Health Care Reform Summary
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (P.L. 111-148), more commonly referred to as health care reform. AWHONN did not endorse or oppose this law in its entirety. However, AWHONN advocated for several specific provisions related to the patients our members serve and to the nursing profession as a whole.
The information below is a summary of the sections of interest to AWHONN members. For a more comprehensive overview of the law, please visit the Kaiser Family Foundation’s website.
Insurance Market Reforms
Health insurers will no longer be able to charge women more than men for the same coverage.
Health insurers will no be longer be able to deny coverage based on a pre-existing condition, such as a previous c-section or being the victim of domestic violence.
Insurance plans offered in the new exchanges, as well as all individual and small group insurance plans, will be required to cover maternity services as part of a basic benefit package.
Maternal and Child Health
The Department of Health and Human Services is authorized to conduct additional research related to postpartum depression (PPD). DHHS may also create a national public awareness campaign to increase awareness of PPD, and establish grants to deliver services to individuals with or at risk for PPD.
States will be prohibited from excluding tobacco cessation drugs from the medications covered by their Medicaid programs. Medicaid must cover smoking cessation treatment for pregnant women, including medication and counseling with no cost-sharing requirements.
Employers are required to provide reasonable break time and a place that is not a bathroom for new mothers to nurse or pump breast milk.
Provides for coverage under Medicaid of services at stat- recognized free-standing birth centers.
Creates a program called the Maternal, Infant and Early Childhood Visitation program to provide grants to states, tribes and territories to develop and implement home visiting programs that serve high-risk families during pregnancy and through the infant and toddler years. The programs are intended to connect new and expectant families with trained professionals to provide parenting information, linkages to community resources, and support during pregnancy and throughout the child's first three years of life.
Authorizes spending for a new Pregnancy Assistance Fund, which will provide grants to states to help pregnant and parenting teens and women.
All plans will be required to cover preventive health services, including women’s preventive care, without cost sharing or deductibles for these services. The Health Resources and Services Administration (HRSA) is tasked with creating "comprehensive guidelines" on which women's health services will be included as part of the covered services.
Nursing Education *
The Nursing Student Loan Program was established in 1964 to address nursing workforce shortages. The program provides nursing students with a maximum of $13,000 at 5% interest. The new law increases the loan amount from $13,000 to $17,000.
The Advanced Education Nursing Grants support masters and doctoral nursing education programs. The new law extends participation in this program to nurse-midwifery programs that are accredited by the American College of Nurse-Midwives Accreditation Commission for Midwifery Education.
The Nurse Loan Repayment Program repays up to 85% of nursing student loans in return for at least two years of practice in a designated health care facility. The new law would modify this program and allow nurses and nursing students to receive loan repayment or scholarships funds if they agree to serve as nurse faculty for at least two years.
The Nurse Faculty Loan Program increases the number of qualified nurse faculty by creating a student loan fund within individual schools of nursing. Students must agree to teach at a school of nursing in exchange for cancellation of up to 85% of their educational loans. The new law expands the loan repayment amount from $30,000 to $35,500. It also creates an “Eligible Individual Student Loan Repayment” program. This program will support current graduate students or recently graduated masters/doctoral students who agree to serve as a faculty for at least four years.
The Workforce Diversity program awards grants and contract opportunities to schools of nursing, nurse managed health centers, academic health centers, state or local governments, and nonprofit entities looking to increase access to nursing education for disadvantaged students. The new law expands the program to provide: 1.) stipends for diploma or associate degree nurses to enter bridge or degree completion programs, 2.) scholarships or stipends for accelerated degree programs, 3.) pre-entry preparation, 4.) advanced education preparation, and, 5.) retention activities.
The Graduate Nurse Education Demonstration is a new program. It authorizes payment to five hospitals for the costs of expanding APRN training programs.
Professional Nursing Issues
Certified Nurse Midwifes will be reimbursed 100% by Medicare for their services —a significant increase over the current 65% reimbursement rate.
Authorizes funding for Nurse Managed Health Clinics, which will provide primary care services to patients and provide clinical training opportunities for nurses.
A number of federal commissions and task forces will be created that require representation from a health care professional.
* Language in this section was adopted and modified with permission from the American Association of Colleges of Nursing.
How to Contact the New Hampshire State Legislators
The NHNA (New Hampshire Nurse Association) advocates for nurses and health related issues on the state level. The GAC (Government Affairs Commission) works under the NHNA and serves as the Voice of Nursing in New Hampshire when it comes to the legislative and health policy arena..
To contact your state legislator go to www.nhnurses.org. Find the Commission of Government Affairs and scroll down to “how to contact your legislator.” It includes background, recent NHNA testimony, talking points and the link to find your own legislator. There are 30,000 NH nurses who collectively can make a difference in NH.
In closing, individual effort is rarely sufficient; collective action is almost always essential for truly transformational change.
Jean Dudley, NH AWHONN Legislative Representative
Page Updated 8/12/10