Overview of healthcare policy
According to the WHO (2019), healthcare policy is defined as the decisions, plans, and actions that are undertaken to ensure that specific health objectives within a society are attained. An explicit healthcare policy outlines the priorities and accepted roles of different people. Problems arising in the clinical setting have their roots in policy issues and therefore, to resolve them, some of the regulations should be reevaluated. On one hand, healthcare policy can affect nursing. The nursing profession operates on a framework that holistically values health, therefore, to attain this objective, it is important to create policies that accurately define and integrate the standards required for the delivery of quality care. Moreover, health policies address conditions needed for quality care to occur, for instance, affecting resource allocation.
However, on the other hand, the nursing profession also influences health care policy through advocacy. Advocacy plays a crucial role in establishing robust health systems. It gives individuals a voice in making the decisions that affect their daily health and lives and holds the government responsible for ensuring that the health needs of all people are met, taking into account the marginalized groups (Chilton, 2015). Nurses engage in advocacy daily on behalf of their patients. In nursing practice, this signifies that nurses promote and endeavor to protect the rights, safety, and health of patients. Nursing practitioners, a type of advanced practice nurse, are elemental advocates for healthcare policy. This is because they possess the required educational background and clinical experience to satisfactorily pass legislation on healthcare issues (Chilton, 2015). Furthermore, NPs are at the forefront of healthcare; thus, they treat patients with specific health needs; thereby, they have a personal experience of how various policies impact particular patient populations.
Health Insurance Abortion Ban in South Dakota
Healthcare policies are created and exist at both the state and federal levels. In the past, state policymakers found ways to make abortion more challenging by restricting insurance coverage for the procedure. This move left many women lacking coverage for a critical reproductive health service. Medicaid is a federal-state partnership. Based on the Hyde Amendment, Medicaid cannot be used to fund abortion except in cases of rape, life endangerment, or incest (Government Accountability Office, 2019). However, the state of South Dakota has violated the Affordable Care Act policy by implementing a Health Insurance Abortion Ban that allows for Medicaid to cover abortion only in situations where the patient’s life is in danger. The state has been violated the law since 1994 (Government Accountability Office, 2019). This ban adversely impacts pregnant victims of rape and incest as they are left to cater for the abortion fees out-of-pocket, which sometimes might be expensive.
Paradoxically, the Central Medicaid Services (CMS) is aware of the situation in South Dakota, yet in 25 years, it has not taken any actions to ensure the state’s compliance. According to (Uniform Crime Reporting 2015), South Dakota is ranked second in rape cases in the country. For instance, as of 2015 and 2016, there we 95 and 107 rape cases, respectively. This number does not include incest and statutory rapes, and this shows how alarming the numbers are considering they are above the national average per capita. Consequentially, the vast rape case numbers suggest that there is a likelihood for a relatively higher proportion of female rape victims getting pregnant. Therefore, this indicates the urgent nature of the need for the state to encompass both rape and incest victims in the Medicaid cover. Moreover, the above research data illustrates the Health Insurance Abortion Ban, thus South Dakota’s policymakers ignore the driving factor, that is, the high number of rape cases, and instead focus on the aftermath, which is pregnancy. Under this policy, these two distinct scenarios go hand-in-hand; hence, none exists independent of the other.
Rape-related pregnancy is considered a public health problem in which sexual violence and reproductive health intersect. This is regarded as a double tragedy; hence, it might have tremendous adverse psychological implications on the victim. Moreover, the lack of Medicaid funding affects 75% of women in the low-income level from obtaining abortions (Roberts, Johns, Williams, Wingo, & Upadhyay, 2019). These out-of-pocket costs are estimated to be over one-third of the monthly income for half of these abortion patients (Roberts et al., 2019). Furthermore, it can be related to depression, suicide, and an increase in the number of families dependent on the state for living expenses.
The solution to the health policy concern
States are given the discretion to set Medicaid eligibility standards, rates of provider payment, identifying the scope, duration, and amount of covered benefits. They also have the power to decide how Medicaid-covered services to beneficiaries are to be delivered. The policymakers of South Dakota should strive to ensure that the Health Insurance Abortion ban is more inclusive by considering rape and incest-related pregnancies. This would be achieved through the CMS forcing South Dakota to comply with the federal law. Secondly, the CMS should ensure that states complying with the Medicaid law are adequately supplied with Mifeprex.
Lastly, the CMS should ensure that abortion is being reported properly, and funds are tracked. These moves would indeed have a positive outcome on the disadvantaged population. This is because the victims would not be obligated to pay out-of-pocket for a situation that they did not bring onto themselves, as the state will fund the procedure. Approximately 25% of those who would have had Medicaid-covered abortions end up giving birth when the cover is unavailable (Jones & Jerman, 2017). The public cost for prenatal care, welfare, and delivery services is five times the amount saved by not paying for Medicaid abortion.
