From your ANA President


There are thousands of pages of regulations that make up the healthcare reform law—the Affordable Care Act (ACA)—and many have been dissected and debated from every possible angle. ANA has been
involved in a number of those crucial discussions, but with our eyes always fixed on the prize: ensuring that millions of people gain access to the health care they need.

Right now, we are closing in on March 31—the end of the first open enrollment period for consumers to obtain health insurance through the federal and state marketplaces, which were created under the ACA. These marketplaces, or exchanges, allow eligible Americans to compare and select from insurance options.

Although there have been some difficult start-up
issues surrounding enrollment—not unexpected
with any massive undertaking—we should not let these overshadow the importance of this endeavor. What it really all comes down to is people. The ACA will mean that millions will finally have access to affordable, essential health care as well as an array of preventive services widely granted to millions more under the ACA.

I’m proud to say that nurses across the country have been helping consumers sign up for coverage, as well as educate patients, their communities, and their healthcare colleagues about the marketplaces, the ACA, and key resources, such as the healthcare.gov website.

Take Wisconsin Nurses Association member and registered nurse (RN) Jessica Coburn. Also trained as an ACA-certified application counselor, Coburn assisted residents coming into a local health department
to enroll through the federal exchange or determine their eligibility for Medicaid. She has witnessed a range of emotions—from tearful relief to sheer joy—when people realize they finally have access to health care. She recalled the story of one middle-aged woman who lost her full-time job 2 years ago and has been working part-time intermittently as she struggles to find a new permanent position. Coburn helped her estimate her projected income and then found two potential health plans that she could select from. She also shared her belief—one I agree with—that nurses are well-suited to help in enrollment efforts because they have the therapeutic communication skills it takes and the ability to draw out information on sensitive topics. Further, they can educate patients about the benefits of health care long after the enrollment application is completed.

Nurse leaders have been serving in other roles as well. Patty Hayes from Washington State was closely involved in developing the marketplace in her state, as well as in helping to create an outreach network and programs to support enrollment in her county.
Alice Benjamin of California has been using her skills as a nurse to make the ACA more understandable to nurses and other key stakeholders. She has also been part of a collaborative effort to create a one-stop shop for residents—including some living in the most underserved communities—to help them learn about and gain coverage.

Looking beyond March 31, nurses can continue to engage in this work. For example, consumers will be able to sign up for coverage after open enrollment under certain circumstances, such as a change in family size or loss of job-based insurance. Further, many people gaining coverage will need ongoing help to find providers and utilize services.

ANA continues to work with officials from the Centers for Medicare & Medicaid Services as well as healthcare providers to support enrollment and the ACA. We’re also committed to promoting nurses’ expanding roles in healthcare reform, such as by ensuring that RNs are fully included as leaders and eligible healthcare providers for emerging team-based care models and that advanced practice RNs are specifically identified as primary care providers.

I encourage you to work with state and specialty nurses associations to learn more about the ACA and promote enrollment efforts. Opportunities abound for you to reach those in your families, workplaces, and communities who could benefit from the law. Let’s keep moving forward to help our nation’s healthcare system move forward.

Karen A. Daley, PhD, RN, FAAN

President, American Nurses Association

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