How the Affordable Care Act Has Impacted Nursing

The Affordable Care Act has resulted in good news, bad news and unexpected news for nurses.

The Affordable Care Act (ACA), also known as Obamacare, is in full effect and now news of its impact on the nursing industry has come in. Some reports are good, such as job growth; whereas others stress that nurses have bigger patient loads resulting in diminished care for patients.

Let’s take a closer look at how the largest group of health care professionals is faring.

What Has Changed?

More—and Sicker—Patients Have Entered the System
Since the Affordable Care Act began, the health care system experienced a rise in the number of new patients, as expected. What wasn’t expected is that some of these patients have chronic illnesses that have been neglected and thus require more care.

According to Amy Dertz, a registered nurse in Oakland, Calif., “Some haven’t had care in a long time (or ever). Some may have pre-existing conditions that enabled insurance companies to refuse them coverage. As they enter my care, their needs may be more complicated.”

The extra time and care it takes to improve the health of these new patients have placed a strain on nurses and hospitals.

Emergency Room Visits Have Increased, Not Decreased
In the past, the uninsured may have been reluctant to go to emergency rooms for treatment. But now that patients have insurance, some facilities are experiencing increased ER visits. As a result, wait times and patient loads have also increased for nurses and doctors.

Health Care Has Shifted Away from Hospitals
To save money, the Affordable Care Act wants to keep patients out of hospitals in favor of outpatient care provided within communities. Although this creates more outpatient workplaces for nurses, the opposite is true for inpatient nurses.

According to Dertz, “If the ACA is successful in contributing to keeping patients out of the hospital, inpatient care will be reserved for patients with acute, severe illnesses and the number of hospital nurses will drop dramatically.” Her hospital has already proposed nursing cuts, which would result in nurses working harder with fewer resources.

What’s the Job Outlook for Nurses?

Very good. According to the Bureau of Labor Statistics, employment for registered nurses is estimated to grow by 5.6% through 2032—much faster than average for all occupations.

The growth is twofold:

• As baby boomers age, there’s an increasing need for health care, particularly from geriatric nurses.
• Because health care is moving away from hospitals to outpatient care in the community, nurses have more workplaces to choose from. In community health centers alone, more than 4,500 nursing positions have been added nationwide since the ACA began. Nurses specializing in home care, care management, case management, and community health care are in high demand.

For nurses looking to advance their training in these and other areas, the Affordable Care Act helps cover training costs.

^{Sources: U.S. Bureau of Labor Statistics Occupational Outlook Handbook, Registered Nurses; Time magazine; Orange County Register.}