President Trump’s Strategy
President Trump has been steadily withdrawing certain portions of the Affordable Care Act. His goal is to clear out the current approach of the Affordable Care Act being where all states are the same in regard to health-care coverage, and let each state decide what they would prefer for issues regarding health-policy. President Trump’s administration has a plan on how they will proceed with withdrawing the Affordable Care Act. This plan includes association health plans, which is where small employers and those that are self-employed can have access that grows to them to provide insurance that offers fewer benefits and is cheaper than was previously tolerable under the Affordable Care Act. Another aspect of the plan is short-term insurance, which allows less comprehensive and lower cost insurance that might not be able to cover previous conditions to be sold by insurers. To reduce an enrollment in the Affordable Care Act, President Trump’s administration also plans to quit all advertisement and diminish the funding for those that help individuals sign up for the Affordable Care Act.
Results of the Plan
There are plans to continue the removal of sections of the Affordable Care Act where the administration sees fit. The administration is projected to issue a new rule allowing individuals to purchase health policies that are short-term, which would be lasting about a year long. In return, these health policies would become less expensive, but would not offer the benefits or protection for the buyer that the Affordable Care Act provides. Leaving regulation of health care coverage to the states has given them broader scope and more flexibility, resulting in insurers, businesses and consumer groups are doing strong lobbying. States that implement the changes will have the opportunity for individuals and businesses to obtain insurance costs that are cheaper, although that also includes more expensive public health expenditures coming from uninsured individuals going to the hospital. There also could be an increase in the cost for insurance for those that are healthy and young in states that are electing for an increase in the regulation of the law.
Republicans had been trying to repeal the Affordable Care Act as a whole, which started to lead more Republican led states to want to do the same thing. Democrats have been fighting to keep the Affordable Care Act in as many states as they can. President Trump’s goal to leave health policy issues up to the states’ decisions, and to withdraw having all states be uniform with one certain way of health care coverage, is supported by the Republicans because they think that since it is better for states to handle certain challenges locally by themselves, that it will be a productive and positive environment for bringing about new ideas that fit each state. Democrats say voters know that Republicans
Reaction from States
The growing divergence between states may be even more pronounced than it was before the Affordable Care Act, also called Obamacare, passed in 2010 (Armour, 2018). States that seemed to have somewhat lenient rules and regulations before the Affordable Care Act seem to be the states that are more assertively trying to implement the changes that President Trump is making. There have been many states that have implemented wider protections for consumers than there were before the Affordable Care Act, while others are making progression toward restricting the running of the law. These restrictions include certain work obligations in order to receive Medicaid. These states include Arkansas, Indiana and New Hampshire, which are considered states that are more conservative.
States are pushing towards letting insurers sell insurance plans at a lower cost, helping to remove benefits such as maternity care, as well as charging people with pre-existing ailments with a higher premium cost. Ms. Reynolds, while signing the bill, said, “Thousands of Iowans will now have affordable coverage” (Armour, 2018). California has banned the establishment of associations that offer the cheap health policies that President Trump’s administration has promoted. The states’ accelerating tendency to peel off in different directions will have significant financial repercussions for nearly 30 million U.S. small businesses, about 17 million people who buy individual coverage, 75 million Medicaid recipients and scores of hospitals and insurers (Armour, 2018). This will be a big change within states, and some will suffer from the change.
Effect on the Nursing Profession
The recent changes that President Trump’s administration has made in regard to the Affordable Care Act can have an impact on the nursing profession. With the split between states, there might be a negative impact on how patients react to health care professionals. I think that in certain states that do not approve of the changes by President Trump’s administration and are having negative effects from it, will have patients that are hostile toward health care professionals. They may become stressed about their health care insurance, resulting in them becoming non-compliant with health care professionals. This can be hard for nurses to provide care effectively.
Certain nurses in states that may have an issue with the changes may decide to move to states that feel the same way they do, which I think could cause job demands to shift. Prior to the Affordable Care Act, there were many people that did not have health care insurance. The Affordable Care Act allowed many of those individuals that were unable to receive health care insurance, get insurance so that they can receive the medical care they need. This caused a shortage in health care professionals. I think that with the recent changes in the Affordable Care Act, there could be less of a demand for nursing jobs.
In conclusion, President Trump’s administration is pulling apart and reforming the Affordable Care Act and putting the states in charge of what to enforce and what to destroy within the plan. This will result in allowing each state to accommodate for what they believe is best for their people. This has caused controversy in the two houses with the Republicans backing President Trump’s idea to remove the Affordable Care Act and the Democrats advocating to keep the plan in as many states as possible. The states have had many different reactions and have developed plans to find one that will work for their people the best. Overall, the nursing community will be impacted due to the inconsistency of the coverage from state to state. Possibly resulting in a job demand shift across the country and hostile patients that do not understand their new policy.