Policy Description
As the costs of chronic conditions such as diabetes continue to rise, new policies and strategies are needed to combat them at the municipal, state, and federal levels. More than $240 billion was predicted to have been spent on diabetes care and management in 2012 (Furmanchuk et al., 2021). The Affordable Care Act (ACA) legislation was implemented to increase the population’s access to health care and promote public well-being. Policymakers drafted it in 2010 to improve patient access to treatment and bolster the quality of that care, all while bringing down the overall cost. The policy expanded the Medicaid program, and more people are now eligible for its benefits.
Diverse Population
People of color are twice as likely as non-Hispanic whites to die from diabetes-related causes. Compared to the general non-Hispanic white population, 13% of African American adults have diabetes (Marino et al., 2020). Diabetes-related complications such as diabetic retinopathy, lower limb amputations, and late-stage nephropathy result in more hospitalizations for people of color than whites. Critical factors, including medical policy, will be required to address health inequities among ethnic minorities effectively, but they are not adequate on their own. Culturally adapted treatments encompass public participation, society, and the medical system. They create effective ways to eliminate health disparities, increase care coordination, and improve patient outcomes for underprivileged populations like African Americans.
Policy Design
The ACA aims to improve the quality and affordability of healthcare for African American diabetics. Insurance coverage was supposed to be extended under the ACA to expand the availability of healthcare services. There were elements in the ACA that applied to all socioeconomic categories (Myerson et al., 2019). However, most of the law’s provisions targeted increasing healthcare accessibility for low-income people of color, primarily African Americans. To make Medicaid available to all Americans who make less than 138 percent of the federal poverty threshold, the federal government has put aside considerable premium subsidies for people who can pay for insurance on the newly established exchange.
Financial Soundness
The ACA cost over $900 billion from 2010 through 2019. Healthcare spending would be cut by $140 billion under this proposal. A health insurance plan would lower the cost of drugs and make preventative services more accessible to the American people. Patients with long-term health issues, such as diabetes, should have regular checkups and monitoring by their doctors (Casagrande et al., 2018). This policy ensures that most people can get the medical care they need, improving their well-being and satisfaction. The policy is fiscally sustainable insofar as it is cost-effective.
Nursing Perspective and Ethical Factors
The socioeconomic status of a person has an impact on the amount of access to medical care. With the ACA, the gap between the wealthy and underprivileged patients with diabetes who can receive healthcare services is being bridged. The policy encourages equality from an ethical standpoint. Nurses and other healthcare personnel are supposed to treat patients equally and fairly. Budgetary constraints may prevent the implementation of this purpose and vision in nursing practice (Huguet et al., 2018). States would receive 100% financial support for the first 3 years of Medicaid expansion, after which it would be lowered to 90%. As a result, the policy includes a variety of initiatives to guarantee that health practitioners give patients the most helpful and quality care.
Federal Health Policies
The states initially operated the Medicaid programs following federal regulations. Moreover, the states were compelled to set enrollment, provider payment rates, and benefits. The new policy’s income requirements were stricter than the old ones. This also applies to non-pregnant women, those over 65 years without dependent children, or those with disabilities. That is why state and federal governments collaborated to create this policy (Lee et al., 2020). Regulators in Washington, DC, would be responsible for most of the rules. For example, states that refuse to extend Medicaid to cover more individuals risk losing federal finances. Under the new proposal, the federal government would cover a high share of the cost of healthcare.
Achieving Equitable Health Care
The policy’s design and scope are thoroughly thought out to achieve the targeted outcome. Insurance companies closely monitor healthcare providers to make sure that they are providing the best possible service (Chen et al., 2020). Some indicators used to monitor the performance of healthcare facilities include readmission rates, length of stay in the hospital, and the rate of nosocomial infections. All institutions must comply with the rules by providing high-quality care to patients, improving their outcomes, and reducing underlying costs. Since this policy has been implemented, the imbalance in health access has been addressed.
