It’s only just begun….
It’s only just begun…..Although the Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23, 2010 by President Barack Obama, the debate over health care reform measures is just getting fired up, especially within the states.
In response to the federal reform legislation, at least 39 states have proposed legislation to limit, alter or oppose measures included in the PPACA; essentially keep the purchase of health insurance optional. (Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin and Wyoming). Virginia was the first of three states to enact law challenging the PPACA insurance purchase mandate, followed by Idaho and Utah. Other challenges include that of proposing state constitutional amendments, which will be seen as ballot questions during the fall 2010 elections; as well as at least 18 attorneys general having filed suit against the federal government citing that compelling everyone to buy insurance or face a penalty is unconstitutional. The lawsuits are raising considerable interest among the legal community, yet history suggests that federal judges are generally unwilling to overturn congressional legislation.
Given the many positive outcomes, it would be unfortunate to see those lost if the law were to be successfully challenged. Specifically, some of the key provisions for nursing resulting from the PPACA, Public Law 111-148 are increased funding for the primary care workforce; grants for nurse managed health centers and nurse education, practice and retention programs; expansion of nurse loan repayment and scholarship programs, including faculty; workforce diversity grants; grants for advanced practice registered nurses (APRNs) agreeing to work in the field of geriatrics or long term care; increased reimbursement for the services of certified nurse-midwives to match that of a physician providing comparable services; creation of an independence at home demonstration program for chronically ill Medicare beneficiaries, with nothing in the law preventing a nurse practitioner (or physician assistant) from participating in or leading the health care team; a non-profit patient-centered outcomes research institute to perform and synthesize research on effectiveness of care; release of staffing data on the Nursing Home Compare Medicare website for each facility; two grant programs for school-based health centers; and establishment of the Center for Quality Improvement and Patient Safety within the Agency for Healthcare Research and Quality to identify best practices for the delivery of quality health care services. Details of these initiatives and others can be viewed here.
Janet Haebler, MSN, RN
Tags: April 2010, health care reform, Patient Protection and Affordable Care Act (PPACA)
