DNP 825 In reviewing the Affordable Care Act, what are the potential effects of having the option for insurance coverage in both the private and public sectors? 

The three main objectives of the ACA were improving access for patients, elevating the quality of care, and reducing healthcare expenditures. Initially, the primary goal for this healthcare change was for all Americans to have greater access to care. The Affordable care act helped millions of Americans obtain insurance and be able to sustain it due to the low cost. This ACT ensured that no American would go without insurance. Wray explained that In recent years, policy makers have called for legislation that would further expand coverage, with proposals including developing a public option, reducing the Medicare eligibility age to 50 years, and expanding Medicare coverage to all US adults. Policy makers have also proposed reducing out-of-pocket costs by increasing subsidies to plans offered on state health insurance exchanges and by expanding eligibility parameters for health insurance subsidies. This was very helpful for nursing as it improved the support at discharge and helped with patient placements. Health care in the United States is financed by a combination of public and private insurance, employers, and individuals who pay out of pocket. Before the ACA, Medicaid covered people who were categorically eligible for benefits based on income and other requirements determined at the state level. Eligibility categories include low-income children and their families, low-income people who are 65 and older, and low-income adults and children who have disabilities. Private health insurance is the most common form of health insurance in the United States. As health-care costs have risen in recent decades, employers have asked employees to share increasingly in the cost of their health care. Employees now pay a higher share of premium costs and face higher coinsurance, copayments, and deductibles than a decade ago. individuals with greater health needs are less likely to disenroll from Medicaid or CHIP coverage and are more likely to have longer periods of Medicaid or CHIP coverage compared to those with fewer health needs. However, findings vary regarding how individuals with health needs respond to premium increases. Some studies show that individuals with greater health needs are less sensitive to premium increases compared to those with fewer health needs, reflecting their increased need for services. Collins, Beth L. MSN, APRN, AGCNS-BC, CGRN; Saylor, Jennifer PhD, APRN, ACNS-BC. The Affordable Care Act: 8 years later. Nursing Management (Springhouse): August 2018 – Volume 49 – Issue 8 – p 42-48 doi: 10.1097/01.NUMA.0000538917.37912.d4 Wray CM, Khare M, Keyhani S. Access to Care, Cost of Care, and Satisfaction With Care Among Adults With Private and Public Health Insurance in the US. JAMA Netw Open. 2021;4(6):e2110275. doi:10.1001/jamanetworkopen.2021.10275