NURS 6050 Week 4 Assignment Legislation Grid and Testimony Advocacy Statement – Online Nursing Essays

NURS 6050 Week 4 Assignment Legislation Grid and Testimony Advocacy Statement

Mental health access improvement bill if enacted would cause an amendment of the existing Medicare law as this bill seeks that mental health counselling, marriage and family therapist be covered under Medicare so as to give access to many who never had or can’t afford to pay for the services (“Senate introduces the mental health access Improvement Act of 2021,” 2021). In America there are statistics that shows that about 20 percent of our seniors aged from 55yrs and above are at higher risk for mental health instability hence the purpose of this bill is to give more vulnerable people especially the seniors access to mental health who can’t afford the services (“Medicare mental health access act would remove barriers to care,” 2020).

Due to the increasing level of stress, financial instability, high level of unemployment just as we have noticed during the time the world has been fighting this pandemic have destabilized a lot of our citizens mentally as the rate of suicide, depression and crime rate has been of the increase lately.

Legislation Comparison Grid Template

Use this document to complete Part 1 of the Module 2 Assessment Legislation Comparison Grid and Testimony/Advocacy Statement

 

Health-related Bill Name	The Mental Health Access Improvement Act, 2019
Bill Number	(H.R.945/S.286)
Description	The Mental health access improvement bill if enacted would cause an amendment of the existing Medicare law as this bill seeks that mental health counselling, marriage and family therapist be covered under Medicare so as to give access to many who never had or can’t afford to pay for the services.
Federal or State?	Federal
Legislative Intent	The bill will give especially the seniors access to mental health care as they can’t afford it and it will in the long run help reduce the cost of treating mental health if its identified and managed at the early onset of mental health challenges.
Proponents/ Opponents	Proponents: American foundation for suicide prevention, National alliance for mental illness
	Opponents: The financial implication, The shortage of mental healthcare professionals (“Top 5 barriers to mental healthcare access,” 2020).
Target Population	Children, adults, all Americans, people who use tobacco
Status of the bill (Is it in hearings or committees?	Currently the bill is in the committee
General Notes/Comments	Due to the increasing level of stress, financial instability, high level of unemployment just as we have noticed during the time the world has been fighting this pandemic have destabilized a lot of our citizens mentally as the rate of suicide, depression and crime rate has been of the increase lately.

 

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Part 2: Legislation Testimony/Advocacy Statement

My position on this bill is that Medicare should be made to cover the services as proposed in this bill such as increasing access to mental health care and also covering the services of marriage and family therapy. This bill if enacted will help relieve some of the pressures people are going through (Milstead, J. A., & Short, N. M. (2019). Also having a plan that focuses on early identification and treatment of mental illness will help reduce eliminate or reduce the indirect cost of managing them in psychiatric hospitals, prisons and so on.

Addressing Opponents

One of the opponents identified in this bill is the cost implication as most committees will focus on the direct cost and not focus on the indirect cost of not identifying mental illness in the early stages. Another opponent I identified is the shortage of mental health care providers especially in the rural areas. Plans should be made at the same time the bill is enacted to ensure or have plans to increase the number of mental health providers by allowing Nurse Practitioners to practice within their license so as to cover the gap in medical care.

Conclusion

This is a welcome bill that majority of the people will be happy about but unfortunately, I feel the bill is not getting the needed attention it should be getting as it has lingered for some time now because most Politian’s have made everything to be politics as they only push for laws that restrict the basic care coupled with their attitude of downplaying on sensitive cases that will benefit the general public (Taylor et al., 2017). If the services of mental health care is covered by the Medicare, it will help in early identification of mental health problems and save the indirect cost of taking care of them in the prisons and hospitals if not well managed in time.

References

Medicare mental health access act would remove barriers to care. (2020). Mental Health Weekly, 30(36), 7-8. https://doi.org/10.1002/mhw.32512

Senate introduces the mental health access Improvement Act of 2021. (2021, March 22). American Counseling Association | A professional home for counselors. https://www.counseling.org/news/updates/2021/03/22/senate-introduces-the-mental-health-access-improvement-act-of-2021

Top 5 barriers to mental healthcare access. (2020, July 28). Social Solutions. https://www.socialsolutions.com/blog/barriers-to-mental-healthcare-access/

Taylor, D., Olshansky, E. F., Woods, N. F., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education [Nursing outlook 65/2 (2017) 242–245]. Nursing Outlook, 65(3), 346-350. https://doi.org/10.1016/j.outlook.2017.05.003

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Good Evening Shirley,

Thank you for your insight and information regarding the ACA. I am not sure for how long this will be an ongoing issue, but I understand why the ACA is such a sensitive subject. To me, I believe it revolves around the bottom dollar or the cost benefit analysis. Being as though we have people living longer, many people dealing with more chronic conditions, and a substantial increase in insured individuals, medical costs are naturally going to rise.

Carey, et al., (2018, p. 1 para 2) explained that multiple states have declined on not expanding Medicaid eligibility via the ACA related to the belief that ACA eligibility may cause strain on health care providers leading to worse care to individuals that are insured. Carey, et al., (2018, p.1 para 2) stated that many people had predicted that there would be a rush and this in turn would lead to a national shortage within the primary care workforce.

