Although the US has recorded hundreds of proposed reforms to its healthcare system, few have been enacted into law. In 2010, however, a landmark reform was enacted with the hope that it would improve access to affordable care. Since its enactment, the Affordable Care Act has seen several changes made to the US healthcare system (United Health Foundation, 2016). Subsequently, the impact of these changes on the state of health in the various states has emerged as an important area of study. In view of this, the current paper compares and contrasts the state of health in the states of Massachusetts and Florida.
According to the US Department of Health & Human Services (HHS), the Affordable Care Act has had a largely positive impact in the states of Massachusetts and Florida. As of February 12th 2015, the websites establishes that the Marketplace insurance coverage had seen 140,540 new consumers enroll for health coverage in Massachusetts (HHS, 2015b). In addition to this, 66% of Massachusetts consumers who had already enrolled for coverage qualified to apply for tax credit. By the end of five years since the Act was adopted, 50,313 consumers aged 34 years and below had enrolled for coverage under the Marketplace option. Of this number, 42,584 were aged 18-34. Overall, the Affordable Care Act has seen the number of uninsured residents in Massachusetts reduce to 4.6% of the total population as of 2014 (HHS, 2015b).
Compared to Massachusetts, health care reform in Florida has had a bigger impact on the state of health insurance. As of February 12th 2015, the number of consumers who had signed up for Marketplace coverage stood at 1,596,296 (HHS, 2015a). By the same date, 93% of Florida consumers already enrolled for coverage qualified for tax credit under the Marketplace coverage. In addition to this, the number of insurers in the state increased to from 11 to 14 by 2014 and this provided consumers with a wider range to choose from. The number of uninsured residents, on the other hand, dropped from 22.1% in 2013 to 18.3% in 2014. What can be drawn from these is that the health care reforms under the Affordable Care Act have improved health insurance rates in both the state (HHS, 2015a).
Despite the Affordable Care Act having had a bigger impact in Florida than in Massachusetts, the latter ranks higher than the former in the 2015 states health ranking. Ranked at number 3 with a score of 0.709, Massachusetts is among the healthiest states in the US. Massachusetts is only behind Hawaii and Vermont which are ranked first and second respectively. Florida, on the other hand, is ranked at number 33 with a score of -0.174. While the wide gap in ranking could be used as an indicator of the health disparity between the two states, it is critical to consider that the population of Florida is almost three times that of Massachusetts (United Health Foundation, 2016).
When comparing specific adult health indicators between the two states, Massachusetts performs better than in Florida and this justifies its higher ranking. As of 2013, adult physical inactivity rate stood at 23.5% of the adult population in Massachusetts compared to 27.7% in Florida. In the same year, the proportion of adults diagnosed with hypertension in Massachusetts was recorded as 29.4% of the adult population while Florida recorded a value of 34.6% for the same indicator. The prevalence of adult obesity was also noted to be higher in Florida (26.4% of adult population) than in Massachusetts (23.6% of adult population).
A comparison of child health indicators between the two states indicates a similar trend to that established by adult health indicators. Overall, children in Massachusetts are healthier than those in Florida. As of 2010, Florida had an infant mortality rate of 6.5 deaths per 1,000 live births. Massachusetts, on the other hand, had a lower infant mortality rate of 4.4 deaths per 1,000 live births. Despite the disparity in child health status, there are minimal disparities between the health statuses of adolescents in the two states. The obesity prevalence rates in Florida and Massachusetts stand at 13.4% and 14.5% respectively. Among high school students, obesity prevalence is higher in Florida (11.6%) than in Massachusetts (10.2%) (United Health Foundation, 2016).
Comparing public health preparedness in the two states, Massachusetts appears to be better prepared than Florida. Although the two states increased their respective funding for public health services for the 2013/2014 financial year, Florida failed to meet the Healthy People 2020 target for vaccination. Massachusetts, on the other hand, reached the 90% target set for children aged 19-35 months. As of 2014, Massachusetts had vaccinated more than half its population aged 6 months and older, a target Florida had not yet reached. In other areas such as HIV/AIDS and food safety preparedness, the two states met the targets set by the Healthy People 2020 (United Health Foundation, 2016).
