagnosed with pyelonephritis. As an experienced nurse, I noticed that the patient was embarrassed and uncomfortable, so I asked about her concerns. I learned that while the new policy provided her with access to affordable insurance coverage, it did not prevent a judgmental attitude towards LGBTQ. Moreover, the medical staff did not understand the peculiarities of her transgender-specific anatomy and health issue. The case exposed the main problem of the policy, which guarantees nondiscrimination protection for LGBTQ populations in healthcare facilities but does not prevent hostility and abusive treatment of LGBTQ people. The policy does not emphasize the unique health problems and needs of transgender patients, which might create disparities in outcomes. Overall, the Affordable Care Act is a valuable policy that ensures financial protection for vulnerable populations, but it needs to be improved to eliminate psychological abuse and discrimination towards LGBTQ patients in clinical settings.
References
Baker, K. (2016). LGBT protections in Affordable Care Act Section 1557. Health Affairs.
Gaffney, A., & McCormick, D. (2017). The Affordable Care Act: Implications for health-care equity. The Lancet, 389(10077), 1442–1452.
Gonzales, G., & Herring-Smith, C. (2017). Coverage for lesbian, gay, and bisexual adults: Analysis of the behavioral risk factor surveillance system. LGBT Health, 4(1), 62–67. Web.
Laureate Education, Inc. (Producer). (2016). Advocacy through healthcare policy with Dr. Letitia Robinson [Video]. Author.