D223 Task 2 Final: Analyzing the Affordable Care Act and Its Impact

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

D223: Healthcare Policy and Economics

A1. Federal and State Public Healthcare Policy

What is a key federal healthcare policy affecting patient care and healthcare delivery?

A pivotal federal healthcare policy influencing patient care across the United States is the Affordable Care Act (ACA), enacted in 2010 under the Obama administration. Commonly known as “Obamacare,” the ACA was designed to enhance healthcare accessibility, affordability, and quality nationwide. The legislation introduced significant reforms, including the expansion of Medicaid to reach low-income individuals, the establishment of health insurance marketplaces, and the definition of essential health benefits that all qualified plans must include.

The ACA also shifted the focus from a fee-for-service model to a value-based care approach, emphasizing preventive services, coordinated care, and improved population health outcomes. These measures collectively sought to reduce healthcare disparities, lower costs, and ensure that all Americans have the opportunity to obtain comprehensive, affordable health coverage.

What is an important Nevada state healthcare policy that impacts healthcare delivery?

In Nevada, a crucial state-level healthcare initiative is the Nevada Health Link, which functions as the state’s official health insurance marketplace under the ACA framework. This online platform allows residents to compare, select, and enroll in health insurance plans suited to their individual and family needs. It also provides income-based subsidies to make insurance more affordable for low- and middle-income residents.

Nevada Health Link aims to reduce the uninsured population, promote preventive healthcare, and improve public health outcomes by encouraging residents to seek timely medical attention. The marketplace ensures that healthcare coverage is both accessible and comprehensible, aligning with Nevada’s broader goal of advancing equitable and affordable healthcare for all residents.

A2. How Does Each Policy Work?

Affordable Care Act (ACA)

The Affordable Care Act operates through multiple integrated mechanisms that aim to enhance healthcare quality and expand access to affordable coverage across diverse populations.

Key Provisions of the ACA:

Provision	Description
Individual Mandate	Initially required most Americans to maintain health insurance or face a tax penalty, promoting broader coverage. This mandate was repealed in 2017.
Health Insurance Marketplaces	Established state and federal platforms that allow individuals and families to compare and purchase insurance plans with income-based subsidies.
Medicaid Expansion	Extended Medicaid eligibility to include low-income adults who were previously ineligible.
Essential Health Benefits	Mandated coverage for core services such as preventive care, mental health, maternity, and prescription drugs.
Pre-existing Condition Protections	Prohibited insurance discrimination or premium increases based on health history.
Dependent Coverage Extension	Permitted young adults to remain on their parents’ insurance plans until age 26.

Through these combined mechanisms, the ACA promotes a more inclusive and equitable healthcare system focused on prevention, continuity of care, and patient-centered outcomes.

Nevada Health Link

Nevada Health Link serves as a user-friendly portal designed to simplify access to ACA-compliant health insurance plans for Nevada residents.

Core Functions of Nevada Health Link:

Feature	Function
Plan Comparison and Enrollment	Residents can evaluate and select plans based on price, coverage level, and benefits.
Financial Assistance	Provides subsidies and tax credits to eligible individuals and families to offset premium costs.
Medicaid Screening	Helps applicants determine Medicaid eligibility or other assistance programs.
Support Services	Includes navigators and call center representatives who guide users through the enrollment process.

Although participation is voluntary, the platform increases healthcare accessibility by streamlining the enrollment process and linking users to essential financial and informational support.

A3. What Are the Impacts of Each Policy on Different Populations?

Both the ACA and Nevada Health Link have had a broad range of effects on various population groups. The table below outlines the primary benefits, challenges, and impacts.

