D223: Performance Assessment 2

Student Name

Western Governors University

D223 Healthcare Policy and Economics

Prof. Name:

Date

A1: Federal and State Public Healthcare Policy

Federal Policy: Tobacco 21 Act

The Tobacco 21 Act, enacted in December 2019, is a federal law that prohibits the sale of tobacco products to individuals under the age of 21. This legislation aims to reduce tobacco use among youth and protect their health by limiting access to tobacco products (Products, 2019).

State Policy: Colorado’s Reproductive Health Equity Act (RHEA)

Passed in 2022, Colorado’s House Bill 22-1279, known as the Reproductive Health Equity Act (RHEA), establishes the right of individuals to use contraceptives and access abortion services. The law explicitly states that fertilized eggs, embryos, and fetuses do not have legal rights under Colorado law, ensuring reproductive autonomy (Reproductive Health Equity Act [RHEA], 2022).

A2: Public Healthcare Policy Process

Level	Policy	Description	Enforcement
Federal	Tobacco 21 Act	A federal mandate prohibiting tobacco sales to anyone under 21 years. The FDA oversees enforcement, including secret purchase operations and ID verification at retail locations.	FDA regulates compliance, including fines and penalties for retailers violating the law (Products, 2019).
State	Reproductive Health Equity Act (RHEA)	Colorado state law ensuring access to contraceptives and abortion without interference from local or state agencies. It prevents discrimination based on pregnancy decisions and guarantees reproductive freedom.	Enforced by local and state regulatory agencies with penalties including fines and license revocation for noncompliance.

A3: Policy Impact on Populations

Federal Policy: Tobacco 21 (T21)

Who benefits? Young people benefit the most from this law, though society as a whole gains from reduced tobacco-related harm.
How do they benefit? The law aims to prevent tobacco initiation among youth, promoting better long-term health outcomes.
Who is negatively impacted? Tobacco companies face reduced sales and customer base, particularly among younger generations.
How are they impacted? Reduced access leads to fewer new smokers, impacting tobacco industry revenues and market growth.
Impact on health disparities and equity: The T21 law promotes health equity by reducing tobacco-related illnesses, lowering healthcare costs, and encouraging reinvestment of funds in healthier sectors. It particularly benefits underserved communities who often bear a disproportionate tobacco burden.

State Policy: Colorado’s RHEA

Who benefits? Women of reproductive age in Colorado.
How do they benefit? The law protects their reproductive rights, allowing safe access to contraceptives and abortion without fear of discrimination or denial.
Who is negatively impacted? Individuals or groups opposing abortion and contraceptive access, often based on moral or religious grounds.
How are they impacted? Their values may be challenged, and advocacy for fetal rights may be hindered, potentially causing social tensions.
Impact on health disparities and equity: The law enhances health equity by removing geographic, financial, and legal barriers to reproductive healthcare, fostering timely care and empowering individuals’ reproductive choices.

A4: Evidence Informing Policy

Federal Policy: Tobacco 21

The goal of T21 is to reduce youth smoking initiation. Evidence from California’s Tobacco Control Program indicates a drop from 10% of high school smokers in 2016 to 2% in 2018 after similar legislation was enacted (Kim et al., 2021). The CDC identifies smoking as the leading preventable cause of death in the U.S., with significant health and economic costs (Centers for Disease Control and Prevention [CDC], 2021). Reducing youth access to tobacco supports healthier generations and lowers smoking-related healthcare expenses.

State Policy: Reproductive Health Equity Act

After Roe v. Wade was overturned in 2022, states regained authority to regulate abortion (Berg & Woods, 2023). Colorado’s RHEA law was enacted to protect abortion access and reproductive rights, ensuring safe, legal options for individuals in the state (Coen-Sanchez et al., 2022). The policy reflects a commitment to reproductive autonomy and healthcare equity in a shifting legal landscape.

A4A: Evidence Supporting Policy and Suggested Improvements

Policy	Supporting Evidence	Suggested Improvements
Tobacco 21	Prevents youth from developing nicotine addiction during critical brain development phases (18-21 years). Reduces long-term tobacco use and associated diseases such as lung cancer and heart disease (Kim et al., 2021).	Increase public education about the law and its health benefits. Expand access to cessation programs, especially in marginalized communities, to support smokers who want to quit.
Reproductive Health Equity Act (RHEA)	Ensures women can safely access abortion and contraceptive services without legal repercussions, emphasizing women’s autonomy over reproductive decisions (Coen-Sanchez et al., 2022). The law nullifies legal rights of fertilized eggs, embryos, or fetuses to avoid discrimination against women.	Expand insurance coverage for reproductive healthcare to reduce delays and barriers. Increase funding for clinics serving underserved populations to enhance access to reproductive health services.

B: Role of Nurses in Policy Development

Nurses play a critical role in shaping healthcare policy at both federal and state levels. Their frontline experience with patients allows them to provide valuable insights into the practical needs and challenges within the healthcare system. Through involvement in professional organizations like the American Nurses Association (ANA), nurses can influence policy development and advocate for nursing priorities, such as safer nurse-to-patient ratios.

At the state level, nurses can engage with groups like the Colorado Nurses Association (CNA), which supports nursing advocacy and policymaking. By participating in these associations, nurses can contribute to local legislation, promote healthcare improvements, and support policies that align with patient care needs.

B1: Barriers Nurses Face in Policy Development

Despite their crucial role, nurses encounter several obstacles when engaging in healthcare policy:

Lack of Training: Many nursing programs do not adequately prepare nurses for involvement in policy creation, resulting in limited knowledge and confidence in this area.
Resistance to Change: Staff members, including nurses themselves, may resist new policies due to concerns about workload and altered responsibilities.
Resource Limitations: Time, funding, and personnel shortages can hinder nurses’ ability to collect evidence and advocate effectively for policy changes.
Rapid Healthcare Evolution: Constant advancements require policies to adapt, but outdated or inflexible policies may impede effective care, necessitating ongoing nurse input to keep policies current.

B2: Nursing Engagement in Policy

This program has inspired me to actively engage in all stages of healthcare policy—development, implementation, and revision. I plan to join the Colorado Nurses Association to access up-to-date information on healthcare legislation and collaborate with peers to advocate for meaningful change. By maintaining communication with compliance teams and participating in policy committees, I aim to contribute evidence-based recommendations and promote policies that enhance patient care and nursing practice. Every voice matters, and I am committed to amplifying mine in support of positive healthcare reform.

References

Berg, J. A., & Woods, N. F. (2023). Overturning Roe v. Wade: consequences for midlife women’s health and well-being. Women’s Midlife Health, 9(1), 2. https://doi.org/10.1186/s40695-022-00085-8

Centers for Disease Control and Prevention. (2021, October 29). Health effects of cigarette smoking. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

Centers for Disease Control and Prevention. (2023, May 26). State System Tobacco MLSA Fact Sheet. https://www.cdc.gov/statesystem/factsheets/mlsa/Minimum-Legal-Sales-Age.html

Coen-Sanchez, K., Ebenso, B., El-Mowafi, I. M., Berghs, M., Idriss-Wheeler, D., & Yaya, S. (2022). Repercussions of overturning Roe v. Wade for women across systems and beyond borders. Reproductive Health, 19(1), 184. https://doi.org/10.1186/s12978-022-01490-y