The Affordable Care Act: Impact on Nursing Practice

Background of the Legislation

President Obama signed the Affordable Care Act (ACA) into law in 2010 facilitate access to healthcare for all Americans. The act was formulated to increase uninsured Americans’ access to quality insurance coverage at a reasonable cost. Significant reforms in the law included expanding Medicare eligibility and allowing people aged 26 or below to use their parents’ healthcare plans as provided in s. 2714 of the Patient Protection and Affordable Care Act 2010. It also subsidized healthcare costs for low-income families and prevented healthcare providers from raising or denying coverage to people with pre-existing conditions. The paper offers an overview of ACA and its impact on the nursing practice in providing quality care.

Issues Stalling the Legislation

The act was strongly opposed by Republicans but favored by the Democrats. Therefore, the former U.S. president Donald Trump attempted to repeal the ACA and its policies because it imposed a fiscal burden on the States (Himmelstein & Woolhandler, 2017). However, President Biden maintained the ACA and its policies with a further promise to implement a public option of Medicare (Sullivan & Weatherspoon, 2021). The current regime maintained the law because it achieved its goals, evidenced by the decreased price of premium insurance, affordability for the public, and improved quality of care (Talbert et al., 2018). Health insurance now covers chronic health conditions, meaning many people exercise early care, avoid admission, and put a less financial strain on the healthcare system.

Key Stakeholders’ Views on the Act

The major stakeholders impacted by the ACA policies include employers, consumers, states, and healthcare providers. Consumers have benefited from the quality and affordable healthcare since the act was enacted. However, not all consumers favor ACA policies because uninsured people pass the cost to everyone else besides high taxes for those in the high-income group (LaFontaine et al., 2019). Both consumers and employers have also benefited from transparent competition among insurance providers due to open enrollment. Nevertheless, s. 1304 of the Patient Protection and Affordable Care Act 2010 that requires employers having over 50 employees working more than 30 hours a week to pay insurance has affected their operations. Healthcare providers have also criticized the act due to the additional workload and costs placed on them. Still, providers benefit from reimbursement and bonuses for services offered.

Impact of the Act on Nurses’ Ability to Provide Quality Care

The ACA has increased access to healthcare but placed more pressure on nurses to prove they can provide quality care. The need for registered nurses, advanced practice nurses, and nurse practitioners increased as more individuals gained access to health insurance. According to Sullivan and Weatherspoon (2021), many patients today prefer Nurse Practitioners to physicians for preventive care because they treat the whole person compared to the medical approach. Although the demand is good news for job-seeking nurses, it presents many challenges to currently practicing nurses. An inadequate patient-to-nurse ratio has forced nurses to work long hours, leading to burnout and low quality of care.

Actions Nurses Need to Take to Advance the Legislation

Nurses have an obligation to advocate the passage of ACA legislation to advance humanity and preserve life despite the challenges. A practicing nurse can help reshape the future of healthcare reforms by becoming active in healthcare political action (Wilson et al., 2021). Since nurses work at the point of care, they are privileged to observe the good things and areas that need improvement. They can use that knowledge by advocating for political actions through representatives from the state legislature. It entails joining American Nurses Association or state associations that vouch for their grievances in the ACA reforms. Nurses can also exploit their position within the healthcare delivery system to link, measure, and re-engineer reforms in the ACA for better working conditions.


Himmelstein, D., & Woolhandler, S. (2017). Trumpcare or transformation. American Journal of Public Health, 107(5), 660–661. 10.2105/AJPH.2017.303729.

LaFontaine, P., Vogenberg, F., & Pizzi, L. (2019). From Then until now: A top-down view of the affordable care act. Pharmacy and Therapeutic, 44(8), 467-470.

Patient Protection and Affordable Care Act. (2010). Publ. L. No. 111-148, 124 Stat. 119 (2010).

Sullivan, D., & Weatherspoon, D. (2021). The nurse’s guide to the affordable care act. NurseJournal Website.

Talbert, P., Martin, L., Frazier, M., & Byas, D. (2018). Benefits and challenges of the affordable care act: What should be the future of the ACA in 2018?, ACTA Scientific Medical Sciences, 2(5), 9-16.

Wilson, D., Underwood, L., Kim, S., & Olukuton, M. (2021). How and why nurses became involved in politics or political action, and the outcomes or impacts of this involvement. Nursing Outlook, 70(8). 10.1016/j.outlook.2021.07.008.

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1. LawBirdie. "The Affordable Care Act: Impact on Nursing Practice." August 8, 2023.


LawBirdie. "The Affordable Care Act: Impact on Nursing Practice." August 8, 2023.