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Benchmark – Population Health Policy Analysis

            The purpose of this paper is to analyze the Patient Protection and Affordable Care Act (P.L. 111-148, as amended) (ACA) 2010 in terms of the nursing perspective with reference to relevant legal, ethical and political factors. In addition, the analysis integrates appropriate federal, state and global health goals and policies for provision of equitable healthcare for low income population. The advocacy strategies that can help improve access, cost-effectiveness, and quality care for diverse populations is also included in this paper. Finally, the moral and professional obligation of an advanced registered nurse from a Christian perspective to prevent disease and promote health for diverse populations is also included in this discussion. ACA (2010) is financially sound and will continue to drive provision of sustainable, accessible, and affordable care for the low-income families through expansion of the health coverage of the Medicaid program.

            Expansion of health access through the Medicaid program promotes provision of affordable and accessible care to low-income families in a financially sound manner. Medicaid accounts for $ 1 out of every $ 6 health care spending in the U.S. Hence, Medicaid is the major source of health financing for U.S. States to meet health care needs of low-income population. It is jointly funded by the federal government and the states (Snyder & Rudowitz, 2015). The Supreme Court ruling in June 2012 that barred states from expanding Medicaid program in 2014 may have raised affordability programs; thus, creating some intention by some states to opt out.  Expansion of the program may be associated with a net cost; however, combined participation by the federal and state governments results in tremendous savings (Zur, Mojtabai, & Li, 2014).

            Politics that influenced enactment of ACA (2010) and associated political debates later on is shaping Medicaid program. Political debate prior to enactment was primarily focused on the need to expand the Medicaid program to expand access to affordable care for all, particularly the low-income families. Afterwards, political debates now focused on how to make Medicaid program more affordable and sustainable through evaluation of financing options. For instance, there are on-going budgetary discussions at the federal level. With reference to financing options, the Federal Medical Assistance Percentage guarantees matching funds for states in which states assured at least $ 1 in terms of federal funding for every $ 1 spent on the  program. In addition, the ACA (2010) Medicaid expansion enhanced matching rate guarantees 100% payment of Medicaid costs to newly eligible, this is from 2014 to 2016,  providers by the federal government. Besides, Disproportionate Share Hospital payment is another alternative source of funding especially for the safety-net hospitals. In addition, states are free to determine funding sources for non-federal share of Medicaid spending, in part through provider fees and taxes (Snyder & Rudowitz, 2015).

            Expansion of the Medicaid program as part of ACA (2010) has important implications in nursing practice. It implies increased number of care coverage for low-income families and individuals as well as increased number of healthcare consumers (Hahn, 2013). Expansion of Medicaid services to include low-income persons who have preexisting conditions creates ethical conflicts since public funded health care insurance is, in part, channeled through private providers. Regardless of this ethical conflict, the reform of the private market has improved access to safe and high-quality care to low-income persons. Insurers should provide health cover for all insurers regardless of their health status. Another relevant factor is that Medicaid program should be properly managed since public programs can become overly inflexible, bureaucratic, lacking adaptability, and can promote bureaucratic self-preservation behavior instead of promoting beneficiary interests (Field, 2015).

            Medicaid program is in accordance with state, federal, and global health goals and policies for populations. First of all, ACA 2010 expands the eligibility and accessibility to be affordable for low-income families since it governs the manner in which state and the federal government will fund and run the program (Wadhera et al., 2018).  The U.S. Supreme Court’s decision made in June 2012 allowed states to decide on ways to expand the Medicaid program without encountering financial penalties as contained in the ACA 2010 (Hahn, 2013). More should be done to improve access and affordability to care since the office of the United Nations High Commissioner for Human Rights (2019) stress the right to health for all; however, some a significant proportion of low-income population remain uninsured in the U.S. (Wadhera et al., 2018). Besides, Medicaid promotes achievement of universal access to health care and universal health care coverage as promoted by the World Health Organization (WHO) (2013).

            Nursing advocacy strategies can help improve quality, access, and cost-effectiveness of the healthcare system for diverse populations. Nurses should advocate for continuous funding of private healthcare insurers through public education and advising legislators about the benefits of private insurers under the Medicaid program using evidenced-based knowledge and information. Besides, the market-based coverage needs to be protected and supported as opposed to a government-run approach to promote sustainability of the Medicaid program in the long run (Field, 2015). Nurses can advocate for further expansion of the health coverage through engagement of all stakeholders such as legislators in the policy discussion since undocumented immigrants are barred from accessing affordable care coverage. They may pose significant public challenges to the population such as the spread of infectious diseases (Edward, 2014).

            A registered nurse has a moral and professional obligation to advance the common good and respect human dignity to prevent disease and promote health. Within the Christian perspective, a registered nurse ought to adhere to Christian values such as fairness, justice, compassion, love, care and honesty (Brown, Humphreys, Whorley, & Bridge, 2019). These values can promote the will and the obligation to do good as well as helping to promote respect for the human dignity. In addition, the WHO affirms the health should be economically and physically accessible to all sections of the population; especially the marginalized and vulnerable groups such as children, women, indigenous populations, persons with disabilities, adolescents, older persons, and persons who live with HIV/AIDS (WHO, 2019).

            In conclusion the ACA 2010 has improved coverage expansion of the Medication program. As a result, many low-income families and individuals have benefited from affordable, accessible, and high-quality health care services provided by both public and private providers. The program is co-funded by the state and federal government.  The program allows for coverage of people with preexisting conditions and may increase the number of health care consumers. Each person has a right to health, hence affordable options for undocumented immigrants should be considered. The last statement is that a registered nurse who is influenced by Christian values ought to respect human dignity and promote realization of the common good.