D223 Healthcare Policy Analysis and Nurse Roles Notes

Grace J.
November 11, 2025November 11, 2025
BSN, D223, Western Governors University

Student Name

Western Governors University

D223 Healthcare Policy and Economics

Prof. Name

Date

A. Analysis of a Federal Public Healthcare Enacted Law

1. What is one federal public healthcare enacted law that affects patient care and healthcare delivery?

One pivotal federal law that has significantly shaped patient care and healthcare delivery in the United States is the Affordable Care Act (ACA), enacted in 2010. The ACA transformed the healthcare system by broadening insurance coverage, enhancing the quality of care, and lowering healthcare expenses. Its multifaceted approach aimed to make healthcare more accessible and equitable, fundamentally altering how patients receive care nationwide.

2. How does the Affordable Care Act work?

The Affordable Care Act functions through several key mechanisms. It mandates health insurance coverage for most Americans, offers subsidies to help low-income individuals afford insurance, and establishes health insurance marketplaces to facilitate plan selection. The enforcement and administration of these provisions are managed primarily by the Department of Health and Human Services (HHS) along with the Centers for Medicare & Medicaid Services (CMS). These agencies ensure compliance among insurers and healthcare providers, manage enrollment processes, and oversee the regulatory framework that supports the ACA’s goals.

3. What is the legislation’s impact on various populations?

Population Group	Benefits	Negative Impacts	Effect on Health Disparities and Equity
Low-income individuals	Expanded access to insurance and preventive services	Some experienced increased premiums based on income	Helped reduce disparities by improving healthcare access
Elderly	Broadened Medicaid for long-term care coverage	Complexity in plan navigation may cause confusion	Enhanced equity by providing coverage for previously uninsured seniors
Small businesses	Access to more affordable group insurance plans	Additional regulatory burdens and costs for some businesses	Mixed effects depending on business characteristics
Uninsured individuals	Significant decrease in uninsured rates	Penalties applied for non-compliance with mandate	Improved overall health equity through expanded coverage

The ACA has notably enhanced healthcare access for millions, especially marginalized groups. However, challenges remain, such as increased costs for some small businesses and compliance complexities for certain individuals.

4. What evidence supports the Affordable Care Act?

Empirical research supports the ACA’s positive influence on healthcare coverage and outcomes. For example, Sommers et al. (2017) demonstrated a substantial rise in insurance coverage and improved self-reported health among low-income adults following ACA implementation. This evidence underscores the law’s success in expanding access to care and promoting health equity across diverse populations (Sommers, Gunja, Finegold, & Musco, 2017).

B. Analysis of a State Public Healthcare Enacted Law

1. What is one state public healthcare enacted law affecting patient care and healthcare delivery?

In California, the California End of Life Option Act (EOLOA), passed in 2016, is a notable state-level healthcare law. It permits terminally ill patients to request and self-administer medications that hasten death. This law profoundly impacts patient care by enhancing autonomy in end-of-life decision-making, offering patients greater control over their final days.

2. How does the California End of Life Option Act function?

The EOLOA includes rigorous eligibility criteria and procedural safeguards to ensure ethical and legal compliance. Patients must be diagnosed with a terminal illness by two physicians and voluntarily consent to the medication. The California Department of Public Health oversees implementation, collects data, and monitors adherence. Healthcare providers must follow strict regulations to legally participate in the program.

3. What is the legislation’s impact on different populations?

Population Group	Benefits	Negative Impacts	Effect on Health Disparities and Equity
Terminally ill patients	Enhanced control over end-of-life choices	Potential conflicts due to moral or religious beliefs	Strengthens patient autonomy; limited impact on disparities
Healthcare providers	Clear legal guidance for administering aid-in-dying	Ethical challenges and possible professional conflicts	May influence provider-patient trust and relationships
Families	Possible reduction in loved ones’ prolonged suffering	Emotional and ethical stress	Neutral effect on health disparities

While the EOLOA empowers eligible patients with increased autonomy, it also raises ethical concerns within families, healthcare providers, and communities.

4. What evidence supports the California End of Life Option Act?

Studies, such as the work by Ganzini et al. (2019), indicate that patients utilizing aid-in-dying laws report better peace of mind and effective symptom management without increased depression or anxiety. This research validates the EOLOA’s role in enhancing quality of life for terminally ill patients (Ganzini, Harvath, Jackson, & Goy, 2019).

C. The Nurse’s Role in Healthcare Policy at the Organizational Level

1. How do nurses contribute to healthcare policy development, administration, and revision?

Nurses play an essential role in healthcare policy due to their direct experience with patient care and advocacy. Their contributions can be broken down as follows:

Development: Nurses identify care gaps, assess patient needs, and collaborate with interdisciplinary teams to draft policies aimed at improving clinical outcomes. Their frontline perspective ensures policies are patient-centered and practical.
Administration: Nurses, especially in leadership roles, oversee the implementation of policies, ensuring compliance with care standards and resolving operational challenges that arise during execution.
Revision: Through continuous evaluation of clinical outcomes and feedback from practice, nurses advocate for necessary changes to policies that enhance safety and quality of care.

Their unique position allows them to connect clinical realities with policy frameworks, significantly influencing healthcare delivery at organizational and broader levels.

2. What barriers hinder nurses’ engagement in healthcare policy?

Policy Area	Barriers to Nurse Engagement
Development	Time constraints, limited education in policy, lack of leadership roles
Administration	Hierarchical structures, resistance to change, insufficient resources
Revision	Minimal involvement in decision-making, lack of feedback mechanisms

Despite these obstacles, nurse involvement remains vital to ensure that healthcare policies reflect clinical realities and patient needs.

3. How will you engage with healthcare policy in your future nursing practice?

In my future nursing career, I intend to actively participate in healthcare policy by:

Staying updated on emerging health challenges and evidence-based practices.
Joining interdisciplinary committees and quality improvement initiatives.
Advocating for equitable patient care in policy discussions.
Collaborating with policymakers and educating colleagues about the importance of policy in clinical settings.

These strategies will allow me to contribute effectively toward shaping policies that improve patient outcomes and healthcare quality.

References

Ganzini, L., Harvath, T. A., Jackson, A., & Goy, E. R. (2019). Experiences of Oregon nurses and social workers with hospice patients who requested aid in dying. Journal of Pain and Symptom Management, 57(2), 247-254. https://doi.org/10.1016/j.jpainsymman.2018.10.005