America’s New Health Policy

What does it mean for nursing?
by Deborah Trautman, PhD, RN

The historic passage of The Patient Protection and Affordable Care Act, signed into law in March 2010, is the most comprehensive piece of healthcare legislation to pass since Medicare and Medicaid in 1965.

While some like the new law and many of its provisions, others either dislike the law or admit to being very confused. In a recent survey, 81% of Americans know the law was passed but 56% said they do not have enough information about it. When queried, many said they view cable TV, not healthcare professionals, as an important source of information about the law.

Opportunities exist for healthcare professionals to educate themselves and be a voice for others in understanding and interpreting the new law and its implications and be stakeholders for effective implementation.

The new law provides coverage for an additional 32 million Americans (expanding Medicaid by 16 million) and strengthens current health insurance. It makes insurance more affordable and ends discriminatory practices, such as denying insurance to people who have a preexisting condition, or limiting how much money the insurance company will pay—or even dropping insurance coverage altogether—if someone gets sick. It also allows young adults to stay on their parent’s insurance plan until the age of 26. All of these provisions are designed to help more people have better coverage.

The law supports new payment models (the accountable care organizations, medical home, bundled payments) to begin movement away from the current payment system that recognizes volume (fee for service) to one paying for value (outcomes and quality). Evidence-based care, improved care coordination, and patient involvement in the decision-making are supported in the law.

Over 40 key provisions specific to nursing are included. These provisions provide funding and support for nursing practice and education—supporting workforce development programs, loan repayment for students and faculty, grant programs for primary care, nurse managed health centers, nurse-family partnerships and independence at home programs.

Transforming the healthcare system will not be easy work and the future is certain to be ripe with challenge and uncertainty.

Why be involved? Nurses count—today there are 3.1 million nurses, representing 1 in 100 Americans and an estimated 1 in 46 voters. Critical thinking and analysis, assessment planning, implementation and evaluation, resilience, optimism, adaptability, negotiation, advocacy, flexibility, comfort in dynamic unpredictable environments, breadth and depth of knowledge and organizational abilities are a sampling of the characteristics and skill set nurses bring to the table. With a history and commitment to making a difference—nurse participation in shaping a healthier America is self-evident.

Deborah Trautman, PhD, RN is the Executive Director of the Johns Hopkins Center for Health Policy.

Learn more about healthcare reform:

• Trautman speaks at School of Nursing (video)
• White House Council of Economic Advisors
• Department of Health and Human Services
• Speaker of the House of Representatives
• Kaiser Family Foundation
• Center on Budget and Policy Priorities