The ACA (2010) illustrates a national effort to increase
access to health care through the restructuring of multiple
elements of the U.S. health care system. The ACA, for example,
expands health insurance through the creation of the
American Health Benefit Exchange (sec. 1211), changing
Medicaid eligibility to cover all individuals at or below
133% Federal Poverty Limit (sec. 2001), and reauthorizing
the State Children’s Health Insurance Program (sec. 2101).
Nurses can maximize the potential impact of the ACA provisions
by advocating at a state level for state participation and
educating high-risk populations about their ability to obtain
health insurance through new options. Nurses can also take
advantage of new grant funding available through the ACA
to pilot creative community prevention strategies, workplace
wellness programs, and more effective approaches to primary
care. Despite the potential for the ACA to significantly
increase access to health insurance in the United States,
nurses must keep in mind that access to health insurance is
not the same as access to health care or a guarantee of
improved health status. Changes in health policy alone are
not sufficient to address the impact of social determinants on
health status.