The Affordable Care Act and Nursing

The costs of health care have been on the rise with the quality of health care having issues which must be addressed such that there is equity of improved health care access. The Affordable Care Act, ACA, which was signed into law in 2010, March 23, stands as the most expansive reform legislation in health care in the United States of America since the 1965 creation of Medicare and Medicaid. The ACA spells a new dawn for health care in America emphasizing on primary care and preventive services providing insurance cover for millions of citizens who are uninsured and addresses issues in the current health care system that need reforms to attain safety in caring for consumer needs and improve the health outcomes (Greenwald, 2010).

The reforms have provisions that will certainly make immediate and direct improvements on health care systems delivery. First is the Access to care provision which extends health coverage to cover more Americans and also protect those who already have coverage from many of the abuses of insurers hence removing many acts of discrimination that have been a limitation to accessing health care. This will also increase the funding for various care delivery sites and programs and help in creating a standard package for health care essential benefits extending Medicaid to all persons under the age of sixty five years who are at or/and below 133% federal poverty level (Djukic and Kovner, 2010).

However, a provision like quality of health care might be under compromise in the process of achieving affordable costs for healthcare. To attain professional and quality health care individuals may consequently be required to spend more than these reforms stipulate. Therefore, the disparities according to economic status of individuals may not be bridged and addressed easily along these reforms towards achieving a better quality of health with minimal costs (Sommer, 2001)).

Although it may seem a good and easy step to implement the Affordable Care Act, there still live challenges. The most challenging aspect will be achieving and maintaining equality, transparency and accountability for access to the reformed health services. In addition, it may be costly training and employing the nurses maintaining the wage budget without struggles (Djukic and Kovner, 2010).

The Affordable Care Act might bring on some ethical issues in the process of implementation. For instance, electronic medical records which are mandatory for the ACA might compromise the privacy and confidentiality of individuals. Also chronic disease management might be faced with some controversy and the responsibility of the nurses to shape health care policy as stipulated in the code of ethics for nurses, provision 9 may be compromised and not fully achieved under ACA reforms (Greenwald, 2010).






Greenwald, H. P. (2010). Health care in the United States: Organization, management, and policy. San Francisco, CA: Jossey-Bass

Djukic and Kovner, (2010), Overlap of Registered Nurse and Physician Practice: Implications for U.S. Health Care Reform, Policy, Politics, & Nursing Practice, volume 11, issue 1, pages 31–22.

Sommer, (2001), “How Public Health Policy Is Created; Scientific Process and Political Reality, American Journal of Epidemiology, volume 154, issue 12,

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