Assessing public health funding in the two states, Massachusetts had a bigger per capita health budget than Florida. For the 2013/2014 financial year, Massachusetts had a state public health budget of $376,797,663 which translated to $56.30 per capita. Florida, on the other hand, had a state public health budget of $376,397,399 ($19.25 per capita). From these figures, it could be noted that Massachusetts’ per capita health budget was almost three times that of Florida. Despite having a population almost three times bigger, Florida had a public health budget almost equal to that of Massachusetts. This finding highlights the extent of disparity in the state of health in the two states.
Influence of Health Care Reform on Professional Nursing
Similar to the case in other states, health care reform in Massachusetts and Florida has influenced professional nursing in a number of ways. By providing increased funding to nursing schools, the Affordable Care Act has enabled these schools to offer loans to nurses who in turn who have in turn acquired the necessary skills to be nurse educators. Under the Nurse Faculty Loan Program (NFLP), more nurses have accessed loans and enrolled for Master’s and Doctoral level education. With the role of the nurse constantly changing, the demand for nurses with baccalaureate level education.
In both the states of Massachusetts and Florida, the Nursing Workforce Diversity Program and the Nursing Student Loan Program have had an important influence on nursing students. Under the two programs, nursing students with limited financial resources have been able to explore a number of opportunities such as low-interest loans. The Affordable Care Act has also seen the Nursing Workforce Diversity Program implemented in the two states and this has enhanced nurse compensation, training, and retention. By improving cultural diversity at the workplace, the program has enabled nurses to improve care to patients.
Under the Affordable Care Act, health care reform efforts have strongly focused on the primary care workforce. Currently, the number of primary care providers in the country has reached an all time high. In Massachusetts, the number of Corps clinicians increased from 124 in 2008 to 231 in 2014 highlighting the important impact of the Affordable Care Act on the state’s primary care workforce. In Florida, the number of Corps clinicians increased from 167 in 2008 to 344 in 2014. This increase was particularly helpful considering the state’s relatively large population.
Summary/Conclusion
Although the US has recorded hundreds of proposed reforms to its healthcare system, few have been enacted into law. In 2010, however, a landmark reform was enacted with the hope that it would improve access to affordable care. Since its enactment, the Affordable Care Act has seen several changes made to the US healthcare system. Subsequently, the impact of these changes on the state of health in the various states has emerged as an important area of study.
Similar to the case in other states, health care reform in Massachusetts and Florida has influenced professional nursing in a number of ways. By providing increased funding to nursing schools, the Affordable Care Act has enabled these schools to offer loans to nurses who in turn who have in turn acquired the necessary skills to be nurse educators. Under the Nurse Faculty Loan Program (NFLP), more nurses have accessed loans and enrolled for Master’s and Doctoral level education. With the role of the nurse constantly changing, the demand for nurses with baccalaureate level education.
As highlighted in the above discussion, it is without a doubt that the health care reform in the US has the potential to address most of the challenges facing the country’s healthcare system. In order for the country to afford healthcare for all, however, there is need for a continued focus on efforts that minimize current inequality in access to quality care. And although the Affordable Care Act has been largely successful, millions of Americans continue to be locked out of quality healthcare for economic reasons. The disparity in the state of health in different states is an equally significant concern that needs urgent attention. As noted in the comparison of Massachusetts and Florida, health care reform under the Affordable Care Act has had varying levels of influence on the state of health in different states. This trend appears to stem from the fact that the Affordable Care Act was not widely supported in some states with concerns raised over some of the provisions contained in it. Going forward, as the largest group of health workers, nurses have an important role to play in advocating for reforms that improve access to quality care such as the Affordable Care Act.
References
United Health Foundation (2016).State Information. Retrieved from http://www.americashealthrankings.org/states
US Department of Health and Human Services. (2015a, November 2). 5 Years Later: How the Affordable Care Act is working for Florida. Retrieved from http://www.hhs.gov/healthcare/facts-and-features/state-by-state/how-aca-is-working-for-florida/index.html
US Department of Health and Human Services. (2015b, November 2). 5 Years Later: How the Affordable Care Act is working for Massachusetts. Retrieved from http://www.hhs.gov/healthcare/facts-and-features/state-by-state/how-aca-is-working-for-massachusetts/index.html