Advocacy Strategies
The policy’s benefits can only be realized if the public is educated about them. Because of a lack of awareness of the necessity of health screening and testing, the vast majority of the population does not participate. A primary, intermediate, and tertiary public health approach relies heavily on providing patients with educational opportunities (Riddle & Herman, 2018). Well-educated people are more likely to adopt healthier lifestyles, therefore reducing the number of diabetes cases. Education aims to encourage people to be tested and screened for diabetes so that it can be detected earlier and treated more effectively. People who live in low-income areas and are enrolled in Medicaid programs are likely to receive timely treatment when diagnosed with chronic illnesses, which improves their prognosis.
Professional and Moral Obligation from a Christian Perspective
Health and illness prevention should be at the forefront of advanced registered nurses’ professional, moral, and Christian responsibilities. Evidence-based policy standards are generated and tailored to meet specific health needs through translational research (Huguet et al., 2018). Activities aiming at improving public health by reducing the incidence of sickness and pain should be enhanced. As part of this procedure, healthcare personnel should learn about the unique health concerns of the identified groups. Self-care skills, including adequate medication adherence and a healthy lifestyle, are critical to the well-being of diabetes patients.
Summary
In 2010, policymakers drafted ACA to improve patient access to treatment, enhance the quality of care, and reduce the overall cost. The Medicaid program was expanded in line with the policy, and more individuals are now eligible for its entitlements. The ACA has played an important part in ensuring that people with diabetes in the US obtain high-quality care. The state and federal governments have a role in executing the ACA. The entire process has significantly influenced the tasks of advanced practice nurses. Health and disease prevention should be at the frontline of advanced registered nurses’ professional, ethical, and Christian duties.
References
Casagrande, S. S., McEwen, L. N., & Herman, W. H. (2018). Changes in health insurance coverage under the Affordable Care Act: A national sample of US adults with diabetes, 2009 and 2016. Diabetes Care, 41(5), 956-962.
Chen, E. M., Armstrong, G. W., Cox, J. T., Wu, D. M., Hoover, D. R., Del Priore, L. V., & Parikh, R. (2020). Association of the Affordable Care Act Medicaid expansion with dilated eye examinations among the United States population with diabetes. Ophthalmology, 127(7), 920-928.
Furmanchuk, A. O., Liu, M., Song, X., Waitman, L. R., Meurer, J. R., Osinski, K., Stoddard, A., Chrischilles, E., McClay, J.C., Cowell, L.G., Tachinardi, U., & Black, B. S. (2021). Effect of the Affordable Care Act on diabetes care at major health centers: Newly detected diabetes and diabetes medication management. BMJ Open Diabetes Research and Care, 9(1), e002205.
Huguet, N., Springer, R., Marino, M., Angier, H., Hoopes, M., Holderness, H., & DeVoe, J. E. (2018). The impact of the Affordable Care Act (ACA) Medicaid expansion on visit rates for diabetes in safety net health centers. The Journal of the American Board of Family Medicine, 31(6), 905-916.
Lee, J., Callaghan, T., Ory, M., Zhao, H., & Bolin, J. N. (2020). The impact of Medicaid expansion on diabetes management. Diabetes Care, 43(5), 1094-1101.
Marino, M., Angier, H., Springer, R., Valenzuela, S., Hoopes, M., O’malley, J., Suchocki, A., Heintzman, J., DeVoe, J., & Huguet, N. (2020). The Affordable Care Act: Effects of insurance on diabetes biomarkers. Diabetes Care, 43(9), 2074-2081.
Myerson, R., Romley, J., Chiou, T., Peters, A. L., & Goldman, D. (2019). The Affordable Care Act and health insurance coverage among people with diagnosed and undiagnosed diabetes: Data from the national health and nutrition examination survey. Diabetes Care, 42(11), e179-e180.
Riddle, M. C., & Herman, W. H. (2018). The cost of diabetes care—the elephant in the room. Diabetes Care, 41(5), 929-932.