The specific provisions within The Affordable Care Act
The Affordable Care Act (ACA) considerably increased the coverage of federal medical insurance programs such as Medicaid; for instance, Medicaid was expanded to cover individuals who gain up to 138% of the federal level of poverty for persons aged <65. For others, health insurance also became more affordable. Also, providers of health insurance were forbidden to deny coverage or charge higher rates from individuals for any reason, such as health status, gender, etc. Also, employers (apart from small businesses) that do not provide health insurance for their workers are to be penalized, according to ACA (The Henry J. Kaiser Family Foundation, 2012).
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Generally speaking, the named provisions of ACA are aimed at expanding the health insurance coverage to supply a greater number of people with health insurance or enable them to more easily purchase one. Therefore, it might be possible to state that an important consequence of ACA will be an increase in the number of patients, which, therefore, will most likely lead to a shortage of nursing and medical personnel (Bradley University, 2016). As a result, the implementation of ACA might mean that nurses will have to care for a greater number of patients. This will increase the workload of nurses, and nurses might only be able to provide a limited amount of time for each patient. This might force nurses to choose less time-consuming methods of care provision.
To successfully face this challenge, it will be important for a nurse to select the methods of care provision that would require less time to carry out, but that would still be effective for delivering high-quality care. Nurses may also have to adopt time management techniques to be able to provide high-standard care for their patients and not to suffer from fatigue.
Florida policies on access to contraception and abortion for women with and without insurance
In Florida, access to abortion services is restricted. For instance, health plans that are provided in the state’s health exchange by ACA may only cover abortion in the cases when the life of the woman is at risk, or when the pregnancy resulted from rape or incest; otherwise, it is needed to buy an optional rider for abortion, which costs additional money (The Guttmacher Institute, 2017). As for uninsured individuals, public funding for abortions for such females is only provided when the woman’s life is endangered, or when the pregnancy resulted from incest or rape (The Guttmacher Institute, 2017). When it comes to contraception, it is stated that there have been attempts to forbid the provision of contraception under health insurance plans (Marcotte, 2016).
As for infant mortality rates, in 2015, three counties have statistically significantly lower than expected infant mortality rates, whereas five counties have statistically significantly greater than expected infant mortality rates (Hernandez & Macdonald, 2015, p. 4). When it comes to pregnancy-associated deaths (PAD) and pregnancy-related deaths (PRD), the exact numbers for the period 2006-2015 can be seen in Figure 1 below (Hernandez, Thompson, & Burch, 2015, p. 5).
It might be possible to hypothesize that the state policies hindering the access to contraception and abortions under health insurance plans may lead to a greater number of infant and maternal mortality rates, because females who wished to purchase contraception and/or undergo an abortion due to various reasons (e.g., medical condition that was not severe enough to warrant an abortion on time, or low income restricting access to proper living conditions), may have not been able to do so, eventually leading to the woman’s or the infant’s death.
As an advanced practice nurse and a nursing leader, one can address the issue by advocating for coverage of contraception and abortion under health insurance plans, permitting for more effectual family planning. This is related to the VI Essential of Master’s education in nursing, namely, “health policy and advocacy” (American Association of Colleges of Nursing, 2011, pp. 20-22), which stresses that nurses should be able to advocate for health care policy changes beneficial for the population.
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American Association of Colleges of Nursing. (2011). The essentials of a Master’s education in nursing. Web.
Bradley University. (2016). How the Affordable Care Act affected nursing. Web.
The Guttmacher Institute. (2017). State facts about abortion: Florida. Web.
The Henry J. Kaiser Family Foundation. (2012). Summary of coverage provisions in the Patient Protection and Affordable Care Act. Web.
Hernandez, L., & Macdonald, M. (2015). Florida’s infant mortality and low birth weight actual rate compared to expected rate by county: 2015 update. Web.
Hernandez, L., Thompson, A., & Burch, D. (2015). Florida’s pregnancy-associated mortality review: 2015 update. Web.