The Patient Protection and Affordable Care Act (ACA) introduced several provisions in 2014 that significantly impacted nursing and medical practice. One key provision was the expansion of Medicaid eligibility, which allowed millions of low-income individuals to gain health insurance coverage. According to the Centers for Medicare & Medicaid Services (2020), this expansion increased access to preventive care, chronic disease management, and mental health services. As a result, nurses and physicians have encountered an increase in patient volume, requiring enhanced care coordination and patient education efforts. This change has placed greater emphasis on nurse practitioners and primary care providers, who play a crucial role in delivering care to newly insured populations.

Another critical component that took effect in 2014 was the individual mandate, which required most Americans to obtain health insurance or pay a penalty. More insured patients meant that healthcare providers had to adapt to a more extensive and more diverse patient population, with an increased focus on preventative care. Nurses, in particular, played an essential role in health promotion and patient education, helping individuals navigate their insurance benefits and seek appropriate medical services. This provision ultimately emphasized the role of healthcare professionals in preventative medicine rather than just acute care interventions.

Lastly, the ACA’s emphasis on value-based care and hospital readmission reductions introduced new challenges and opportunities for nursing and medicine. The Hospital Readmissions Reduction Program (HRRP) imposed financial penalties on hospitals with high readmission rates for conditions such as heart failure, pneumonia, and chronic obstructive pulmonary disease (Centers for Medicare & Medicaid Services, 2018). This policy encouraged healthcare teams to implement more substantial discharge planning, patient follow-up programs, and interdisciplinary collaboration. Nurses, particularly in case management and home health, have taken on a more significant role in ensuring continuity of care and patient adherence to treatment plans. Overall, these provisions have transformed healthcare delivery, reinforcing the importance of preventative measures, cost control, and quality outcomes.

References
Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The Affordable Care Act at five years. The New England Journal of Medicine, 372(25), 2451-2458.

Centers for Medicare & Medicaid Services. (2018). Hospital Readmissions Reduction Program (HRRP).

Centers for Medicare & Medicaid Services. (2020). Medicaid and CHIP enrollment trends snapshot