Name
Western Governors University
D223 Healthcare Policy and Economics
Prof. Name
Date
What is a key federal healthcare policy affecting patient care and healthcare delivery?
One of the most significant federal healthcare policies shaping patient care across the United States is the Affordable Care Act (ACA), enacted in 2010 during the Obama administration. Known popularly as “Obamacare,” the ACA was designed to improve healthcare access, affordability, and quality nationwide. It introduced major reforms such as expanding Medicaid eligibility to low-income populations, creating health insurance marketplaces, and defining essential health benefits that all qualified insurance plans must cover.
Importantly, the ACA shifted the healthcare system from a traditional fee-for-service model towards a value-based care approach. This change prioritizes preventive care, coordinated services, and improved population health outcomes. These reforms aim to reduce healthcare disparities, lower overall costs, and provide all Americans with the opportunity to obtain comprehensive and affordable health insurance.
What is an important Nevada state healthcare policy that impacts healthcare delivery?
In Nevada, a critical healthcare initiative is the Nevada Health Link, the state’s official health insurance marketplace operating under the ACA framework. This platform allows Nevada residents to compare, choose, and enroll in health insurance plans tailored to their personal and family needs. It also provides income-based subsidies to help make insurance more affordable for low- and middle-income individuals.
Nevada Health Link’s mission is to lower the uninsured rate, promote preventive healthcare, and improve health outcomes by encouraging residents to seek timely medical care. The marketplace ensures healthcare coverage is accessible and understandable, supporting Nevada’s broader goals of equity and affordability in healthcare.
Affordable Care Act (ACA)
The ACA functions through several key provisions designed to expand healthcare access and improve care quality:
| Provision | Description |
|---|---|
| Individual Mandate | Required most Americans to have health insurance or face a tax penalty (repealed in 2017). |
| Health Insurance Marketplaces | Created platforms for comparing and purchasing plans with income-based subsidies. |
| Medicaid Expansion | Extended Medicaid eligibility to low-income adults previously ineligible. |
| Essential Health Benefits | Required coverage of core services like preventive care, mental health, maternity, and drugs. |
| Pre-existing Condition Protections | Prevented insurance discrimination based on health history. |
| Dependent Coverage Extension | Allowed young adults to stay on parents’ plans until age 26. |
Together, these provisions promote a healthcare system that is more inclusive, prevention-focused, and patient-centered.
Nevada Health Link
Nevada Health Link operates as a streamlined portal making ACA-compliant insurance plans easier to access:
| Feature | Function |
|---|---|
| Plan Comparison and Enrollment | Allows residents to compare plans by price, coverage, and benefits. |
| Financial Assistance | Offers subsidies and tax credits to reduce premium costs for eligible users. |
| Medicaid Screening | Helps determine eligibility for Medicaid and other assistance programs. |
| Support Services | Provides navigators and call center help to assist users through enrollment. |
Though voluntary, Nevada Health Link improves healthcare access by simplifying enrollment and connecting users with financial and informational support.
Both the ACA and Nevada Health Link have influenced various groups in diverse ways. The following table summarizes key benefits and challenges:
| Population | Benefits from ACA & Nevada Health Link | How They Benefit | Potential Negative Impact | How They Are Impacted |
|---|---|---|---|---|
| Low-income individuals and families | Increased access through Medicaid expansion and subsidies | Lower premiums, improved access to preventive and chronic care | Those in non-expansion states remain uninsured | Face gaps in coverage and limited affordable options |
| Young adults | Coverage on parents’ plans until age 26 | Maintains insurance during education or early career | Risk of higher premiums due to risk pool balancing | Some opt out due to cost or low perceived need |
| Individuals with pre-existing conditions | Guaranteed insurance access without discrimination | Consistent treatment and financial protection | Premiums may increase in some markets | Healthy individuals may bear slightly higher costs |
| Small employers | Incentives and mandates to provide coverage | Better workforce retention and productivity | Compliance costs and administrative burden | Financial strain on some small businesses |
| Vulnerable populations | Outreach encourages participation and health literacy | Reduced disparities and improved health engagement | Language or technology barriers persist | Challenges in accessing and using benefits effectively |
Overall, these policies promote health equity, preventive care, and community wellness, though ongoing adjustments are necessary to close remaining coverage gaps.
The ACA was developed based on strong evidence highlighting the negative consequences of millions of uninsured Americans delaying or skipping necessary care. Jacobson and Pilch (2019) found that ACA marketplace provisions notably expanded affordable coverage, especially benefiting people with pre-existing conditions.
At the state level, Nevada Health Link builds on the ACA by addressing Nevada-specific demographic and economic factors. Senate Bill 420 (SB420), enacted in 2021, introduced a public option to provide affordable plans to those ineligible for Medicaid or federal subsidies (Beerman, 2021).
Kelly (2019) emphasizes that expanded insurance coverage results in better management of chronic diseases, higher use of preventive services, and overall improvements in public health, supporting the ethical imperative for universal healthcare access.
Do the evidences suggest policy modifications?
Despite successes, coverage gaps remain, particularly for individuals just above Medicaid eligibility. Recommended enhancements include:
Broadening subsidy eligibility to moderate-income groups
Increasing financial help for out-of-pocket costs
Strengthening incentives for preventive care
Addressing social determinants like housing and education
Implementing cost controls to sustain affordability
Such reforms could enhance equity, reduce costs, and improve population health outcomes further.
Nurses play an essential role in healthcare policy development and management by applying their clinical expertise and advocacy skills to influence healthcare reforms.
Key contributions of nurses include:
Advocacy: Supporting equitable policies, patient rights, and care quality improvements.
Expert Consultation: Offering frontline clinical insights to policymakers.
Research and Evidence: Providing data and research to inform policy decisions.
Collaboration: Partnering with interdisciplinary teams for effective policies.
Education: Informing legislators, patients, and the public about healthcare issues.
Nurses engage in policy at both federal and state levels through professional organizations, advisory roles, and direct collaboration with legislators.
| Policy Area | Barriers |
|---|---|
| Development | Time constraints, lack of policy education, limited access to legislative resources |
| Administration | Organizational resistance, limited authority, staffing shortages, financial constraints |
| Revision | Political opposition, institutional inertia, low representation in policymaking |
| Policy Area | Planned Engagement Strategies |
|---|---|
| Development | Advocate for nursing voices in policymaking, collaborate with advocacy groups, use research to promote equity |
| Administration | Lead policy implementation, monitor compliance, work with interdisciplinary teams to ensure quality |
| Revision | Support continuous policy improvement through evidence-based advocacy and stakeholder education |
Beerman, L. (2021). Nevada’s public option continues healthcare’s cost versus coverage debate. Healthcare Leadership Review, 40(8), 6–8.
Jacobson, G. P., & Pilch, S. (2019). The Affordable Care Act (ACA): It gets personal, very quickly. Journal of the American Academy of Audiology, 30(8), 656–658. https://doi.org/10.3766/jaaa.30.8.1
Kelly, D. (2019). Why we need insurance coverage for all Americans. Journal of Oncology Navigation & Survivorship, 10(6), 244–246.
