Nursing Is Critical as the Affordable Care Act Is Implemented
This post is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act. Nancy Ridenour, PhD, APRN, BC, FAAN, is dean of the University of New Mexico College of Nursing and an alumna of the RWJF Health Policy Fellows and Executive Nurse Fellows programs.
During my time working as an RWJF Health Policy Fellow on Capitol Hill, I had a recurrent nightmare that reflects the complexity and intensity of the debate over health reform. In this dream I am working in my clinic as a family nurse practitioner. I open the clinic doors and am trampled by the enormous numbers of people rushing to obtain access to care. As I pick myself up off the floor and look outside, I realize that I cannot see the end of the line of people waiting to enter the clinic!
When I was an RWJF Health Policy Fellow working on the House Committee on Ways and Means, I drafted language that survived in the Affordable Care Act (ACA). The need for health reform is clear, but how to achieve the goals of health reform continues to be a challenge. Increasing access and improving quality while cutting cost creates a perfect storm with highly charged debate.
The recent Supreme Court ruling upholding the constitutionality of the ACA spurs us to look forward to implementing the provisions of the law. Nursing is critical for the successful implementation. Transforming our health system from disease-based rescue care to primary care and disease prevention requires dramatic change in how we approach our practice. Focusing on the health of our nation necessitates public health approaches to all levels of care.
The opportunities for nursing include:
- Employing the health promotion, disease prevention, and public health expertise of nurses;
- Dramatic need for increased numbers of primary care providers. Nurse practitioner programs need to rapidly ramp up program enrollments and graduations while continuing high quality health professionals; and
- Quality outcomes and transitions of care depend on nurse sensitive activities and measures.
For the state of New Mexico, in addition to the access, workforce, quality, and cost issues mentioned above, the nuances of the Supreme Court ruling bring expansion of Medicaid to the forefront. Increasing access to quality care is one component in achieving health equity. Continued involvement is needed at the state level to see the transformation to fruition.
In the final analysis, merely implementing the ACA is not enough. We need to continue to forge new partnerships, engage our patients and communities in healthy living, and prepare the health professional workforce to be successful in the transformed system.