NR_443 Week 7 Discussion, Healthcare Policy

NR_443 Week 7 Discussion, Healthcare Policy • Provide a brief overview of the article, and include the URL link. • As a healthcare professional, has this raised any ethical questions or concerns for you? • How can a community health nurse (CHN) be involved as a change agent for related healthcare policies? While millions of people have gained coverage through the expansion of Medicaid under the Affordable Care Act (ACA), state decisions not to implement the expansion leave many without an affordable coverage option. Under the ACA, Medicaid eligibility is extended to nearly all low-income individuals with incomes at or below 138 percent of poverty ($28,676 for a family of three in 20181). The characteristics of the population that falls into the coverage gap largely mirror those of poor uninsured adults. For example, because racial/ethnic minorities are more likely than White non-Hispanics to lack insurance coverage and are more likely to live in families with low incomes, they are disproportionately represented among poor uninsured adults and among people in the coverage gap. Nationally, more than two million poor uninsured adults fall into the “coverage gap” that results from state decisions not to expand Medicaid, meaning their income is above current Medicaid eligibility but below the lower limit for Marketplace premium tax credits. These individuals would be eligible for Medicaid had their state chosen to expand coverage. As a nurse, I think adults in the coverage gap are likely to face barriers in health services or if they do require medical care, potentially serious financial consequences. Many people who are in fair or poor health or are in the age range when health problems start to arise but lack of coverage may lead them to postpone needed care due to the cost. While the safety net of clinics and hospitals that have traditionally served the uninsured population will continue to be an important source of care for the remaining uninsured under the ACA, and this system has been stretched in recent years due to increasing demand and limited resources. One way Community Nurses can help close the insurance gap is to participate in local health events that target the uninsured. Nurses need to be savvy about knowing which programs their own facility can and cannot provide to uninsured patients and to become familiar with their own processes for helping patients move between providers. Nurses are professionals whose understanding, skills and caring concern are used to endorse both individuals and community’s welfare, (Nies, M.A., McEwen, 2019). References: Rachel Garfield. (2019). The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid. Retrieved from Luhby, T. (February 2019). Closing the Health Insurance Gap. Retrieved from Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.