Affordable Care Act Preview

November 2013

Average people on the street were recently asked by comedian Jimmy Kimmel which they preferred, the Affordable Care Act or Obamacare. Many did not get the joke: they’re two ways of referring to the same law. Considering all the information and misinformation out there about the ACA, that’s understandable. We’ve all heard a lot about it, but most of us probably have more questions than answers. Most importantly for UNAC/UHCP members, how will the continued rollout of ACA affect us on the job, and how will it affect patient care?

Almost a million people have already benefited from the ACA, including patients with pre-existing conditions and children allowed to remain on their parents’ plans until age 26. In 2014, by law everyone will be required to have health insurance. This October 1, health insurance exchanges opened in many states, offering a range of plans provided by different insurers, including Kaiser and Sharp, at four levels: bronze, silver, gold and platinum. Early interest has been strong, with over half a million people accessing the website for Covered California on just the first day, though it’s still too soon to know how many new patients we can expect at our hospitals.

We do know that we can expect changes to our country’s health care system both short and long term. Fewer people will be forced to use our ERs just to see a doctor. UNAC/UHCP members who have won a voice in patient care through our Labor-Management Partnerships, RN Advisory Committees, Patient Care Committees and other contractual mechanisms that force greater teamwork hospital-wide, are ahead of the curve. Greater communication between doctors, nurses, administration and specialists will be needed to integrate care. More systems will be created to close gaps and help people navigate their health care system. There will be more emphasis on preventive rather than acute and emergency care. A hospital stay is much more expensive and demands more time from the whole medical team than a good diet and exercise plan.

We will need to be even more vigilant about protecting our voice in patient care decisions, safe staffing and scope of practice. It is important to have the right person doing the right job. Many of us face unsafe staffing conditions even with our state law on ratios and contractual protections for safe staffing. Any large influx of new patients could exacerbate those problems. It will be more important than ever for UNAC/UHCP members to fill out Staffing Objections and organize with our co-workers, affiliate leadership and Staff Reps to be the proper advocates for quality and safe patient care.