The Affordable Care Act Bills (ACA) 2010 enactment significantly impacted the United States Healthcare System.

Evolution of the Affordable Care Act

When the ACA was launched in 2010, it was a period when the United States was recovering from a harsh recession, the worst since the Great Depression. Policymakers at the time were concerned about the potential of the newly established law, with its ambitious insurance coverage expansion and strict requirements for employer-provided health benefits, to possibly hinder employment growth and the ongoing economic recovery. However, some speculated that the ACA, with its provisions designed to curb the growth in healthcare expenses and its strategies to expand the insured populace, would stimulate the economy. This economic boost would come from liberating funds that could be channeled toward job creation and wage increases, along with expanding demand in sectors other than healthcare (Schoen, 2016).

The ACAs fundamental objective is to revamp insurance and health frameworks to enhance healthcare access, quality, and the costs associated with individuals and the public. The ACA, if effective, can enhance individuals health and positively influence public health. Compared to other nations, the U.S. emphasizes diagnostics and treatment technologies more than primary prevention measures. This emphasis is reflected in the nations high rates of preventable health issues, like obesity, and its relatively low standings in global rankings concerning infant survival and life expectancy. The country also displays significant disparities in health outcomes across different social groups. With its staunch support for primary prevention and public health initiatives, the ACA might be pivotal in reducing these health disparities among vulnerable economic and social groups.

Consequences for the U.S. Healthcare System

For years preceding the ACA, the rise in healthcare expenditure and private insurance costs consistently outpaced economic growth, often by over 2%. Consequently, for those depending on employer-based insurance plans, the escalating healthcare costs began taking up a more significant portion of their total compensation. This situation led to stagnated wages and created a reluctance among employers to hire full-time workers. Research suggests that this rapid cost inflation negatively affected employment wages and increased employee dependency on overtime work. For example, one study inferred that a 10% surge in health insurance costs would diminish employment probability by 1.6% and reduce wages for insured workers by 2.3% (Schoen, 2016).

However, the trend has reversed in the last five years, contributing positively to economic growth. With the rate of increase in premium payments slowing down, businesses found themselves with extra funds, which were then invested in production and job creation, even though this hasnt yet resulted in a significant rise in wages and salaries for most workers (Schoen, 2016).

In the long run, changes brought about by the ACA such as guaranteed access to coverage and prohibition of exclusions based...…various appointment roles. They aim to foster health improvement initiatives within and beyond their immediate communities. Theres a growing acknowledgment and emphasis on incorporating nurses viewpoints in diverse environments, including boardrooms. According to data self-reported to the Nurses on Boards Coalition (NOBC) database, as of the conclusion of 2021, a total of 10,353 board seats were occupied by nurses (NOBC, 2022). As evidenced by Sundean et al. (2022), nurses infuse boards with their deep understanding, skilled expertise, and wise insights about healthcare, embodying values of care and collaboration. These attributes significantly shape board resolutions, potentially influencing both the effectiveness of governance structures and organizational performance dynamics (p. 111).

Nurses on Boards Coalitions Initiatives

Established in 2014, the Nurses on Boards Coalition (NOBC) has been instrumental in facilitating the involvement of nurses in board leadership capacities. The NOBCs inception was responsive to the Institute of Medicines (IOM) 2010 report titled The Future of Nursing: Leading Change, Advancing Health. This report emphasized the importance of enhancing the presence of nurse leaders in key decision-making positions on boards and commissions dedicated to improving nationwide health outcomes. The initial assembly of these groups was orchestrated by the Campaign for Action, a joint venture initiated by the AARP Foundation, AARP, and the Robert Wood Johnson Foundation. This collaborative endeavor to realize the IOM reports recommendations was operationalized through the Future of Nursing: Campaign for Action…