Affordable Care Act Upheld: What’s It All Mean?
Unless you’re living under a rock or, worse, have been without Internet access, you have probably noticed the news screaming out that the Supreme Court has upheld most of the Affordable Care Act (ACA). If you have been under that rock, read The New York Times article here. According to the article, the Supreme Court upheld the ACA with a major exception: it denied the part of the Act that would have expanded Medicaid, on the grounds that the part of the Act containing this provision amounted to coercion.
Not surprisingly, social media is abuzz with opinions both pro and con regarding this decision, and even less surprisingly, those opinions are falling solidly on political party lines. Nurses, however, are nurses first and political creatures second, no matter how strongly we feel about politics or today’s decision. What does this ruling mean for us and our patients?
I immediately checked the ANA’s site for a bird’s-eye view. Like them or hate them, the ANA is our voice. See their press release here [PDF]. The ANA is pleased about the decision for several reasons, not just for nurses, but also for consumers. In its eyes, this ruling is beneficial because
- People who currently do not have health care coverage will receive it
- Therefore, they will receive preventive health services and treatment that they otherwise could not receive
- RNs’ role will likely increase to “lead in providing essential prevention and wellness services and care coordination for individuals and families” (for more on this topic, see my previous post on ACOs)
- The ACA will decrease insurance companies’ ability to deny or withdraw coverage from patients with preexisting conditions or to impose coverage caps for expensive illnesses
The Huffington Post additionally points out a huge advantage to minority patients: “just over 48 percent of the nearly 24 million people likely to gain health insurance as the law’s provisions are implemented across the country will be people of color.” This is because the law extends healthcare coverage largely to a lower-income population and because lower income and minority status remain linked. The ACA extends no coverage to illegal immigrants.
What about problems?
The strongest objections to the ACA center around individual freedom. Can the government make Americans purchase health insurance? Shouldn’t healthy people have the choice of not doing so? From what I can tell, this major issue was resolved by the Court’s decision that this “mandate” is essentially a tax, which is constitutional. In other words, yes, the government can make Americans purchase health insurance.
Healthcare consumers may therefore not see an individual decrease in their healthcare spending. It may actually increase. Also, this law does not take full effect until 2014, a long wait for those in need right now.
Patients are going to have a lot of opinions and questions about the ACA itself and the Supreme Court’s decision today. I suggest that all nurses read a few news articles and the ANA press release just to familiarize themselves with the basic tenets of the law and the ruling today. We may also refer patients to online resources such as HealthCare.gov’s summary of the law (“Key Features of the Law”) and Medicaid.gov’s information on “Medicaid and CHIP Affordable Care Act (ACA) Implementation.”
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