Name
Purdue University Globle
NU506 Health Policy, Ethical, and Legal Perspectives of the Health Care System
Prof. Name
Date
Nursing advocacy is essential to implementing health policies that promote preventive care, patient safety, healthcare access, and health equity. In the context of Kelley v. Becerra, nursing advocacy is particularly relevant because the litigation concerns the federal framework for requiring coverage of certain preventive health services under the Affordable Care Act (ACA). For nurses and advanced practice registered nurses (APRNs), policy decisions involving preventive care can directly affect whether patients obtain screenings, vaccinations, counseling, and other services without significant financial barriers.
Nurses are uniquely positioned to participate in health policy because they see how regulations affect patients in clinical settings and communities. Their observations can help policymakers understand whether a policy improves access, creates unintended barriers, or disproportionately affects vulnerable populations. Through patient education, professional organizations, research, legislative engagement, and evidence-based advocacy, nurses can contribute to health policies that support better population health outcomes.
Preventive healthcare is closely connected to nursing practice. Early screening and intervention can identify health risks before they develop into serious conditions, while patient education can encourage healthier behaviors and appropriate use of healthcare services. Consequently, nursing advocacy has an important role in protecting access to evidence-based preventive care while ensuring that policy decisions consider clinical evidence and patient needs.
The Affordable Care Act of 2010 established several reforms intended to increase access to health insurance and healthcare services. One important provision requires many private health plans to cover certain recommended preventive services without patient cost-sharing when applicable requirements are met.
The preventive-services framework relies on recommendations from organizations and advisory bodies, including the U.S. Preventive Services Task Force (USPSTF). Depending on the service and applicable coverage rules, preventive care may include screenings, counseling, immunizations, and other interventions designed to prevent illness or identify health conditions early.
Examples of preventive services may include:
Blood pressure and cardiovascular risk screening
Screening for certain cancers
Diabetes screening for eligible populations
Recommended immunizations
Preventive visits and health assessments
Prenatal and maternal healthcare
Contraceptive-related services covered under applicable federal requirements
Counseling related to disease prevention and healthy behaviors
The purpose of providing preventive services without cost-sharing is to reduce financial barriers that could discourage patients from obtaining healthcare before symptoms develop. Evidence suggests that removing or reducing cost barriers can increase the use of certain preventive services, although the effect varies by population and type of service.
Kelley v. Becerra involves a legal challenge to aspects of the federal government’s authority and process for requiring coverage of certain preventive healthcare services under the ACA. The litigation has raised questions concerning the constitutional and statutory authority underlying preventive-service coverage requirements and the role of expert recommendations in determining which services must be covered.
The case is important to healthcare professionals because changes to preventive-service coverage requirements could have consequences beyond the courtroom. Health insurance rules influence whether patients can afford recommended screenings and interventions, how clinicians counsel patients, and how healthcare organizations plan preventive services.
The broader policy questions raised by the case include:
How federal law establishes preventive healthcare coverage requirements
The authority of federal agencies and advisory bodies
The role of evidence-based recommendations in healthcare policy
The balance between federal regulation and insurance-plan flexibility
The potential effects of cost-sharing on healthcare utilization
From a nursing perspective, these questions are important because nurses routinely provide or coordinate preventive services. Policy changes that increase patient costs may influence whether patients follow recommendations for screenings, vaccinations, counseling, and routine healthcare visits.
Healthcare policy does not remain confined to legislation or courtrooms. Policy decisions can influence what services patients receive, what providers recommend, and how healthcare organizations allocate resources.
For nurses, the significance of Kelley v. Becerra lies in the connection between health policy and clinical practice. If coverage requirements change, patients could potentially face different levels of financial responsibility for preventive services, depending on the applicable law, insurance plan, service, and implementation rules.
Potential consequences of reduced access or increased cost-sharing may include:
Greater patient out-of-pocket expenses
Lower use of some preventive services
Delayed detection of health conditions
Increased challenges addressing health disparities
Greater reliance on treatment after disease progression
These effects are especially important for populations that already experience barriers to healthcare. A relatively small increase in healthcare expenses may influence whether some patients schedule a screening, fill a prescription, attend a follow-up appointment, or seek preventive counseling.
Nursing advocacy extends beyond speaking on behalf of an individual patient. Nurses can advocate at the organizational, community, professional, and legislative levels.
Because nurses interact closely with patients and families, they frequently see how healthcare policies affect access, affordability, health literacy, and treatment decisions. This clinical perspective can provide valuable information when healthcare policies are developed or evaluated.
Nursing advocacy may involve:
Supporting evidence-based healthcare policies
Promoting equitable access to healthcare services
Educating patients about preventive care
Communicating patient and community needs to policymakers
Participating in nursing and healthcare organizations
Supporting research that evaluates healthcare outcomes
Contributing to legislative and regulatory discussions
Effective advocacy requires nurses to combine clinical experience with credible evidence. Rather than advocating solely from personal opinion, nurses can use research findings, population-health data, patient experiences, and professional standards to explain why a policy may improve or hinder healthcare outcomes.
