Introduction
While the Affordable Care Act (ACA) was implemented by President Barack Obama back in 2010, its effects and coverage continue expanding to this day, with remaining provisions expected to be phased in up until 2020. The purpose of the ACA was to provide the population of the United States with the increased security in healthcare services they receive through the expansion of service coverage, holding insurance companies accountable, lowering costs on health care, guaranteeing more choice of services, and enhancing the overall quality of care (“Affordable Care Act,” 2017). Therefore, the healthcare driver for the policy is a combination of several factors. Taking into consideration Kingdon’s policy window model, the problem stream related to the ACA is the insufficient access to healthcare services as well as challenges associated with insurance. Policy stream, in this case, is linked to the expansion of the act country-wide. Lastly, political stream is related to the ability of legislators to enforce the proposed changes.
Effects of the Policy
Based on the findings of the Commonwealth Fund, getting an insurance coverage increased the probability “of having a usual place of care by between 47.1% and 86.5%” (“Effect of the Affordable Care Act on health care access,” 2017, para. 1). Also, it was found that the ACA decreased the likelihood of patients not receiving healthcare services between 20.9% and 25%. Both National Health Interview Survey and Behavioral Risk Factor Surveillance System data show that prior to the implementation of the ACA, the population had lower rates of access to healthcare services while healthcare facilities showed the decreased profitability because the majority of their patients did not have a usual place of care. With regards to the effect of the ACA on the nursing practice, several accomplishments should be mentioned. First, the demand for nurse practitioners (NPs) skyrocketed due to the increased use of emergency rooms and regular hospital visits. To address this demand, it is forecasted that between 2010 and 2020, the active supply of registered nurses (RN) in healthcare facilities will increase from 3.5 million to 3.95 million (“How the Affordable Care Act affected nursing,” 2016). On the other hand, the nursing profession has been challenged by the increased workload and short-staffing that are dangerous issues that could only be addressed through hiring and training new personnel.
Policy Issue
As a direct implication of the Affordable Care Act, there is a shortage of nurses due to the increased workload in healthcare settings. An essential point with regards to this problem relates to nursing education as well as “effective workforce planning and policy making” with “better data collection and an improved information infrastructure” (Milstead, 2016, p. 5). Through the use of Kingdon’s policy window model, it is proposed to influence the further change in the policy to address the problem of the lack of nursing personnel in the workplace. The problem stream (issue identification) is as follows: due to the increased demand of patients for receiving healthcare services in emergency rooms or general hospital settings, the profession is currently challenged by the shortage of personnel that usually exasperates the increasing workload. Political stream is associated with the possible involvement of stakeholders such as nurse managers who will report the problem to policymakers. Lastly, the policy stream involves a solution – encouraging students to choose the nursing profession, preparing new nurses for the immense workload, and facilitating the effective collection of information to enhance professionals’ competence.
Conclusion
It has been shown that the ACA has achieved significant results after being implemented. The Act both improved Americans access to healthcare and decreased the number of uninsured. However, the increased demand for skilled RNs and NPs contributed to the shortage of personnel, which is a challenge that remains to be addressed.
References
Affordable Care Act. (2017). Web.
Effect of the Affordable Care Act on health care access. (2017). Web.
How the Affordable Care Act affected nursing. (2016). Web.
Milstead, J. (2016). Health policy and politics: A nurse’s guide (5th ed.). Burlington, MA: Jones and Bartlett Publishers.