NEW YORK NURSE: April 2010
by Erin Silk
After many months of heated debate, the U.S. Congress passed the Senate version of the healthcare reform bill on Sunday, March 21, including provisions to insure 32 million more Americans. President Barack Obama signed the bill two days later. A companion package, including additional changes sought by Democrats, was also approved.
Coined the “healthcare overhaul bill,” it includes immediate reforms, as well as long-term plans for change. Ninety days after the bill’s enactment, those previously denied insurance will receive immediate access to coverage through a temporary high-risk pool.
Also effective this fiscal year: extending dependent coverage for children until age 26, reducing the impact of the Medicare Part D “donut hole” with $250 rebates to qualifying Medicare beneficiaries, and prohibiting insurers from dropping coverage for children with pre-existing medical conditions.
The bill includes tax credits for small businesses to help make newly mandated employee health coverage more affordable. Tougher restrictions of annual limits for new plans will also kick in this year.
Other measures, such as requiring all Americans to purchase health insurance or face fines, increasing tax subsidies to help low-income people afford health care, and expanding state Medicaid programs, will not go into effect until 2014.
Additional highlights of the bill:
“Although we recognize that the bill falls short of a comprehensive overhaul, it will enact significant reforms necessary to move our healthcare system in the right direction to meet the needs of all Americans,” said Tina Gerardi, NYSNA CEO.
The reforms, while thought to be too costly by some, will ultimately cut the deficit by $130 billion in the first decade and $1.2 trillion in the second decade.
The bill begins to address nursing shortages through funding support for a Nursing Workforce Development program and the creation of a Public Health Workforce Corporation, providing scholarship and loan repayment support for public health professionals serving in areas of need.
Reform measures also expand the Nurse Loan Repayment and Scholarship program to provide loan repayment for students who serve for a period of not less than two years as a faculty member at an accredited school of nursing.
Included in the overhaul is a Center for Quality Improvement to identify and implement best practices. Within 18 months of the bill’s passage, the director of the Agency for Healthcare Research and Quality must submit a report to Congress “on the impact of the nurse-to-patient ratio on the quality of care and patient outcomes, including recommendations for further integration into quality measurement and quality improvement activities.”
APRNs and certified nurse midwives are integral to primary care and the American Nurses Association has long advocated for more inclusive language relating to their scope of practice. The new healthcare overhaul law reflects provider-neutral language acknowledging the role of APRNs and nurse midwives as providers of high-quality, cost effective primary care.
The bill addresses Medicaid disparities by requiring state programs to reimburse school-based health clinics receiving funds on the same basis as federally-qualified health centers.