Healthcare  policies target socioeconomic determinants of health by addressing the  social environment in which individuals are born, develop, live, work,  and age to reduce health inequalities. These include housing, education,  income, healthcare, and food security, significantly impacting  well-being and quality of life. Policies that improve non-medical health  minimize sickness in underprivileged and marginalized communities.  Expanding Medicaid under the “Affordable Care Act” (ACA) is one such  policy that has helped reduce inequities by covering low-income  individuals and families who cannot afford necessary treatments.

Medicaid  expansion targets low-income communities to alleviate income  inequality, a significant social predictor of health that leads to poor  health outcomes and restricted care. Coverage for people earning up to  138 percent of the federal poverty line enhances access to preventative,  psychiatric, and chronic illness care. For vulnerable communities  confronting various barriers to treatment, increased access leads to  early intervention, better illness management, and fewer needless  emergency department visits (Baten et al., 2024). Medicaid expansion  also helps healthier people work and go to school, boosting long-term  economic and educational growth.

Medicaid  expansion also reduces geographic inequities in treatment, especially  in rural and underserved urban regions where hospitals and clinics  depend on Medicaid funding. These institutions assist populations with  high unemployment, insecure housing, and inadequate transportation,  which are socioeconomic determinants of health. Medicaid expansion  supports local healthcare providers and allows people to receive  treatment close to home. This increases the continuity of treatment and  eliminates structural obstacles that cause health disparities,  especially for Black, Hispanic, and Native Americans in disadvantaged  areas (Bailey et al., 2017).

One  strength of Medicaid expansion is its evidence-based ability to lower  uninsurance rates, boost preventive care use, and enhance health  outcomes for disadvantaged groups. States that expanded treatment have  seen gains in access, illness control, and racial and ethnic insurance  gaps. The program also lowers out-of-pocket expenditures, allowing  families to spend more on essential health determinants such as housing,  nutrition, and education (Sommers et al., 2024). Its capacity to lower  hospital uncompensated care expenses helps safety-net providers stay in  business and serve the community.

Although Medicaid  expansion has many benefits, its uneven adoption across states leaves  millions of Americans in non-expansion states without coverage and  unhealthy. Political resistance and state-level decisions have impeded  broad adoption, putting many low-income individuals in a “coverage gap”  where they earn too much for Medicaid but not enough for marketplace  insurance (Sommers et al., 2024). Additionally, Medicaid reimbursement  rates are lower than commercial insurance, which may restrict provider  involvement and access to specialists and sophisticated therapies.  Quality differences in care can occur even among those newly covered by  the expansion scheme.

By  advocating for patient-centered changes that prioritize fairness and  access, advanced practice nurses (APNs) can impact socioeconomic  determinants of health legislation (Flaubert et al., 2021). APNs can  discuss patient challenges and provide solutions based on frontline  experiences in community health, education, and policy forums. APNs can  also study, join professional groups, and work with legislators to  support Medicaid expansion, representing underprivileged areas in  decision-making.

In  conclusion, Medicaid expansion can minimize health disparities by  addressing poverty, access to care, and geographic inequities. Even with  implementation and provider availability issues, the legislation is a  significant step toward health fairness, especially when backed by  dedicated healthcare professionals like advanced practice nurses.

References

Baten,  A., Noman, A., & Rahman, M. N. (2024). Affordable Care Act Medicaid  expansion, access to health care, and financial behavior of the United  States adults. Journal of Public Health Policy, 45. https://doi.org/10.1057/s41271-024-00522-0 

Flaubert,  J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K.  (2021). The role of nurses in improving health equity. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573898/ 

Sommers,  B. D., Rebecca Brooks Smith, & Figueroa, J. F. (2024). Closing Gaps  or Holding Steady? The Affordable Care Act, Medicaid Expansion, &  Racial Disparities in Coverage, 2010–2021. Journal of Health Politics Policy and Law. https://doi.org/10.1215/03616878-11567660 

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