Effective Care for Minority Marginalized Communities in the United States Essay Paper

Select a current or proposed health care policy that is designed to improve a specific population’s access to quality, cost-effective health care. In a paper of 1,000-1,250 words, include the following:

Explain the policy and how it is designed to improve cost-effectiveness and health care equity for the population. Is the policy financially sound? Why or why not? How does the policy account for any relevant ethical, legal, and political factors and the nursing perceptive one must consider when implementing it?
To what state, federal, global health policies or goals is this particular policy related? How well do you think the policy is designed to achieve those goals?
Finally, discuss the advocacy strategies you would employ on behalf of your population to ensure they have access to the benefits of the policy. Explain, from a Christian perspective, the professional and moral obligation of advanced registered nurse to advocate for and promote health and prevent disease among diverse populations.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.  Effective Care for Minority Marginalized Communities in the United States Essay Paper

The ACA 2010 Healthcare Policy: Improving Access to Quality Cost-Effective Care for Minority Marginalized Communities in the United States
The United States is one of the most expensive countries in terms of healthcare (Sultz & Kroth, 2018). Part of the reason for this is that the healthcare sector in the country has been left in the hands of private enterprise. It is therefore run like any other business for purposes of gaining maximum profit. This means that those who can afford will get the best quality healthcare services; while those who cannot afford will die from preventable causes and conditions. Providers who have come together under Managed Care Organizations (MCOs) decide and control the cost of services as well as the provider that a patient visits for services. Referrals are made among the same members of an MCO. The situation is made worse by the fact that the United States does not have a single-payer healthcare system too. The closest that the US has come to a single-payer system is the Centers for Medicare and Medicaid Services (CMS). However, this is not the case because policies in place have not enabled the concept of “Medicare for All” to take place (Cai et al., 2020). Because of systematic racism over the decades, the populations most affected by the lack of access to quality cost-effective healthcare services are those of minority communities. Effective Care for Minority Marginalized Communities in the United States Essay Paper These happen to be overwhelmingly Hispanics and African Americans or Blacks. This is because they are the ones affected by negative social determinants of health such as low socioeconomic status (poverty), low educational achievement, unsanitary living conditions, lack of access to quality healthcare, and lack of regular access to clean drinking water (Powell, 2016). In 2010, the first African American (Black) President in US history signed into law a revolutionary healthcare policy that would change the situation of access to quality cost-effective healthcare for this marginalized population of Americans. The law was the Patient Protection and Affordable Care Act or simply ACA 2010 (Kominski et al., 2017). The purpose of this paper is to discuss the impact of this healthcare policy in facilitating access to quality cost-effective healthcare services for marginalized Black and Hispanic populations in the US.
An Explanation of the Affordable Care Act (ACA 2010) Policy and Its Effect on Healthcare Equity
The ACA 2010 was a revolutionary healthcare policy from the standpoint of healthcare advocacy and equity. From the introduction above, it has been stated that because the healthcare system in America is so expensive only some citizens can afford it. A large number of the rest cannot and end up not accessing quality healthcare services. The results are catastrophic. For instance, the mortality rate for treatable and manageable diseases is higher among the poor communities than the rest of the country. Also, those with pre-existing conditions in these marginalized communities have been dying in larger numbers because they could not afford the cost of the constant care and treatment they needed. All this changed when the ACA 2010 was enacted into law by President Barack Obama. The Act brought into healthcare coverage an additional 22 million Americans who were poor and could not afford the high premiums of healthcare coverage (Kominski et al., 2017). The scheme involves harnessing the power of economies of scale. The Act therefore requires everybody to take up healthcare coverage with the ACA 2010. Because there are hundreds of millions of citizens, the premiums are cheaper. A provision has then been put that will have the citizen that does not take the coverage imposed with a penalty. This is the provision referred to as the individual mandate.