Even though states have been hesitant or declined the use of the ACA, Carey, et al., (2018, p. 2 Abstract) found no evidence regarding the expansion of the ACA and a reduction of utilization in the Medicare beneficiaries’ population. Carey, et al., (2018, p.4), stated negative spillovers that were of concern for others were not unfounded related to economic predictions that ACA’s spillovers would be big. Carey, et al., (2018, p.4) further explained that cited work from Glied and Hong on predictions related to physician care spending within Medicare beneficiaries’ group would be reduced specifically in lower income areas because of a large increase in coverage.  Manner, (2018, para 1) stated that most individuals agree on the country’s healthcare system as unaffordable, a mess, and confusing. It has been suggestion that reform follows the party affiliation. The support is generally given by the overall public that family members may be eligible for insurance, but the mandatory penalties stemming from not having insurance is not something the public opinion is in agreement with. Although resolution may bot be found soon, the sentiment on giving the citizens insurance is there. It is my hope that a solution may come about sooner than later that will be able to give quality care to all, but to not have a harsh economic impact on the country and citizens. Have a great evening.

Sincerely,

Ana O.

References

Carey, C., Miller, S., & Wherry, L. (2018). The impact of insurance expansions on the already Insured: The Affordable Care Act and Medicare. https://doi.org/10.3386/w25153

Manner P. A. (2018). Editor’s Spotlight/Take 5: The Affordable Care Act Decreased the   Proportion of Uninsured Patients in a Safety Net Orthopaedic Clinic. Clinical  orthopaedics and related research, 476(5), 921–924.  https://doi.org/10.1097/01.blo.0000532687.97507.8b

Good day! It was enlightening discussion of yours.

 

I agree that the ACA has been highly controversial despite the positive outcomes and the ACA is subject to changes every year. The legislation can be amended and budget decisions can affect how it is implemented.

 

The Affordable Care Act (ACA) was signed into law in March of 2010 and despite repeated attacks, not only has it survived – it has thrived and continues to provide tens of millions of Americans with access to health care coverage, because of the law, but millions of people also gained insurance coverage for the first time. Millions more have increased security when insured, benefitting from prohibitions on discrimination by insurers and protections for people with preexisting conditions.

 

The ACA was intended to expand options for health coverage, reform the insurance system, increase coverage for services (particularly preventive services), and provide a funding stream to improve quality of services. Has it improved coverage? Indisputably, yes. More than 20 million people have gained coverage as a result of the ACA.  It has dramatically reduced the uninsured rate.  On the day President Obama signed the ACA, 16 percent of Americans were uninsured; in March 2020, it was nine percent.  Health access?  Again, yes. The ACA’s first two open enrollment periods showed significant improvement not only in rates of coverage, but also in access to care, including access to a personal physician and medications and improved reported health status.

 

The ACA was passed by a Democratic Congress and signed by a Democratic president in 2010.  This political configuration lasted only for the first two years of the Obama administration. Once Republicans gained control of Congress in 2013, having campaigned on a promise to repeal the ACA, they made more than 50 attempts to eliminate the law. President Obama vetoed attempts at outright repeal, but some targeted actions were successful, as Congress made use of its appropriation power that the President either could not or chose not to fight. For example, the ACA created a Prevention and Public Health Fund, initially authorized to disburse $15 billion over 10 years.  These funds were to be used for, among other things, programs to increase access to primary care and preventive care. After Republicans gained control of Congress in 2013, they made repeated cuts to the Fund. The ACA also created a “risk corridors” program, which limited insurer profits and losses for the first three years of the program. This was intended to insulate insurers covering high needs patients from significant losses, as the ACA prohibited plans from discriminating based on health condition. When Trump took office in 2017 and Congress was under Republican control, it was widely expected that the ACA’s days were numbered. But, defying expectations, the ACA survived largely intact. One notable exception was a repeal of the financial penalty for violating the ACA’s individual mandate.

 

After years of neglect and sabotage, the Biden administration burst out of the gate with executive orders and proposed legislation to strengthen the ACA, and the 117th Congress passed a massive economic rescue package that includes funding to strengthen and expand the ACA’s reach and effectiveness.  Yet, an imminent decision from the Supreme Court could threaten the ACA’s success – and its very existence.

 

In the meantime, the ACA is the law of the land and will remain so until alternative legislation is passed. It behooves Republicans not to exacerbate the churn and disruption that has been ongoing in the exchanges until alternative legislation is in place and ready to be implemented. Controlling the White House, House, and Senate, even with precarious margins will make it difficult to convince the American public that any problems with health care aren’t the government’s  responsibility. Changes in the healthcare field along with changes to the political make up of future presidential administrations and Congress, make it likely that the ACA will continue to change for years to come.

References

Beauregard, Lisa Kalimon, and Edward Alan Miller. 2020. “Why Do States Pursue Medicaid Home Care Opportunities? Explaining State Adoption of the Patient Protection and Affordable Care Act’s Home and Community-Based Services Initiatives.” RSF: The Russell Sage Foundation Journal of the Social Sciences6(2): 154–78. DOI: 10.7758/RSF.2020.6.2.07.

Duggan, Mark, Gopi Shah Goda, and Emilie Jackson. 2019. “The Effects of the Affordable Care Act on Health Insurance Coverage and Labor Market Outcomes.” National Tax Journal 72(2): 261–322.

Gutierrez, Carmen M. 2018. “The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments Under the ACA.” American Sociological Review (6): 1144–70.