Advanced practice registered nurses have an especially important role in preventive healthcare. Depending on their specialty and scope of practice, APRNs may conduct health assessments, provide screenings, manage chronic conditions, administer or recommend immunizations, provide counseling, and coordinate preventive services.
Nurse practitioners and other APRNs may address areas such as:
Cardiovascular risk assessment
Hypertension screening and management
Diabetes screening and prevention
Cancer screening recommendations
Immunization education
Reproductive and preventive healthcare
Lifestyle and nutrition counseling
Chronic disease prevention
Patient and family health education
Because APRNs frequently interact directly with patients, they may recognize the effects of healthcare policy at an early stage. For example, a patient who postpones recommended screening because of cost may eventually present with a more advanced condition. Although a single clinical encounter cannot establish that a policy caused a particular outcome, patterns observed across populations can provide important evidence for health policy discussions.
Preventive healthcare is designed to identify disease risks early and reduce the likelihood of preventable illness or complications. Screening can identify health conditions before symptoms become apparent, while immunization and counseling can reduce the risk of certain diseases.
| Preventive Service | Potential Healthcare Benefit |
|---|---|
| Blood pressure screening | Identifies hypertension and cardiovascular risk |
| Diabetes screening | Identifies elevated risk or disease for appropriate follow-up |
| Cancer screening | Supports earlier identification of certain cancers |
| Immunization | Helps prevent vaccine-preventable diseases |
| Prenatal care | Supports maternal and fetal health monitoring |
| Preventive counseling | Supports healthier behaviors and risk reduction |
The effectiveness of preventive services depends on factors such as patient eligibility, adherence to recommendations, quality of care, and timely follow-up. Nursing advocacy can help address these factors by educating patients and supporting policies that facilitate appropriate access to preventive healthcare.
Health equity is another important consideration in debates about preventive healthcare coverage. Individuals do not enter the healthcare system with the same financial resources, transportation options, health literacy, insurance coverage, or access to healthcare providers.
When patients face financial barriers to preventive services, those with fewer economic resources may be more likely to postpone care. This makes affordability an important consideration when evaluating the potential effects of healthcare policy.
Nurses often work with patients who experience healthcare access barriers, giving them firsthand knowledge of how these challenges affect health outcomes.
Important factors that may contribute to healthcare disparities include:
Income and financial limitations
Insurance status and coverage
Geographic access to healthcare
Transportation difficulties
Limited availability of healthcare professionals
Health literacy
Language and communication barriers
Social and environmental conditions
Nursing advocacy can help bring these concerns into policy discussions. Nurses can emphasize that effective health policy should consider not only aggregate healthcare spending but also whether patients can realistically access recommended care.
Preventive healthcare policy also has implications for reproductive and women’s health. The ACA expanded access to certain preventive services, including contraceptive services under applicable coverage requirements.
Access to contraception can influence reproductive planning and the ability of individuals to make informed decisions about pregnancy. Research has examined associations between ACA-related contraceptive coverage and contraceptive use and unintended pregnancy outcomes.
For nurses and APRNs providing reproductive healthcare, policy changes can affect patient counseling, access to services, and the financial considerations patients face when selecting healthcare options.
Nursing advocacy in this area can support:
Patient education
Reproductive health planning
Access to appropriate preventive services
Informed decision-making
Maternal and family health
Debates surrounding preventive-service coverage involve competing policy considerations. Supporters of greater insurance-plan flexibility may argue that insurers should have more control over benefit design and that federal requirements can impose administrative or financial burdens.
From this perspective, potential benefits of reducing federal coverage requirements could include greater flexibility in insurance-plan design and potentially fewer regulatory requirements.
However, critics of reducing preventive-service protections emphasize the possibility of increased patient costs and decreased use of recommended care. These concerns are particularly relevant when cost-sharing discourages patients from obtaining services that can identify disease risks early.
A balanced health policy analysis should therefore consider both the potential administrative or economic benefits of regulatory flexibility and the possible effects on patient access, preventive care utilization, health disparities, and long-term healthcare outcomes.
Nurses represent one of the largest groups of healthcare professionals and interact with patients throughout many stages of care. Their clinical experience provides an important perspective on how healthcare policy works in practice.
Nurses can use clinical research, population-health data, professional guidelines, and patient outcomes to support healthcare policies grounded in evidence. Evidence-based advocacy helps policymakers distinguish between interventions supported by research and those based primarily on assumptions or anecdotal experiences.
Nurses can advocate for patients who may have limited opportunities to participate directly in policy discussions. This includes individuals who face financial, geographic, social, or educational barriers to healthcare.
Nursing advocacy can encourage policymakers to evaluate whether healthcare regulations affect different populations equally. Policies that appear neutral may have different consequences for individuals with different levels of healthcare access and financial resources.
Nurses also serve as educators. By explaining preventive services, screening recommendations, healthcare policies, and available resources, nurses can help patients make informed decisions about their health.