The policy of ACA 2010 is therefore designed to improve cost-effectiveness and healthcare equity of marginalized communities in several ways. First, it has a provision that requires all private insurance companies to indiscriminately cover patients with pre-existing conditions. The government then compensates these companies by providing financial incentives every year. Second, a provision is present that changes the model of care from a volume-based care system to a value-based care system. This means that maximum reimbursement will only be realized by providing quality care, regardless of the number of patients. Initially, reimbursement was pegged on the number of patients seen regardless of quality. This provision is the pay-for-performance stipulation in the ACA 2010 (Holmström, 2017). This way, there will be equitable provision of care because it will not matter the status of the patient treated. What will matter will be the quality of care.
Financial Soundness of the ACA 2010
It was estimated that the Patient Protection and Affordable Care Act 2010 would cost $940 billion by the time it would have been fully implemented after 10 years (Amadeo, 2020). Given the immense benefits that it would accord the poor citizens and minority populations, this policy is definitely financially sound. The policy accounts for the bioethical principle of justice by trying to bring about equity and fairness in the access to quality cost-effective healthcare services in the US (Haswell, 2019). Legally, the policy accounts for international humanitarian law that requires all human beings to be treated equally and with dignity. Part of that dignity is according them access to quality healthcare at affordable cost. Politically, the policy makes the Democratic Party the first to have its president offer poor Americans something close to Universal Healthcare Coverage (UHC). There would however be intense lobbying by the private enterprises running healthcare to have the ACA 2010 repealed and replaced by a Republican President in the form of President Trump. The nursing perspective to consider when implementing the ACA 2010 is patient advocacy. This is because the whole policy in itself is a result of advocacy and a testament to consideration of the patient’s rights regardless of their socioeconomic status.
Alignment to State, Federal, and Global Policies or Goals
He state and federal policies and goals that the ACA 2010 relates to are those that prioritize preventive healthcare. These are policies and goals that aim to preserve public health by cutting down the incidence of disease before it even occurs. The policies depend more on screening and early identification of disease. An example is colorectal cancer screening. The ACA covers these preventive measures and is therefore related to these policies and goals at the state and federal level. Globally, the ACA 2010 is related to the policy of health for all as advocated by the World Health Organization (WHO). This goal was epitomized by the Alma Ata Declaration (Topp & Abimbola, 2018). The ACA 2010 policy appears very well designed to achieve these goals. The reason for this is that its implementation is staggered over time, and some provisions have been left for the individual states to see through. Effective Care for Minority Marginalized Communities in the United States Essay Paper

Advocacy Strategies to Employ
Some of the advocacy strategies the advocacy strategies to ensure the marginalized populations benefit from the ACA 2010 policy include (i) working with faith-based organizations in these communities to sensitize them on its availability, and (ii) organizing community townhall-style education meetings for health promotion outside the era of Covid-19). From a Christian perspective, the professional and moral obligation of the advanced practice registered nurse (APRN) is to “do unto others what you would like them to do unto you.” Ensuring healthcare equity in access and quality is part of this Christian philosophy.

Amadeo, K. (2020). How much did Obamacare cost? The Balance. https://www.thebalance.com/cost-of-obamacare-3306050
Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J.S., & Kahn, J.G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine, 17(1), 1-18. https://doi.og/10.1371/journal.pmed.1003013
Haswell, N. (2019). The four ethical principles and their application in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 177-179. https://doi.org/10.12968/joan.2019.8.4.177
Holmström, B. (2017). Pay for performance and beyond. American Economic Review, 107(7), 1753–1777. https://doi.org/10.1257/aer.107.7.1753
Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. https://doi.org/10.1146/annurev-publhealth-031816-044555
Powell, D.L. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 24(1), 5-10. http://dx.doi.org/10.1891/1078-4535.22.1.5
Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9th ed. Jones & Bartlett Learning.
Topp, S.M., & Abimbola, S. (2018). Call for papers – the Alma Ata Declaration at 40: reflections on primary healthcare in a new era. BMJ Global Health, 3(2), 1-2. http://dx.doi.org/10.1136/bmjgh-2018-000791  Effective Care for Minority Marginalized Communities in the United States Essay Paper


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