Introduction
Obamacare, or The Affordable Care Act (ACA), is one of the most prominent health care policies in the United States because disputes over its advantages and disadvantages last for years. This policy has made health insurance more accessible and has covered a more significant part of the population that previously could not afford the necessary medical services. People with low income, chronic illnesses, and mental disorders experienced most of the problems since companies did not provide them with insurance. Today, the ACA still has flaws that policy opponents use to justify the need for its elimination and promotion of other insurance policies that do not cover mental health services. Consequently, although Obamacare has positively impacted mental health and substance abuse treatment, its flaws, along with the action of its opponents, threaten to reduce progress and eliminate previous improvements in this field of health care.
The Effects of the Affordable Care Act (ACA)
The American health insurance system is based on a network of private companies that cover the costs of their clients. At the same time, the prices of medical services are very high, which puts people who are denied insurance companies in a hopeless position. This situation was common for the United States, as most Americans did not have insurance due to company denials. However, The Affordable Care Act (ACA), signed by the Obama administration, made healthcare more affordable by increasing the benefits for low-income populations and expanding the list of services covered by insurance. One of the most noticeable and significant changes was the introduction of the prevention and treatment of mental and behavioral problems, including substance abuse, into this list.
Before the adoption of the ACA, people with mental health problems could not get insurance because companies refused them. This situation has led to severe consequences and a high level of deaths due to suicides or overdose (Abraham et al., 2017). At the same time, many people with mental problems could not get counseling, treatment, and medication to control their condition. However, the ACA has covered both categories of people and problems. First, since 2014, all individual and insurance plans should include services for treating mental health and drug or alcohol addiction. These changes also contribute to the treatment and prevention of substance abuse and cover consultations with a therapist to overcome emotional problems and avoid severe mental issues (Norris, 2018). Second, the ACA has made insurance reduce insurance costs for low-income populations, which are typically more prone to abuse and mental issues. The abolition of the lifetime limit, or the maximum amount of money allocated by insurance to cover medical expenses during life, also is a significant positive change. (Norris, 2018). Consequently, the ACA has affected a considerable part of the population by enabling them to remain healthy.
An Impact of the ACA on Advanced Practice Registered Nurse (APRN)
The new policy has affected not only people who require health services, but also healthcare staff by expanding their capabilities. Financing for medical personnel is one of the critical factors of the ACA as such reforms increase the quality of service and reduce healthcare costs. For this reason, the main changes affecting the APRN are higher demand for services, increased funding for nursing education, and their initiatives.
The first effect is that the demand for nursing services has grown significantly because the number of people with access to medical services has also increased. Such a change has both positive and negative effects on the work of nurses. The lack of staff forces hospitals to offer their employees more favorable working conditions, which is a positive change for nurses who can receive a higher salary for their job. However, at the same time, many patients for limited staff create conditions that interfere with the quality of a nurse’s work and lead to high physical and moral stress. Although nurses specializing in mental issues of patients are not so demanded as specialists working in first aid, a similar feature also applies to them.
At the same time, one of the ACA aims is to finance the education of nurses, since their knowledge and professionalism reduce the lack of staff and improve the quality of services. For this reason, nurse practitioners and students have more opportunities to raise their level of education and skills by using scholarships and government support (Erickson, 2016). The ACA also provides additional funds for the implementation of nurse practitioners’ initiatives that are aimed at the study and practice of methods for the prevention and treatment of various diseases. For example, the ACA provides school nurses with sources to implement preventive measures against substance abuse and mental problems in students (Cleveland, Motter, & Smith, 2019). Therefore, the ACA has many positive features that affect APRNs and, thus, contribute to the mental and physical health of the population.
Facilitators and Barriers of the ACA
The Obamacare policy has many reasons for its successful implementation. The main ones are the availability of insurance for the population and coverage of a wide range of services, particularly in the treatment of mental health and substance abuse. However, the policy has disadvantages that diminish its popularity, such as the high cost of insurance for the middle-income population, the inaccessibility of certain medications, and the limited network of mental health providers. However, the main obstacle is the actions of the Trump administration, which tries to reduce the influence and cancel current policies.
The principles and results of the ACA demonstrate that it is successful for the health and well-being of people. Benefits for a low-income population reduce insurance spending to a minimum, and youth under 26 can use their parents’ insurance (Abraham et al., 2017). Since adolescence and young age are the most sensitive to the development of mental problems and addictions, this approach significantly improves the health of the population. In addition, the abolition of the lifelong limit contributes to the constant monitoring and treatment of mental diseases, which also attracts people who cannot have state benefits. Consequently, the policy has support among the population and also contributes to the security and health of the country.
The debate against Obamacare is national in scope since the current US president is opposed to the principles of this policy. For example, recently, the administration filed another lawsuit against the ACA in the Supreme Court to refute its constitutionality (Goodnough, Abelson, Sanger-Katz, & Kliff, 2020). At the same time, policy flaws to draw public attention also foster Obamacare opponents. For example, the high cost of insurance due to companies’ poor regulation makes many people buy shorter-term health insurance plans, which are cheaper but do not cover the treatment of mental health. People can also be encouraged by the fact that some essential medicines and diagnoses are not covered by insurance, such as anorexia (Norris, 2018). In addition, the lack of psychiatrists and therapists, especially in rural areas, can also encourage people to choose a cheaper package option, since they cannot access the services anyway. Maintaining this trend will lead to a situation in which people will return to the previous insufficient level of care for their mental health due to the inability to pay and receive services.
Solution
Elimination of the most significant flaws of Obamacare policy help to keep and regain its reputation among the population, and some measures for this purpose are already at the stage of implementation. The ACA finances the education of nurses and medical staff; consequently, the solution to the lack of psychiatric services providers is to shift the focus on educating this kind of specialty. Policymakers also acknowledge the high-cost problem and see it as their mistake, so they are determined to review some basic principles of the ACA to rectify the situation (Goodnough et al., 2020). It is also necessary to review and expand the list of mental issues and means for their treatment that should be covered by insurance. All these changes contribute to the fact that people will be able to afford packages that include the treatment of mental health and addictions, and will also see the point in acquiring it.
Conclusion
In conclusion, the Affordable Care Act is a policy that positively affects the mental health of Americans; however, its shortcomings and the actions of its opponents diminish its significance among the population. Overcoming and correcting these flaws focuses on their advantages and makes people think about the importance of their mental health. In addition, supporting and maintaining this policy will improve the nursing practice and the quality of health care in general.
References
Abraham, A. J., Andrews, C. M., Grogan, C. M., D’Aunno, T., Humphreys, K. N., Pollack, H. A., & Friedmann, P. D. (2017). The Affordable Care Act transformation of substance use disorder treatment. American Journal of Public Health, 107(1), 31–32.
Cleveland, K.A., Motter, T., & Smith, Y., (2019). Affordable care: Harnessing the power of nurses. OJIN: The Online Journal of Issues in Nursing, 24(2).
Erickson, F. (2016). The role of nurse practitioners in health care reform. Georgetown University, School of Nursing & Health Study.
Goodnough, A., Abelson, R., Sanger-Katz, M., & Kliff, S. (2020). Obamacare turns 10. Here’s a look at what works and doesn’t.
Norris, L. (2018). How Obamacare improved mental health coverage. Healthinsurance.org. Web.