According to Ehlke (2009), Buerhaus, Ulrich, Donelan, and DesRoches (2008), the health insurance and health care system in America have become an overly politicized arena. Some authors like Healy (2010) perceive that the current health care system is a political positioning that is highly subjective and devised to benefit a select few while the majority will suffer under the heavy burden of higher premiums. It is affirmative that the health care system needed urgent amendments (Guevara & Mendias, 2002). Nonetheless, improving health care needed to be an all-round, all-inclusive undertaking that takes into account all parties involved without oppressing a given party (McLaughlin, 2005).
Different institutions have reacted to the Affordable Care Act, which has also been brandished Obama Care (Ellerbe and Regen, 2012; Healy, 2010; McLaughlin, 2005; Gibson & Singh, 2011). In the nursing profession, the Affordable Care Act (ACA) has aroused mixed reactions and issues that tend to conflict with nursing profession (Ellerbe & Regen, 2012). Ellerbe and Regen connote that while ACA has a set of important implications, the nursing profession is increasingly a competitive environment that “emphasizes on the importance of positive patient outcome” (p. 210).
The challenge comes from consumers (patients) that have learnt the quality of service expected from health care providers (Arah, Klazinga, Delnoij, Ten Asbroek, & Custers, 2003; Ellerbe & Regen, 2012). This tends to increase the pressure on the nursing profession especially with an increase in health care insurance covers (Arah et al., 2003; Ellerbe & Regen, 2012). The basic concept of the ACA was to ensure that middle and low-income earners will afford health care insurance covers. On the other hand, the premium covers for those perceived to be higher income earners increases (American Academy of Nursing [AAN]. 2010).
AAN (2010) connotes that the complexity of the Affordable Care Act accentuates challenges in health care delivery mechanism, coverage, payment, and education. Some of these issues have already been introduced and others are underway, but the complexity in expectation from nursing profession varies. Patients paying more for their health insurance cover demand high-quality services, which is a sleek divide that ACA fails to delineate. Although under the Advanced Practice Registered Nurses (APRNs), the role of nurses is expanded, the “role and quality of service expectation for primary and other health care services” seems obscured (AAN. 2010, p. 1). The main challenge in this issue is unclear role of the nurse in the ACA as regards to “affordability, quality, equitableness, and appropriate health care” (AAN. 2010, p. 2). However, lack of a clear regulatory framework that addresses these challenges in enforcement mechanisms creates a challenge for nursing professionals (AAN. 2010).
Although APRNs have been in existence for some time, a large number of insurers...