Strengths And Weaknesses of a Current Health Care Act of the United States.

Healthcare acts, laws, and policies are developed with specific targets for the care delivery process to enhance efficiency, quality, safety, access, inclusivity, and other aspects of care delivery. Their components have complex interactions with the various professions, such as nurses and doctors. These acts, policies, and acts are not always effective, and success in one area may negatively affect other care and patient aspects. The affordable care act has been a successful law in improving healthcare delivery and the healthcare systems. It has also been associated with various consequences, and thus the degree of implementation varies from state to state. This essay evaluates three components of the affordable care act as they apply to the family practice act, their implementation in California, and the impact of implementation on healthcare.

Components of ACA and their Importance to APN (FNP)

The affordable care act (ACT), or the federal health reform developed in 2010, is a comprehensive act with various stipulations that affect professionals and healthcare delivery. The first component is reforming the private insurance market for individuals and small groups. The first component of the affordable care act is increased demand for healthcare insurance by mandating insurance on individuals and small groups by placing a penalty for defaulters. The ACA has had varying success in its implementation in several states. Failure to implement the act has been under delegation and consultancy with the judiciary in the various states. The component increased the number of individuals with essential health insurance. Access to healthcare insurance services increases the care-seeking behavior and access to healthcare services. According to Coombs et al. (2021), healthcare finances are the major barrier to accessing care. Individuals with essential health insurance coverage do not fear accessing healthcare services, and thus there is an increase in demand for primary healthcare. The primary effect of the component was increased demand for primary care professionals, including FNPs (Peikes et al., 2020).

A second component is improving the quality and efficiency of healthcare by prohibiting insurance carriers from restricting access to coverage due to existing health conditions, health status, and gender (Dow & Sommers, 2019). Most insurance firms have restrictions on whom they give their insurance. Individuals with chronic health conditions such as cancer and diabetes prior to seeking health insurance have problems acquiring it. Most institutions reject them due to the high healthcare costs associated with these conditions. Other factors include the nature of the job and some high-risk. The initiative was a counter-effect to minimize the insurance companies’ efforts of filtering individuals and ensuring that all willing Americans have access to healthcare services (Karpman et al., 2018). The ACA component increased the number of primary care patients requiring and accessing special care, further increasing the demand for advanced practice nurses such as family nurse practitioners (Biener et al., 2018). FNPs majorly work in primary care, and that means their increased demand. According to the US Bureau of Labor Statistics (BLS) (n.d.), there has been an increasing demand for FNPs, and the role’s projected growth is about 45% between 2020 and 2030.

The ACA also mandated the Medicaid insurance programs to accommodate the working poor with income up to 133% of the federal poverty level (McKenna et al., 2018). This group, coverage gap, is ineligible for Medicaid insurance because they earn above the limits but do not earn enough to afford the market insurance premiums. The group is rather large, and the Medicaid program will provide affordable premiums to this group, increasing their access to healthcare. This component has increased the demand for healthcare services in primary care. Like the other components, the Medicaid program has increased access to healthcare, thus increasing the demand for primary health professionals. The FNPs also have an added role in informing patients of these insurance plans to improve their health (Cadmus et al., 2020).

State and Component Implementation

California is an aggressive state that began implementing the act once the act’s bill was passed. California passed an individual mandate to fulfill the ACA act requirements requiring individuals to purchase health insurance under various conditions. California state laws require individuals to purchase minimum essential coverage, and failure to do so would attract a fine effective January 1, 2020 (Fiedler et al., 2020). The law also affected small groups and required individuals to ensure their spouses and dependants maintained health coverage. Exceptions of the law included individuals with extreme hardships. According to Fiedler (2020), the mandate surpassed expectations, and many individuals purchased insurance more than expected by the policymakers. Individuals purchased insurance in numbers to avoid penalties. The act increased access to healthcare services through essential insurance coverage.

Under the ACA, California state established a new eligibility limit for Medicaid at 138 percent of the federal poverty level. More than 5 million individuals have benefitted from the expansion under the ACA (Saltzman, 2019). The new eligibility limit for Medicaid increased access to healthcare services and the enumeration of healthcare services (Duggan et al., 2022). More individuals can receive comprehensive care, leading to healthier individuals and communities and effective control of various diseases.

The component of The Affordable care act requires healthcare insurance to reimburse contraceptives costs and provide maternity coverage filling the gender equality role (Dom & Sommers et al., 2019). The act also allowed individuals with chronic conditions to appeal denied coverage and claim eligibility for cover. Access to these services has markedly increased women’s perinatal and contraceptive health. Their health around childbirth has also significantly improved following these rules. Individuals with chronic health conditions such as cancer have access to affordable, high-quality care hence better outcomes and improved quality of life (Karpman et al., 2018). The healthcare systems enjoy a decreased burden of managing complications of these chronic conditions, which could have been prevented by better access to healthcare services.


The affordable care act has had various successes in achieving healthcare insurance coverage in the various states. The states have also adapted the various components to varying degrees, thus affecting the health of their populations. The affordable care act has added roles to FNP and has increased the demand for primary care providers and advanced care services. California state has been on the frontline in implementing the components which have significantly improved insurance coverage and the health of its population.


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Saltzman, E. (2019). Demand for health insurance: Evidence from the California and Washington ACA exchanges. Journal of Health Economics63, 197-222.

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