Population	Benefits from ACA and Nevada Health Link	How They Benefit	Potential Negative Impact	How They Are Impacted
Low-income individuals and families	Increased access to affordable insurance through Medicaid expansion and subsidies.	Reduced premiums and expanded access to preventive and chronic care services.	Residents in non-expansion states remain uninsured.	These individuals face coverage gaps and limited access to affordable plans.
Young adults	Continued coverage under parents’ plans until age 26.	Maintains insurance during education or early career years.	Risk of higher premiums due to balanced risk pools.	Some opt out of coverage due to cost or low perceived need.
Individuals with pre-existing conditions	Guaranteed access to insurance without premium hikes or denials.	Enables consistent medical treatment and financial protection.	Premiums may rise in some markets to balance coverage costs.	Healthy individuals may bear slightly higher costs.
Small employers	Incentives and mandates to provide employee coverage.	Improves workforce retention and productivity.	Compliance and cost challenges for small businesses.	May face financial strain or administrative burdens.
Vulnerable populations	Outreach and culturally competent services encourage participation.	Decreases disparities and promotes health literacy.	Persistent language or technology barriers.	May experience challenges accessing or using benefits effectively.

Overall, these policies collectively contribute to health equity, preventive care, and community well-being, though continuous refinement is needed to close remaining coverage gaps.

A4. What Evidence Supports These Policies?

The development of the ACA was grounded in substantial evidence demonstrating that millions of Americans were uninsured, leading to postponed or foregone care. According to Jacobson and Pilch (2019), the ACA’s marketplace provisions successfully expanded access to affordable and comprehensive insurance, particularly for individuals with pre-existing conditions.

At the state level, Nevada Health Link builds upon the ACA’s foundation by tailoring access to the specific demographic and economic needs of Nevada’s residents. The enactment of Senate Bill 420 (SB420) in 2021 established a public option to offer more affordable plans to residents who were ineligible for Medicaid or federal subsidies (Beerman, 2021).

Moreover, Kelly (2019) highlights that expanded coverage leads to better chronic disease management, increased preventive service utilization, and overall public health improvements, reinforcing the ethical and societal necessity of universal access to healthcare.

Do the Evidences Suggest Policy Modifications?

While evidence supports the effectiveness of both the ACA and Nevada Health Link, certain coverage gaps persist, particularly for populations just above Medicaid eligibility thresholds. Recommended improvements include:

Expanding subsidy eligibility to include moderate-income groups.
Increasing financial assistance for out-of-pocket expenses.
Enhancing incentives for preventive care participation.
Addressing social determinants of health such as housing and education.
Implementing cost-control mechanisms to maintain affordability.

Such reforms could further promote equity, cost-efficiency, and improved population health outcomes.

B. The Role of Nurses in Policy Development and Administration

Nurses serve as crucial stakeholders in health policy development and administration, utilizing their clinical expertise and patient advocacy experience to influence healthcare legislation and reform.

Advocacy: Nurses champion equitable policies, patient rights, and improved care standards.
Expert Consultation: Their firsthand clinical knowledge informs policymakers about real-world challenges.
Research and Evidence: Nurses contribute to policy formulation through research and data analysis.
Collaboration: Interdisciplinary partnerships enhance policy effectiveness and community engagement.
Education: Nurses educate legislators, patients, and the public about healthcare issues and reforms.

At the federal level, nurses engage through national organizations, advisory boards, and legislative advocacy campaigns. At the state level, they influence policies via nursing associations, professional networks, and direct collaboration with local legislators.

B1. What Barriers Do Nurses Face in Policy Engagement?

Policy Area	Barriers
Development	Time constraints due to heavy workloads, lack of policy education, and limited access to legislative resources.
Administration	Organizational resistance, limited authority, staffing shortages, and financial limitations.
Revision	Political pushback, institutional inertia, and limited representation in policy-making processes.

B2. How Will I Engage with Healthcare Policy in My Future Nursing Practice?

Policy Area	Planned Engagement Strategies
Development	Advocate for nursing input in policymaking, collaborate with advocacy groups, and utilize research to support equitable health initiatives.
Administration	Lead policy implementation projects, monitor compliance, and engage in interprofessional collaboration to ensure quality outcomes.
Revision	Promote continuous policy improvement through evidence-based advocacy, stakeholder engagement, and education initiatives.

References

Beerman, L. (2021). Nevada’s public option continues healthcare’s cost versus coverage debate. Healthcare Leadership Review, 40(8), 6–8.

Jacobson, G. P., & Pilch, S. (2019). The Affordable Care Act (ACA): It gets personal, very quickly. Journal of the American Academy of Audiology, 30(8), 656–658. https://doi.org/10.3766/jaaa.30.8.1