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The important elements of the Affordable Care Act (ACA) is the availability of health insurance to millions of Americans who did not previously qualify for insurance.

The important elements of the Affordable Care Act (ACA) is the availability of health insurance to millions of Americans who did not previously qualify for insurance. Prior to healthcare reform individuals could not get health care coverage with pre-existing conditions and insurance companies could drop you from your plan without warning if a person falls sick. Insurance companies also showed bias based on a person’s gender or socioeconomic status. However, with the ACA, individuals are able to buy insurance irrespective of their pre-existing conditions, and their premiums cannot be higher because of their age, gender, or medical history. Also, patients will be able to receive routine/preventative health care at no cost. “The Affordable care act bans lifetime and most annual dollar coverage limitations, the use of preexisting condition exclusions, and excessive waiting periods (i.e., longer than 90 days), and requires the use of “modified community rating” so that prices can vary only to a limited degree based on age, as well as by family size and tobacco use. The law also guarantees the right to internal and external impartial appeal procedures when coverage is denied, and requires insurers to cover routine medical care as part of clinical trials involving cancer and life-threatening illnesses (Rosenbaum, 2011).

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Starting in 2014, most adults under age 65 with incomes up to about $15,000 per year for single individual (higher income for couples/families with children) will qualify for Medicaid in every state. Families of four or more who do not make over 80,000 a year and their job doesn’t offer affordable insurance may be eligible for tax credit to help pay for insurance (MACMH, 2018).

The nurses’ role in the new healthcare reform is educating patients and becoming a resource on how health insurance can be accessed through the ACA. Individuals can be referred by the nurse to the website healthcare.gov, where they can shop at the marketplace for the best insurance plans. Nurses can support families and communities to get healthy. They can also advocate for free preventative healthcare services. The ACA allows individuals joining a new healthcare plan to receive recommended preventative care services with no out of pocket costs. Nurses should obtain the information needed to effectively communicate how to access healthcare insurance and reach as many uninsured people as possible (Wakefield, 2013).

References:

Wakefield, M. (2013, December 21). https://www.reflectionsonnursingleadership.org/fea…

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