The Patient Protection and Affordable Care Act (ACA) brought major changes to the healthcare system in 2014. It introduced provisions such as the Individual Mandate, Pre-existing Condition Coverage, and Medicaid Expansion, each having significant impacts on the practice of nursing and medicine. The Individual Mandate was designed to ensure that most Americans maintained health insurance or faced a fine when income tax came around. This was meant to increase the number of insured individuals and diversify risk pools to help stabilize insurance premiums (French, Homer, Gumus, & Hickling, 2016). As a result, the use of primary care services was expected to increase. However, as we continue to observe the healthcare landscape, it is still challenging to fully understand the long-term effects the mandate has on healthcare costs and service utilization (French et al., 2016). Luckily, as a veteran, I am fortunate that this mandate does not impact me since I automatically receive coverage through veteran healthcare benefits.

Another significant component of the ACA is the Medicaid Expansion. This provision aimed to expand access to healthcare for low-income individuals, with the full rollout taking effect in 2014, although early enrollment was available in some states (French et al., 2016). Expanding Medicaid helped many people access necessary medical care and better manage chronic conditions like diabetes. However, decisions on whether to adopt Medicaid expansion were heavily influenced by political and economic considerations, resulting in many patients in non-expansion states without adequate coverage (French et al., 2016). Finally, the Pre-existing Condition Coverage ensured that insurance companies could no longer deny coverage or adjust rates based on health status, which broadened access to necessary healthcare services (French et al., 2016). These provisions have brought a range of challenges and opportunities to healthcare systems, requiring adjustments in how care is delivered and managed effectively to meet the needs of more people. Observing this evolution in healthcare policy within my studies has shown me the dynamic nature of our healthcare system and the critical role nurses and medical practitioners play in adapting to these changes.

Reference:

French, M. T., Homer, J., Gumus, G., & Hickling, L. (2016). Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings. Health services research, 51(5), 1735–1771. https://doi.org/10.1111/1475-6773.12511