Compare Public Healthcare Policies At Federal And State Leve

Compare public healthcare policies at federal and state levels that affect patient care

Your task is to compare public healthcare policies at the federal and state levels that influence the provision of patient care and healthcare delivery. You need to describe one federal and one state public healthcare policy, explain how each policy functions (e.g., whether it is mandatory, enforcement requirements, responsible agencies), and analyze their impacts on different populations. Additionally, discuss the supporting evidence for each policy from recent scholarly sources, evaluate whether the evidence supports the policies, and suggest potential modifications based on this evidence. Furthermore, explore the role of nurses in policy development, administration, and revision, reflecting on barriers to nurse engagement and strategies for future involvement in these areas. Proper citation of sources with in-text citations and references is required.

Paper For Above instruction

The landscape of healthcare policy is complex, involving multiple levels of governance that collectively shape the quality, accessibility, and equity of patient care. At the core of this system are federal and state policies, each with unique mechanisms and impacts. This paper compares one federal and one state public healthcare policy, examines their operational frameworks, their effects on various populations, and the evidence underlying these policies. Additionally, it explores the vital role of nursing professionals in policy development, emphasizing strategies to overcome barriers and enhance engagement.

Federal Healthcare Policy: The Affordable Care Act (ACA)

The Affordable Care Act (ACA), enacted in 2010, represents a landmark federal policy aimed at expanding healthcare access, reducing costs, and improving quality of care (Sommers et al., 2017). Key provisions include the expansion of Medicaid eligibility, the establishment of health insurance exchanges, and mandates for coverage. The ACA is mandatory; compliance is enforced through federal mandates, and federal agencies such as the Department of Health and Human Services (HHS) oversee its implementation.

The ACA impacts diverse populations by increasing insurance coverage among low-income and marginalized groups, thereby potentially reducing disparities. Specifically, Medicaid expansion benefits economically disadvantaged populations, providing them with access to preventive and primary care, which can lead to better health outcomes (Sommers et al., 2017). Conversely, populations in states that did not expand Medicaid might experience limited benefits, possibly exacerbating existing disparities. The policy aims to reduce health disparities and promote health equity by broadening coverage but faces challenges in uniform implementation across states.

The evidence supporting the ACA indicates significant improvements in insurance coverage and access to care. Studies show that expansion has led to increased preventive service use and improved health outcomes among vulnerable populations (Woolf et al., 2018). However, some evidence suggests that policy modifications, such as enhanced outreach and enrollment support, could further reduce disparities and improve the effectiveness of the policy.

State Healthcare Policy: California’s Medi-Cal Expansion

California’s Medi-Cal expansion, part of the state’s efforts to implement ACA provisions, extends Medicaid coverage to all income-eligible adults up to 138% of the federal poverty level. This policy is mandatory for states that opted into Medicaid expansion under the ACA, and its administration is managed by the California Department of Health Care Services (DHCS) (California Department of Health Care Services, 2020). The policy mandates participation, with enforcement mechanisms involving state oversight and federal funding incentives.

The Medi-Cal expansion primarily benefits low-income adults previously ineligible for Medicaid, improving access to preventive and ongoing healthcare services. Populations benefitting include uninsured adults with low income, resulting in better health management and reduced reliance on emergency services. However, some populations, such as undocumented immigrants, are excluded from coverage, which can perpetuate disparities and impact health equity negatively (Gordon & Ponce, 2021). The policy has contributed positively to health equity by reducing uninsured rates among low-income groups, yet challenges remain in fully addressing disparities related to social determinants of health.

The evidence supporting Medi-Cal expansion demonstrates an increase in insurance coverage, improved access to primary care, and reductions in hospitalizations for preventable conditions (Gordon & Ponce, 2021). These outcomes suggest the policy's effectiveness but point to potential modifications such as expanding coverage to include undocumented immigrants or enhancing outreach efforts to marginalized groups.

Role of Nurses in Policy Development and Impact

Nurses play a crucial role in shaping healthcare policies by serving as advocates, researchers, and policymakers. Their frontline experience and understanding of patient needs position them to influence policy development and revision effectively (Buchanan, 2019). Nurses can contribute valuable insights into how policies are enacted and experienced at the ground level, helping to tailor policies to better meet patient needs and promote health equity.

However, barriers to nurse engagement include limited awareness of policy processes, lack of institutional support, time constraints, and insufficient training in policy advocacy. To overcome these obstacles, nurses should pursue ongoing education in health policy, participate in professional organizations, and seek leadership roles that influence policy decisions (Buchanan, 2017). In practice, nurses can engage in policy development by providing expert testimony, collaborating with policymakers, and participating in community advocacy initiatives.

Future nurses can enhance their involvement by engaging in policy education, leveraging social media platforms for advocacy, and collaborating with interdisciplinary teams to influence healthcare reforms. Such efforts can lead to meaningful improvements in healthcare delivery, ensuring policies are more responsive to patient and community needs.

Conclusion

In summary, federal and state healthcare policies critically influence the accessibility, quality, and equity of patient care. The ACA exemplifies broad federal efforts to improve coverage, while state policies like California’s Medi-Cal expansion target specific population needs. Evidence supports the positive impacts of these policies but also highlights areas for potential improvement. Nurses, as vital contributors to healthcare, have a pivotal role in policy development, administration, and reform. Overcoming barriers to nurse engagement and fostering active participation can lead to more equitable and effective healthcare systems.

References

• Buchanan, E. (2017). Nursing and health policy: A call to action. Nursing Outlook, 65(2), 136-138.
• Buchanan, E. (2019). Nursing influence in policy development: Strategies for engagement. Policy, Politics & Nursing Practice, 20(3), 135-144.
• California Department of Health Care Services. (2020). Medi-Cal expansion implementation. https://www.dhcs.ca.gov
• Gordon, L., & Ponce, N. (2021). Addressing disparities in Medicaid expansion: Lessons from California. Health Affairs, 40(3), 471-479.
• Sommers, B. D., Gunsalus, C. K., & Cummings, J. (2017). The Affordable Care Act and its impact on health equity. New England Journal of Medicine, 377(16), 1506-1509.
• Woolf, S. H., Schoomaker, H., & French, M. (2018). Reframing the public health role in health care reform. JAMA, 320(20), 2095-2096.