DNP- 840 PEER RESPONSES

Bonnie Flores

The implementation of the Affordable Care Act (ACA) was a huge benefit to the American population; however, while there were many benefits that came out of it, barriers continue to exist. The passage of the ACA enabled people with pre-existing conditions to purchase health coverage for a reasonable amount of money, and it allowed those who were ineligible due to pre-existing conditions to purchase insurance (Harvard, 2017). For middle-class Americans, being able to purchase a plan or receive a health plan from work enabled them to keep their children on their plan until the age of 26 for lower medical premiums (Harvard, 2017). Medicaid benefits were also greatly expanded under this program, but these benefits vary depending on where you live. For example, Medicaid coverage was expanded in most states; however, twelve states elected not to expand coverage (Alio et al., 2022; Harvard, 2017). Some of these states do not allow for Medicaid benefits unless you are well below the poverty line; Texas does not allow for Medicaid coverage unless a single parent earns less than $6,000 annually, for those with no children, you do not qualify for Medicaid unless you are disabled (Harvard, 2017). This illustrates the point that healthcare can be inequitable depending on where you live and shows how many disparities exist due to racial stigmatization of Medicaid since their health systems are highly politicized and do not advocate for health equity (Alio et al., 2022; Harvard, 2017). Additionally, Medicaid reimburses providers at a lower rate than Medicare, which reduces the number of physicians who take the coverage (Alio et al., 2022). This adds to continued health inequities in poor and minority populations, thus continuing a cycle of health disparities based on structural racism Alio et al., 2022).

As a doctoral leader, I would advocate for increased reimbursement for Medicaid recipients so that providers would not have to choose between Medicare and Medicaid. Increased reimbursements or incentives to take on Medicaid recipients would allow for minorities and those with lower socioeconomic means to be treated as equally as everyone despite their geog