In a long-awaited decision this past June, the Supreme Court upheld the constitutionality of the Affordable Care Act (ACA). As a staunch supporter of the ACA and longtime advocate for reform of health care that is illness-focused and inaccessible to millions of uninsured in this country, the American Nurses Association (ANA) welcomed this news.
Health care reform didn’t just become a priority for ANA within the past few years. As early as 1991, with the national health care system already in a state of crisis, ANA collaborated with the nursing community to develop Nursing’s Agenda for Health Care Reform. This document served as a blueprint for reform that was endorsed by more than 60 nursing and health care organizations.
ANA was the only organization that, in addition to the three pillars of health care reform: access, cost and quality, advocated for workforce as an additional pillar. We knew more than 20 years ago that, in order for health care reform to be truly effective, there must be an adequate supply of RNs and other health care professionals. Research in the decades since then has consistently demonstrated the intrinsic value and contribution of RNs to quality patient outcomes and the difference a BSN degree and advanced education make in nurses’ ability to reduce patient complications and mortality.
ANA has long supported health care reform because we believe health care should be a basic human right in this country. We believe that society has a moral obligation to provide basic health care to all people and that access to basic health care should not be limited by an individual’s ability to pay. Despite spending more per capita for health care for our citizens than any other country in the world, more than 40 million people are estimated to have no or limited access to vital health care services. As a direct result, tens of thousands suffer preventable death each year and hundreds of thousands face financial ruin because they can’t afford medical care when they are sick. In the United States, we have failed to accomplish what every other industrialized country in the world has managed to do – provide health care for all at a reasonable cost.
While the ACA is admittedly not a perfect law, it moves us closer toward the vision of accessible, basic health care for all. In fact, we are already seeing the benefits from the law in people’s lives. The ACA has afforded millions of people greater protections against losing or being denied health care coverage, as well as better access to primary and preventive services. Young adults are able to retain health coverage under their parents’ policy. Seniors are receiving free preventive services. Insurance companies can’t impose annual or lifetime coverage limits, and individuals with pre-existing conditions have new options for health insurance.
I recently attended a meeting with the Assistant Secretary for Health, Dr. Howard Koh, and other health care leaders to discuss how best to integrate the most recently available preventive ACA health benefit – free screening and counseling for interpersonal and domestic violence – into primary care service provision. Under the ACA, effective Aug. 1, 2012, women will now have access to these potentially life-saving preventive screening and counseling services. The list of preventive services under the ACA grows as the law’s provisions continue to roll out. (For the list, go to www.healthcare.gov/prevention/index.html).
As nurses, we know the value and cost-savings associated with preventive care and early intervention. We also know the price we all pay when people without insurance defer necessary care or treatment. ANA will continue to advocate for a health care system that provides all individuals access to basic health services and focuses on wellness, early intervention, chronic disease management and care coordination – all areas where nurses’ knowledge, education and expertise can and do make a difference.