NU506 Critique the Role of Nursing Advocacy in the Implementation of Health Policy

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Purdue University Global

NU506 Health Policy, Ethical, and Legal Perspectives of the Health Care System

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Critique the Role of Nursing Advocacy in the Implementation of Health Policy: Kelley v. Becerra

The Kelley v. Becerra case has significant implications for preventive healthcare services in the United States because it challenges the Affordable Care Act’s (ACA) requirement that many preventive services be covered without patient cost-sharing. Nursing advocacy plays a critical role in protecting these services by promoting equitable access to care, supporting evidence-based policy, educating patients, and influencing legislative decisions. Advanced practice nurses, particularly family nurse practitioners (FNPs), are uniquely positioned to advocate for policies that improve population health and reduce healthcare disparities.

Understanding Kelley v. Becerra and the Affordable Care Act

The Affordable Care Act (ACA) was enacted to expand healthcare access regardless of an individual’s income, medical history, or pre-existing conditions. One of its most impactful provisions requires most private health insurance plans to cover recommended preventive services without copayments, deductibles, or coinsurance (Skopec & Banthin, 2022).

These preventive services include:

Routine health screenings
Cancer screenings
Vaccinations
Contraceptive services
Wellness visits
Preventive care for pregnant women and children

The Kelley v. Becerra lawsuit challenges this requirement by arguing that the federal government improperly delegated authority to expert panels responsible for recommending preventive services. The plaintiffs also claim that mandatory coverage increases insurance costs and that the ACA does not clearly define which preventive services insurers must cover (Skopec & Banthin, 2022).

If these arguments are upheld, insurers may no longer be required to provide many preventive services without cost-sharing, potentially reducing access for millions of Americans.

The Role of Nursing Advocacy in Health Policy

Nursing advocacy extends beyond bedside patient care. Nurses actively influence healthcare policy by ensuring that legislation supports patient safety, health equity, and evidence-based practice.

Advanced practice registered nurses (APRNs) advocate by:

Promoting equitable healthcare access.
Educating policymakers about patient outcomes.
Supporting preventive care initiatives.
Participating in professional nursing organizations.
Influencing healthcare legislation through advocacy campaigns.
Educating communities about available preventive services.

Family nurse practitioners frequently witness the consequences of delayed preventive care. Their clinical experience provides valuable insight into how healthcare policies affect patient outcomes, making their voices essential during policy debates such as Kelley v. Becerra.

How Kelley v. Becerra Could Affect Advanced Practice Nurses

Preventive healthcare is a cornerstone of advanced nursing practice. Nurse practitioners routinely identify health risks early and intervene before chronic diseases become severe or costly.

Examples include:

Hypertension screening
Diabetes screening
Breast and cervical cancer screening
Prenatal care
Childhood wellness examinations
Immunizations
Contraceptive counseling

Without guaranteed insurance coverage, many patients may postpone or completely avoid these services because of financial barriers. This delay can result in advanced disease, higher treatment costs, and poorer health outcomes.

The ACA’s preventive service requirement has also contributed to improved reproductive healthcare. Expanded access to contraception has been associated with increased contraceptive use and reductions in unintended pregnancies (MacCallum-Bridges & Margerison, 2020). These improvements support healthier pregnancies and better maternal and infant outcomes.

Advantages and Disadvantages of the Kelley v. Becerra Decision

Potential Advantages

Supporters of the lawsuit argue that overturning the preventive service mandate may offer several financial and administrative benefits for insurers.

Potential advantages include:

Reduced insurance expenditures.
Greater flexibility in designing insurance plans.
Lower regulatory requirements for private insurers.

However, these benefits primarily affect insurance companies rather than patients.

Potential Disadvantages

The potential disadvantages are considerably broader and directly affect public health.

If preventive coverage requirements are weakened:

Patients may face higher out-of-pocket costs.
Preventive screenings may decline.
Chronic diseases may be diagnosed at later stages.
Healthcare disparities may widen.
Emergency care utilization may increase.
Long-term healthcare expenditures may rise.

Several vulnerable populations could experience the greatest impact, including:

Children requiring routine wellness visits
Pregnant women receiving prenatal care
Older adults
Individuals with chronic illnesses
Low-income families
Patients requiring vaccinations and preventive screenings

Research consistently demonstrates that preventive healthcare improves health outcomes while reducing avoidable hospitalizations and long-term healthcare costs (Skopec & Banthin, 2022).

