Affordable Care Act Users Guide for Nurses - page 2

by JB85 10,407 Views | 55 Comments

Sentiments run high regarding the Affordable care Act, but whether one supports the new law or believes it to be a case of government over-reach, the fact is that the ACA is now the law and as nurses we are obligated to make sure... Read More


  1. 12
    Bedside nurses have never been the ones to explain complicated insurance information to patients. Why ever would we start now? We don't have the time, nor do we have the knowledge to navigate "the system" for them. That is the job of discharge planning, social services, and insurance companies. All we can do is refer the patient to them; as far as educating people about ACA or any other kind of insurance ourselves, that is patently absurd and should not be expected of us.
  2. 5
    Show me the section of the law that specifically tells me as a bedside nurse that I need to answer questions about ACA. If it is required for me as a bedside nurse then I'm sure my hospital and every other hospital in this country would have to provide education to the bedside nurse in order for us to explain this act to our patients.

    Until I'm am told by my employer and the government that a bedside nurse has to provide this information then no I'm not doing it. Not once have I ever had to discuss insurance information with any of my patients. And if they ask I refer them to case management or social work. Very seldom do I even know what type of insurance my patient has let alone explain what their insurance will and won't pay for.

    Sent from my iPhone using allnurses.com
    GM2RN, Jessy_RN, VivaLasViejas, and 2 others like this.
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    We won't have to tell them.....they are going to be discussing it with other moms they run into at the grocery store...and of course there were the ACA Thanksgiving dinner conversations, and next week the Christmas conversations about it. They will have been happy to hear about it at the bookstores, Jiffy Lube and all the other places being used (and I do mean used) to get out the propaganda.
    GM2RN, Jessy_RN, and VivaLasViejas like this.
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    The article is well written, but I'm with Viva and tntrn on this one. Even if we are to accept the facts vs myth as outlined by the OP, I've rarely had a patient respond with, "OK, thanks bye!" to patient education. There will be questions. I'd expect something as complicated as the ACA to be the same, and therein lies the problem.

    If my understanding is not comprehensive I don't feel qualified to act as a resource for insurance and health care coverage information. It is not a political issue to me, it's a "how can I best be of service to my patient?" issue, and sometimes that is referring them to those who do have expertise on the subject.
    MBARNBSN, Jessy_RN, herring_RN, and 1 other like this.
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    There are people who are specialized in education patients about the ACA; a percentage are nurses; if anything, referring them to a phone number and or local office is the most resourceful and objective intervention nurses can do.

    I have referred my patients to case management, social work if necessary; there were positions I held where referrals to resources were on the nurse; I have no issue referring my population to the RIGHT resources.
    MBARNBSN, cardiacfreak, herring_RN, and 1 other like this.
  6. 0
    I like the part where you will not go to jail, give it time...IRS driven, my scenario,you refuse to get insurance and then penalized in turn you do not pay the penalty, you do this for a few years. Eventually the IRS will garnish your wages and if that doesn't work, well get ready for debtors’ prison....wait and see...
    Last edit by Esme12 on Dec 20, '13 : Reason: Formatting
  7. 6
    I work at a major medical office where we just had training about the ACA. Most, if not all of what the OP wrote down is factual.

    Also, personally I think it benefits all of us nurses to be well informed about how the ACA affects our patients, regardless of what we think of it. My take away from this article was that it's in our best interest to be knowledgeable about how it can make an impact on our patient's healthcare. I've seen doctors in my practice who use their familiarity with how insurance works to help patients financially.

    That said, this is all brand spanking new, so I can understand referring to brokers and insurance reps (for now) until healthcare professionals can learn to work with the system in a way that can ultimately benefit our patients.
    rebel902004, CosmicHymns, MBARNBSN, and 3 others like this.
  8. 4
    Can't agree that it's now the bedside nurses' responsibility to explain insurance coverage... or that it ever was.

    Surely someone at a facility should be accountable for this function, but not the clinical floor staff... that'd be ridiculous, IMHO.
  9. 9
    I understand that many nurses in certain facility settings may not discuss insurance with their patients. However, some of us do. I work in a specialty rehabilitation facility focusing on only spinal cord and brain injury. We have our patients, and their families, for 2-10 months. We talk about insurance all the time. Especially since there are very few insurance companies that really have good trauma/long term coverage for patients like these. It is a daily issue these patients, and their families deal with. Especially because their spouses have stopped working as well.

    As a result, us bedside nurses need to be able to discuss these issues. Yes, we have social workers, but they are not here 24/7, nurses are.

    You all are right, there is no law that states nurses are required to explain insurance to patients. But there is also no law that requires nurses to be compassionate. There is also no law that requires nurses to care about their patients. And yet we do. As nurses, I believe part of our job is to always strive to be better. I believe that means educating ourselves on laws and issues that affect our patients so we can discuss them intelligently.

    For those of you who think the Affirdable Care Act is a piece of garbage, please make sure you have done your own research and come to that conclusion on your own instead of listening to the propoganda and repeating stuff. Here is why I believe it is beneficial for all and these benefits outweigh the negative:

    1. You cannot be rejected, or dropped, for pre-existing conditions
    2. The insurance company cannot cap your benefits
    3. There is a basic core of services that all insurance plans must contain
    4. Maternity and newborn care is included
    5. Preventive and wellness care is included.

    As a single female, with no kids, and no intention of having kids, I still believe all of us will be better off with all of this.
  10. 1
    Quote from Raicho
    You all are right, there is no law that states nurses are required to explain insurance to patients. But there is also no law that requires nurses to be compassionate. There is also no law that requires nurses to care about their patients. And yet we do. As nurses, I believe part of our job is to always strive to be better. I believe that means educating ourselves on laws and issues that affect our patients so we can discuss them intelligently.
    Well said!
    herring_RN likes this.


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