Implementation of the health insurance exchanges (Exchange), a key provision of the Affordable Care Act, is less than nine months away. The deadline for notifying the Department of Health & Human Services (HHS) as to the proposed design of a state health insurance exchange is history. Seventeen states plus the District of Columbia (DC) have received conditional approval from HHS to run their own Exchange. Those states are California, Colorado, Connecticut, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont, Utah, and Washington. If not planning to operate a state based exchange, states have until February 15th to notify HHS of the desire for a state-federal partnership. Arkansas and Delaware have already been conditionally approved for the partnership model as others wait to hear. Any states not having submitted a request to HHS for either of the two models will be subject to a federally run Exchange with the ability to amend their decision in the future. Regardless of the decision as to the type of Exchange, there remains allot of work yet to do by all involved parties.

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With less than a month before the 2012 Presidential election, both candidates have offered vastly different visions for the future of America’s health care system. At the heart of the debate is the Affordable Care Act (ACA) – the President’s landmark legislative achievement and a lightning rod for his opponents.

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Election year or not, this time of year is always a busy time for ANA and the state nurses associations as they come together for the annual lobbyist meeting and the American Nurses Advocacy Institute (ANAI), both held in Washington, DC, just blocks from the Capitol. Rich discussions and attempts to predict upcoming legislative sessions are plentiful.

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On July 30, 2012, Secretary of Health and Human Services Kathleen Sebelius announced selection of five hospitals to participate in the Graduate Nurse Education Demonstration, to support training of additional advanced practice registered nurses in hospital and community settings. Created by the Affordable Care Act, the demonstration “will provide APRNs with primary care, preventive care, transitional care, and the chronic care management skills needed to provide effective and well-coordinated care.”

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New federal regulations from the Department of Health and Human Services (HHS) give States considerable flexibility in creating “Affordable Insurance Exchanges,” an important part of health care reform. The Affordable Care Act (ACA) requires each State to have in place, by 2014, a health insurance exchange market where consumers and small businesses can compare and enroll in health plans, get answers to questions, and see if they are eligible for tax credits or subsidized programs like the Children’s Health Insurance Program (CHIP).

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My name is Cece Henry, and I’m an intern this spring with the ANA Government Affairs Department (GOVA). After 20 years of primarily ICU/CCU nursing, I decided to return to school for my master’s degree. I wanted to do something that took me out of the traditional hospital setting, and learned about this internship after taking a class last semester with Abby Ehret, a former GOVA intern. After hearing about her memorable experiences, I knew I had to be here!

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