Nurses can participate in health policy advocacy at multiple levels. Professional engagement is particularly valuable when nurses combine clinical observations with reliable evidence.
Professional nursing organizations provide opportunities for nurses to learn about proposed legislation, participate in advocacy initiatives, and communicate nursing perspectives to policymakers.
Nurses can contact legislators and policymakers to explain how healthcare policies affect patients and clinical practice. Effective communication should be factual, respectful, and supported by credible evidence.
Possible activities include:
Writing policy letters
Contacting elected representatives
Participating in legislative meetings
Attending healthcare advocacy events
Providing professional testimony when appropriate
Patient education is another form of advocacy. Nurses can explain why preventive services are recommended and help patients understand available healthcare resources.
Education should be individualized to the patient’s health literacy, cultural context, clinical needs, and circumstances.
Nurses can contribute to health policy by conducting or supporting research that examines preventive healthcare utilization, health disparities, patient outcomes, and the effects of healthcare policies.
Research findings can strengthen advocacy efforts by providing measurable evidence about how policy decisions affect healthcare delivery.
Health policymakers can consider several approaches when evaluating preventive-service coverage. Policies should maintain access to evidence-based care while addressing legitimate questions about regulatory authority, implementation, and insurance-market effects.
Potential policy approaches include:
Maintaining access to evidence-based preventive services
Clearly defining the legal authority for preventive-service recommendations
Strengthening coordination among federal agencies and healthcare experts
Monitoring the effects of cost-sharing on preventive-service utilization
Evaluating policies for their effects on vulnerable populations
Supporting public health and preventive-care initiatives
Using current scientific evidence when determining recommended services
Policymakers should also evaluate the real-world consequences of policy changes. Changes in coverage rules can influence patient behavior, provider recommendations, and healthcare utilization, making ongoing evaluation important.
Nursing advocacy plays a critical role in connecting healthcare policy with patient needs and clinical outcomes. Kelley v. Becerra illustrates why nurses and APRNs should understand how legal and regulatory decisions involving preventive healthcare can affect access to screenings, vaccinations, counseling, and other services.
The ACA’s preventive-service provisions were designed to reduce financial barriers to recommended preventive care. Any changes to these requirements can have implications for patients, healthcare providers, insurers, and public health. Nurses are well positioned to contribute to these policy discussions because they understand both the clinical importance of prevention and the practical barriers patients encounter when accessing care.
Through professional advocacy, patient education, research, community engagement, and communication with policymakers, nurses can help promote healthcare policies that are evidence-based, equitable, and responsive to population health needs.
Ultimately, nursing advocacy is not limited to the bedside. It is an important component of health policy implementation and can help ensure that healthcare decisions support prevention, early intervention, patient safety, and equitable access to care.
Kelley v. Becerra is litigation concerning aspects of the federal government’s authority and the Affordable Care Act’s preventive-services coverage requirements. The case has raised legal questions about the process and authority used to establish certain preventive-service coverage requirements.
The case is relevant to nurses because preventive-service coverage policies can affect patients’ access to screenings, counseling, immunizations, and other preventive interventions. Nurses frequently provide or coordinate these services and therefore see how coverage and affordability affect patient care.
Changes in coverage could influence whether some patients obtain recommended preventive services. Nurse practitioners may consequently encounter challenges related to delayed screenings, unmet preventive-care needs, and health disparities.
Nurses advocate for health policy by educating patients, communicating clinical experiences, participating in professional organizations, supporting evidence-based research, contacting policymakers, and promoting equitable access to healthcare.
Preventive healthcare can identify health risks early, support disease prevention, and reduce complications associated with untreated conditions. Screenings, immunizations, counseling, and preventive visits are important components of population health.
Nursing advocacy promotes health equity by identifying barriers that disproportionately affect underserved populations and supporting policies that improve access to appropriate, affordable, and evidence-based healthcare.
People with limited financial resources or other healthcare access barriers may be particularly sensitive to increased out-of-pocket costs. Vulnerability can also depend on factors such as insurance coverage, geographic access, health needs, and availability of healthcare providers.
MacCallum-Bridges, C. L., & Margerison, C. E. (2020). The Affordable Care Act contraception mandate and unintended pregnancy in women of reproductive age: An analysis of the National Survey of Family Growth, 2008–2010 vs. 2013–2015. Contraception, 101(1), 34–39. https://doi.org/10.1016/j.contraception.2019.09.003
Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010). https://www.congress.gov/bill/111th-congress/house-bill/3590
Skopec, L., & Banthin, J. (2022). Free preventive services improve access to care. Robert Wood Johnson Foundation. https://www.rwjf.org/en/library/research/2022/07/free-preventive-services-improve-access-to-care.html
U.S. Preventive Services Task Force. (2024). A and B recommendations. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations
U.S. Department of Health and Human Services. (n.d.). Preventive care benefits for adults. HealthCare.gov. https://www.healthcare.gov/preventive-care-adults/
U.S. Department of Health and Human Services. (n.d.). Preventive care benefits for women. HealthCare.gov. https://www.healthcare.gov/preventive-care-women/
