297 Nursing Care of the Postmenopausal Woman, 3rd Edition
Private companies often provide addi- tional drug coverage for seniors to pur- chase (U.S. Department of Health and Human Services [HHS], Centers for Medi - care & Medicaid Services, 2022). The Patient Protection and Affordable Care Act, usually referred to as the Affordable Care Act (ACA), was passed and signed into law in March 2010. The law had three primary goals: ● Allow more people to afford health insurance. ● Expand the Medicaid program to cover adults whose income falls below 138% of the federal poverty level. ● Encourage innovative methods of medical care delivery designed to lower costs of healthcare. The ACA insurance companies were not allowed to refuse coverage to individuals or charge them more because of preex- isting conditions. It allowed young adults to remain on their parents’ insurance pol- icies until they turned 26, at which time they were able to enroll in an ACA plan themselves. Insurance companies are not able to cancel coverage due to a mistake on the policy. The ACA provides a set of preventive services at no cost to the pa- tient (HHS, 2022a). The ACA remains in place today,12 years after the enactment of the law, and the number of people with coverage re- lated to the Affordable Care Act reached approximately 35 million in 2022. The rate of uninsured persons is nearing an all-time low (HHS, 2022b).
| NURSING CONSIDERATION
It is essential that the nurse is aware of what healthcare insurance resources are available for older women so that they can share available options with patients and make referrals to the appropriate agencies. PREVENTIVE SERVICES Preventive services can decrease healthcare costs and improve the health of individuals in the workplace, but fewer than half of adults older than age 65 are up to date with recommended preven- tive services. The ACA makes preventive services affordable and accessible for all Americans, but only if they take advan- tage of the services provided (Health Resources and Services Administration [HRSA], 2022). The Health Resources and Services Administration awarded a five- year contract to the Women’s Preventive Services Initiative (WPSI) and the Ameri- can College of Obstetricians and Gyne- cologists (ACOG) to conduct a rigorous scientific review of guidelines for women. In 2021, ACOG was asked to review and recommend updates to the guidelines (HRSA, 2022). See Table 3-2. Routine screenings for diseases and scheduled immunizations are clinical pre- ventive services that are key to reducing death and disability and improving the health of the individual and the nation. Yet even though preventive services are covered by private insurance plans, Medi - care, Medicaid, and insurance plans un - der the Affordable Care Act, many aging women go without these preventive ser- vices that could prevent illnesses or diag- nose illnesses early enough to treat be- fore they become serious (Healthy People 2030 [HP2030], 2022).
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