Strengths and Weaknesses of the Current Healthcare Act of the United States

The Affordable Care Act (ACA) is a statute that was enforced in 2010 by President Barack Obama. It can be considered one of the most significant reforms in the country’s approach to health care since the establishment of Medicaid and Medicare. The ACA was designed to increase the number of insured individuals, make preventive care more accessible, and slow the rise of healthcare costs. However, the act has received both criticism and appraisal; some states have challenged its provisions. Florida is one of the states that has opposed the ACA since its introduction. This paper presents the strengths and weaknesses of the state’s approach to the ACA and its impact on all stakeholders, including consumers and providers, from the perspective of a family nurse practitioner.

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Strengths and Weaknesses of Florida’s Approach to the ACA

The ACA can be considered a product of challenging issues of the current healthcare system in the United States, such as the poor levels of provided care, a growing number of uninsured individuals, and the unaffordability of health insurance. President Barack Obama signed the public law in 2010 (Cameron, 2016). The ACA resulted in the improved rates of the insured population and the decreased growth of healthcare costs.

Florida has a distinct approach to the ACA, as it has opposed the act since its establishment. Lanford and Quadagno (2016) report that the state filed a lawsuit against the Medicaid expansion and the constitutionality of the individual mandate on the day the ACA was signed. Although the Supreme Court’s decision stated that the latter was the constitutional exercise of the act, it concluded that the government could not refuse to provide Medicaid funds if Florida did not comply with the program’s expansion. Thus, the state’s approach to the ACA has made Medicaid expansion optional; the state did not embrace expansion (“The Affordable Care Act in Florida,” 2019).

Strengths of Florida’s Approach to the ACA

The first strength of Florida’s actions towards the act is that the expansion of Medicaid could potentially delay doctor visits for patients, as more people would be qualified for government coverage. The state’s approach can help nurse practitioners to implement preventive measures more extensively, increasing the general health state of the population. Second, the full implementation of the ACA would require significant financial investments, which could be challenging due to balanced budget amendments. Thus, Florida’s approach has allowed the state to avoid expenses (“Did Florida accept the ACA expansion?” 2019). For nurse practitioners, it means that medical institutions can have a larger budget for medical supplies and the implementation of technologies, as well as invest in educational programs for staff and patients. Third, it is necessary to mention that some groups of the population can benefit from the state’s actions too. For example, private insurers can obtain specific rates for care, while, if Medicaid was expanded, medical professionals could attempt to maximize services, as compensations would be set strictly.

Weaknesses of Florida’s Actions

However, Florida’s approach to the ACA has significant weaknesses too. First, Medicaid expansion is a crucial component of the ACA. It is especially important for the underserved groups of the population and people of low economic advantages that have health problems. Lanford and Quadagno (2016) estimate that as a result of Florida’s approach, there are around 3,5 million fewer insured individuals. For family nurse practitioners, it means that many patients seek care when their conditions are severe because they do not want to spend much money on medical assistance. Second, because of the state’s opt-outing of Medicaid, there are significant losses in federal payments. Third, Florida’s action could minimize cost-shifting issues within the economy that occur when insured individuals pay more for healthcare services compared to uninsured ones.

Impact on Stakeholders

Impact on Consumers

Florida’s approach to the ACA has a significant impact both on care providers and on the population. Consumers are the significant group of stakeholders, as they are the ones affected by changes in approaches to care the most. Consumers include the individuals receiving care, both advantaged and underserved individuals. Florida’s approach affects minority groups significantly. For instance, Calvo, Jablonska-Bayro, and Waters (2017) report that there are 20% of uninsured Latinos living in the state, who do not qualify for Medicaid regardless of their income level. Due to the state’s actions regarding ACA, family nurse practitioners may experience challenges in advocating for preventive care among minority groups. Moreover, nurse practitioners have limited opportunities to provide effective treatment, as many individuals are uninsured and do not seek care timely.

In addition, the state’s approach to the ACA leads to a decreased level of financial protection for the population. It means that individuals from a lower economic background may have to reduce their expenses significantly, as they cannot be sure that they will not need healthcare services in the future. Family nurse practitioners may encounter challenges from this perspective, too, as patients may delay visits or refuse to adhere to follow-up care. It is also possible to say that Medicaid expansion could have increased the number of the population’s hospital visits due to the higher affordability of healthcare services (Barakat et al., 2017). Thus, the health level of the state’s population would increase if Florida had a different approach to the ACA.

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Impact on Providers

There are some outcomes of Florida’s actions towards the ACA on care providers, too, including family nurse practitioners. Care providers can be considered stakeholders because they ensure and support the population’s health. For instance, the state’s approach can be beneficial to medical institutions as it can increase the number of self-paid visits among the patients. For family nurse practitioners, however, self-paid visits can be potentially associated with challenges, as they often require urgent treatment. It means that nurse practitioners are unable to prevent the development of the disease, which is one of their primary missions.

Another beneficial point for care providers is that the taxes, including those associated with medical devices, would increase significantly if Medicaid was expanded. In this case, medical institutions would possibly try to minimize expenses in other ways, for example, by reducing medical supplies for nurse practitioners or stopping investing in technologies. However, the disadvantages of the state’s approach prevail, as it can lead to an increase in uncompensated care burdens and reduced benefits due to lower tax revenues.


The report shows that Florida’s approach to the ACA has both strengths and weaknesses for the population, consumers, and care providers, including nurse practitioners. The outcomes of the state’s policy can include the poor impact on minority groups and their inability to apply for coverage, the decreased level of financial protection for the population, and the lower health level among individuals. This approach deprives family nurse practitioners of the opportunity to provide preventive care and advocate for preventive measures in general. At the same time, Florida’s approach is associated with reduced taxes for healthcare providers and the increased number of self-paid visits, which may be beneficial for medical institutions. It is possible to say that the disadvantages of the state’s actions towards the ACA prevail.


Barakat, M. T., Mithal, A., Huang, R. J., Mithal, A., Sehgal, A., Banerjee, S., & Singh, G. (2017). Affordable Care Act and healthcare delivery: A comparison of California and Florida hospitals and emergency departments. PloS One, 12(8). Web.

Calvo, R., Jablonska-Bayro, J. M., & Waters, M. C. (2017). Obamacare in action: How access to the health care system contributes to immigrants’ sense of belonging. Journal of Ethnic and Migration Studies, 43(12), 2020-2036.

Cameron, P. A. (2016). The Affordable Care Act: A study of the modern United States health insurance system. Web.

Did Florida accept the ACA expansion? (2019). Web.

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Lanford, D., & Quadagno, J. (2016). Implementing ObamaCare: The politics of Medicaid expansion under the Affordable Care Act of 2010. Sociological Perspectives, 59(3), 619-639.

The Affordable Care Act in Florida. (2019). Web.

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