The disadvantaged population, that is, victims of incest and rape-related pregnancies should present their complaints to local abortion-supporting organizations to present their grievances on their behalf to policymakers to approve the increase of Medicaid cover to abortion in rape and incest cases. If the solution is effectively implemented, factors such as the decrease in South Dakota’s economic burden through catering for children in the adoption program and decreasing reliance on low-income families on state funds.
However, several challenges can affect the implementation of the proposed solution. Since the health policy issue is a concern of both the CMS and South Dakota’s policymakers failing to perform their roles, the challenges in implementation might also arise from these two distinct realms. For instance, the CMS is aware that for the past 25 years, South Dakota is not compliant with enacted federal law. Therefore, it might be a challenge to confront them on why the CMS is allowing such and putting pressure on them to tighten its grip on South Dakota. The other problem is that South Dakota as a state has been trading for 25 years on a path in which rape and incest–related pregnancies are not funded by Medicaid. Hence it might be challenging to convince the policymakers to shift their point of view. These challenges seem imminent; therefore, the Planned Parenthood Federation of America should present in-depth research on the adverse effects of excluding rape and incest from Medicaid and be rigid on their stance.
The Planned Parenthood Federation of America
It is a non-profit organization that aims to provide high-quality and affordable healthcare to both the U.S. and global population. Therefore, in an attempt to fight for their rights, the disadvantaged community should approach Sarah Stoesz, the President, and CEO of Planned Parenthood in Minnesota, North Dakota, and South Dakota. She is the best candidate because she is the highest Planned Parenthood official in charge of South Dakota, and she is exceptionally talented and skilled. For instance, her efforts have been recognized by the Minnesota Business Magazine, which honors healthcare leaders in the state of Minnesota. For leaders to be recognized by the magazine, they have to have accelerated and supported the state through workplace innovations, business growth in the medical sector, and corporate philanthropy.
Moreover, Ms. Stoesz is a seasoned political advocate who successfully challenges and defends policies and laws to protect women’s health. She has made it her initiative to establish ground strategies to ensure that women of all incomes have access to quality reproductive and contraceptive care. She even led Planned Parenthood to several victories which included defeating balloting proposals to ban abortion and restrict access to contraceptives in Minnesota, South, and North Dakota. Therefore, the above illustrations of Ms. Stoesz’s involvement in the women reproductive advocacy board are intriguing and greatly justify her involvement in championing the lifting of the Health Insurance Abortion ban in South Dakota.
Conclusion
Healthcare policies are among the key elements affecting the delivery of health care. These policies are ever-evolving to suit the needs of all people, as the aim of any healthcare system is to provide equal and affordable care for all. Therefore, there are various stakeholders given the responsibility for advocating for the needs of specific patient populations. The primary health policy concern affecting the delivery of quality and care in South Dakota is the Health Insurance Abortion ban. This policy only allows abortion in cases where the life of the patient is endangered. Therefore, this disadvantages the victims of rape and incest-related pregnancies in the region. Moreover, by implementing this policy, South Dakota violated federal law. The victims of the Health Insurance Abortion ban can fight for their health rights by presenting their misfortune to a local abortion advocacy organization, which in this situation will be the Planned Parenthood Federation of America. The Planned Parenthood South Dakota office is managed by Ms. Sarah Stoesz, who seasonally advocates for women’s health. By partnering with an abortion advocacy organization, disadvantaged South Dakota Citizenry is more likely to win the case.
Moreover, by the state taking up the responsibility of funding rape-related pregnancies, policymakers will recognize other crucial problems affecting it, precisely the relatively high rate of rape and incest cases.
References
Chilton, L. (2015). Nurse practitioners have an essential role in health policy. The Journal for Nurse Practitioners, 11(2), 178-183.
Government Accountability Office. (2019). CMS action needed to ensure compliance with abortion coverage requirements.
Jones, R. K., & Jerman, J. (2017). Abortion incidence and service availability in the United States, 2014. Perspectives on Sexual and Reproductive Health, 49(1),17-27.
Planned Parenthood. (2019). Planned Parenthood CEO named health care executive of the year by Minnesota Business Magazine. Web.
Roberts, S., Johns, N., Williams, V., Wingo, E., & Upadhyay. (2019). Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion. BMC Women’s Health, 19(78),1-8.
Uniform Crime Reporting. (2015). State totals. Web.
WHO. (2019). Health policy.