Why Nursing Advocacy Is Essential

Nursing advocacy is fundamental to implementing health policy because nurses directly observe how policy decisions affect patient care.

Nurses advocate by:

Supporting Evidence-Based Policy

Healthcare policies should reflect scientific evidence rather than financial interests. Preventive services have consistently demonstrated improved health outcomes across diverse populations.

Protecting Vulnerable Populations

Children, pregnant women, older adults, and underserved communities rely heavily on affordable preventive care. Advocacy helps ensure these groups maintain access to essential healthcare services.

Reducing Health Inequities

Removing financial barriers allows patients to seek care before illnesses become severe, promoting greater health equity across socioeconomic groups.

Educating Patients

Nurses educate patients about preventive screenings, vaccinations, healthy lifestyle choices, and available healthcare resources, improving community health literacy.

Policy Recommendations

Maintaining preventive service coverage aligns with the ACA’s goals of improving healthcare access and reducing preventable disease.

Several policy recommendations could strengthen preventive healthcare protections:

Preserve mandatory insurance coverage for evidence-based preventive services.
Clarify the federal authority responsible for approving preventive service recommendations.
Strengthen legislative language defining preventive services.
Increase collaboration between the Department of Health and Human Services and expert advisory organizations.
Continue funding preventive health initiatives that improve population health outcomes.

Clarifying statutory authority through congressional action could address constitutional concerns raised in Kelley v. Becerra while preserving patient access to preventive care.

How Nurses Can Advocate Against Kelley v. Becerra

Nurses have multiple opportunities to influence healthcare policy at local, state, and national levels.

Effective advocacy strategies include:

Joining professional organizations such as the American Nurses Association (ANA) and specialty nursing associations.
Participating in legislative advocacy events.
Educating elected officials about patient experiences.
Collaborating with healthcare coalitions supporting preventive care.
Publishing evidence-based research and policy commentary.
Using social media responsibly to educate the public.
Encouraging patients to participate in healthcare advocacy efforts.

Healthcare organizations, including the American Medical Association and numerous professional societies, have expressed concerns that limiting preventive service coverage could negatively affect population health and increase healthcare costs.

Preventive healthcare remains one of the most effective strategies for improving long-term health outcomes, and nursing advocacy continues to play a vital role in preserving these essential services.

Preventive services covered without cost-sharing under the ACA improve healthcare access, increase early disease detection, reduce health disparities, and lower long-term healthcare costs. Kelley v. Becerra challenges the legal authority supporting these coverage requirements, making nursing advocacy essential for protecting evidence-based preventive care and promoting equitable healthcare access.

Frequently Asked Questions

What is Kelley v. Becerra?

Kelley v. Becerra is a federal lawsuit challenging portions of the Affordable Care Act that require most private health insurance plans to cover recommended preventive services without patient cost-sharing.

Why is preventive care important under the Affordable Care Act?

Preventive care helps identify diseases early, reduces long-term healthcare costs, improves health outcomes, and removes financial barriers that discourage patients from seeking essential healthcare.

How does Kelley v. Becerra affect nurse practitioners?

If preventive services are no longer guaranteed without cost-sharing, nurse practitioners may see fewer patients receiving routine screenings, vaccinations, prenatal care, and wellness visits, leading to delayed diagnoses and poorer health outcomes.

What role do nurses play in health policy advocacy?

Nurses advocate by educating policymakers, participating in professional organizations, promoting evidence-based legislation, educating patients, and supporting policies that improve healthcare access and health equity.

Who would be most affected if preventive services are no longer fully covered?

Low-income individuals, children, pregnant women, older adults, and patients with chronic disease risk factors would likely experience the greatest impact due to increased financial barriers to preventive healthcare.

References

MacCallum-Bridges, C. L., & Margerison, C. E. (2020). The Affordable Care Act contraception mandate and unintended pregnancy in women of reproductive age: An analysis of the National Survey of Family Growth, 2008–2010 vs. 2013–2015. Contraception, 101(1), 34–39. https://doi.org/10.1016/j.contraception.2019.09.003

Skopec, L., & Banthin, J. (2022, July). Free preventive services improve access to care. Robert Wood Johnson Foundation. https://www.rwjf.org/en/library/research/2022/07/free-preventive-services-improve-access-to-care.html