ANSWER
Through its definition of scope of practice, reimbursement systems, and patient care practices, health policy efforts greatly affect the clinical practice of Advanced Practice Nurses (APNs). Policies like the Affordable Care Act (ACA) have increased healthcare availability, so allowing APNs to service a larger patient base. State-specific rules define APNs’ degree of autonomy, including prescriptive power and the right to practice alone. Initiatives supporting value-based care also highlight areas where APNs are quite important: preventative services and management of chronic diseases. These rules help to define APNs’ obligations and chances for providing complete healthcare services.
Different states have different Medicaid eligibility rules, which influences low-income people’s access to healthcare facilities. In keeping with ACA expansion rules, California’s Medi-Cal programme, for instance, covers adults making up to 138% of the federal poverty level (FPL). Texas has not expanded Medicaid under the ACA, hence eligibility is more limited; parents with dependent children qualify only if their income is less than 14% of the FPL; non-disabled people without dependent children are generally ineligible. With additional state-funded initiatives covering some groups above this level and more extensive coverage extending Medicaid to those earning up to 138% of the FPL, New York presents more options.
These discrepancies have important ramifications. Greater access to healthcare for low-income people made possible by more broad eligibility helps states like California and New York produce better health outcomes and lower uncompensated care loads on their healthcare systems. On the other hand, in states such as Texas, tight criteria lead to higher uninsured rates, so restricting access to primary and preventive care services, thus aggravating health inequalities and raising emergency care usage. Consequently, state-specific Medicaid policies directly affect the health and well-being of citizens, so underlining the need of policy decisions in determining healthcare access and quality.
QUESTION
Discuss how health policy initiatives are used to guide and direct your clinical practice as an Advanced Practice Nurse.
2. Please locate the Medicaid eligibility criteria for 3 different states. Compare and contrast the eligibility criteria, then discuss the implications of the criteria for people in each state.