Phillip December 11, 2025 No Comments

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

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?

One of the most significant federal healthcare policies shaping patient care and healthcare delivery in the United States is the Affordable Care Act (ACA), enacted in 2010 during the Obama administration. Often referred to as “Obamacare,” this legislation was created to improve the accessibility, affordability, and quality of healthcare for all Americans. The ACA introduced major reforms such as expanding Medicaid eligibility to cover more low-income individuals, creating health insurance marketplaces to facilitate plan comparison and enrollment, and establishing essential health benefits that all insurance plans must cover.

Moreover, the ACA marked a shift from the traditional fee-for-service payment model toward value-based care, emphasizing preventive services, care coordination, and better population health outcomes. These changes aimed to reduce health disparities, lower overall healthcare costs, and provide comprehensive, affordable coverage options for individuals nationwide.

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

At the state level, Nevada has implemented the Nevada Health Link, the official health insurance marketplace operating under the ACA framework. This digital platform allows residents to browse, compare, and enroll in health insurance plans that best meet their needs, while also offering income-based subsidies to make coverage more affordable for low- and middle-income populations.

Nevada Health Link’s goal is to decrease the number of uninsured residents by promoting timely access to preventive and primary healthcare services. The marketplace ensures that insurance options are transparent and accessible, supporting Nevada’s broader commitment to equitable healthcare access for all its citizens.

A2. How Does Each Policy Work?

Affordable Care Act (ACA)

The ACA functions through a combination of mechanisms designed to expand healthcare coverage and improve quality across various populations. Key provisions include:

Provision	Description
Individual Mandate	Originally required most Americans to maintain health insurance or pay a penalty (repealed in 2017).
Health Insurance Marketplaces	Created platforms (state and federal) for individuals/families to compare and buy plans with subsidies.
Medicaid Expansion	Extended Medicaid to low-income adults previously excluded from eligibility.
Essential Health Benefits	Required insurance plans to cover fundamental services like preventive care, mental health, and maternity care.
Pre-existing Condition Protections	Prevented insurers from denying coverage or charging higher premiums based on health history.
Dependent Coverage Extension	Allowed young adults to stay on their parents’ insurance until age 26.

Together, these provisions foster a more inclusive healthcare environment focused on prevention, continuous care, and improved patient outcomes.

Nevada Health Link

Nevada Health Link acts as a user-centric online portal designed to facilitate residents’ access to ACA-compliant insurance plans. Its core functions include:

Feature	Function
Plan Comparison and Enrollment	Enables users to evaluate insurance options based on price, coverage, and benefits.
Financial Assistance	Offers subsidies and tax credits to eligible applicants to reduce premium costs.
Medicaid Screening	Assists in determining eligibility for Medicaid and other assistance programs.
Support Services	Provides navigators and help desks to guide users through the enrollment process.

While enrollment is voluntary, this platform streamlines access to essential financial aid and information, thus enhancing healthcare accessibility in Nevada.

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

Both the ACA and Nevada Health Link have generated diverse effects across various demographic groups. The following table summarizes these impacts:

Population	Benefits from ACA and Nevada Health Link	How They Benefit	Potential Negative Impact	How They Are Impacted
Low-income individuals & families	Expanded insurance access via Medicaid and subsidies	Lower premiums; improved access to preventive/chronic care	Residents in states without Medicaid expansion remain uninsured	Face coverage gaps and limited affordable plan options
Young adults	Coverage on parents’ plans until age 26	Maintains insurance during college or early career	Risk of higher premiums due to risk pool balancing	Some avoid coverage due to cost or perceived low need
Individuals with pre-existing conditions	Guaranteed coverage without denial or premium hikes	Consistent medical care; financial security	Market premiums may rise to offset risk	Healthy enrollees may face increased costs
Small employers	Incentives/mandates to offer employee coverage	Enhances employee retention and productivity	Compliance and cost burdens on small businesses	Financial and administrative strain
Vulnerable populations	Outreach and culturally competent services	Reduces disparities; improves health literacy	Language and tech barriers remain	Challenges accessing or effectively using benefits

Collectively, these policies promote health equity, preventive care, and community well-being, although ongoing adjustments are necessary to address existing coverage gaps.

A4. What Evidence Supports These Policies?

The creation of the ACA was driven by compelling evidence that millions of Americans lacked insurance, resulting in delayed or forgone medical care. Research by Jacobson and Pilch (2019) indicates that ACA marketplace provisions effectively increased access to affordable and comprehensive insurance, especially benefiting those with pre-existing health conditions.

Nevada Health Link complements the ACA by addressing the unique demographic and economic characteristics of Nevada’s population. For example, Senate Bill 420 (SB420), passed in 2021, introduced a public option to provide more affordable plans to residents ineligible for Medicaid or federal subsidies (Beerman, 2021).

Kelly (2019) emphasizes that broader insurance coverage improves management of chronic diseases, boosts utilization of preventive services, and enhances public health outcomes. This evidence underscores the moral and societal importance of pursuing universal healthcare access.

Do the Evidences Suggest Policy Modifications?

While research supports the effectiveness of the ACA and Nevada Health Link, some challenges remain, particularly for individuals just above Medicaid eligibility. Suggested policy improvements include:

Expanding subsidy eligibility to cover moderate-income groups.
Increasing financial aid to reduce out-of-pocket costs.
Strengthening incentives for preventive healthcare participation.
Addressing social determinants of health, such as housing stability and education.
Implementing cost-control measures to maintain affordability.

These reforms would further advance health equity, cost-effectiveness, and population health.

B. The Role of Nurses in Policy Development and Administration

Nurses are essential contributors to healthcare policy development and administration, bringing clinical expertise and patient advocacy to influence legislation and reform.

Key roles of nurses include:

Advocacy: Promoting equitable healthcare policies, safeguarding patient rights, and improving care standards.
Expert Consultation: Providing policymakers with real-world clinical insights.
Research and Evidence: Supporting policy formulation with data and analysis.
Collaboration: Partnering with interdisciplinary teams to enhance policy outcomes and community engagement.
Education: Informing legislators, patients, and the public about healthcare reforms and issues.

At the federal level, nurses participate through national organizations, advisory panels, and advocacy campaigns. At the state level, they work via nursing associations, professional networks, and direct collaboration with local lawmakers.

B1. What Barriers Do Nurses Face in Policy Engagement?

Policy Area	Barriers
Development	Heavy workloads, insufficient policy education, and limited access to legislative resources.
Administration	Organizational resistance, limited decision-making power, staffing shortages, budget constraints.
Revision	Political opposition, institutional inertia, and lack of representation in policymaking.

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

Policy Area	Planned Engagement Strategies
Development	Advocate for nursing perspectives in policymaking, collaborate with advocacy groups, use research to support equitable healthcare policies.
Administration	Lead policy implementation efforts, monitor adherence, and foster interprofessional collaboration for quality outcomes.
Revision	Promote ongoing policy improvement through evidence-based advocacy, stakeholder involvement, and educational 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