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2 APA scholarly references per reply within 5 yrs. (Different sources for each reply)
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Respond to at least two of your colleagues* on two different days by either supporting or
respectfully challenging their explanation on whether there is an evidence base to support the
proposed health policy they described
Please use 2 references in APA format for each response. Do them separately
Response followed by references.
Response to Dacia
The Affordable Care Act(ACA), also known as Obama Care, was the first
comprehensive healthcare reform law and was passed on March 23rd, 2010
(Rosenbaum, 2011). The ACA aimed to address the issue of insufficient access to
affordable healthcare in the United States. The primary goal was to tackle the high
number of uninsured Americans and the challenges of acquiring coverage due to
preexisting conditions. The ACA sought to expand Medicaid, create a health insurance
marketplace, and implement consumer protection (Tilhou et al., 2020,p.1292).
Socioeconomic status is the primary social determinant affecting the ACA. Access to
health care is “strongly associated with socioeconomic characteristics, including
income, education, employment, and wealth”(Griffith et al., 2017,p.1503). Lower-income
individuals often face barriers to healthcare access. Before the ACA, individuals with
lower incomes faced higher rates of uninsurance due to limited access to employerbased coverage and preexisting condition exclusions. Addressing this social
determinant involves continued support for Medicaid expansion and subsidies to make
insurance more affordable for those with limited financial means.
Evidence supports the ACA’s impact on increasing insurance coverage. Within the first
two years of full implementation, the ACA was able to improve access for Americans in
low-income households, unemployed individuals, and those who were not college
graduates (Griffith et al., 2017,p.1509). According to Griffith et al., the ACA was
responsible for the considerable narrowing of socioeconomic disparities in access,
significantly in states that expanded Medicaid. Diabetes is the most common underlying
chronic condition in the United States, as over 122 million Americans are actively living
with diabetes and prediabetes today (ADA, 2020,p.1). The ACA prohibited insurers from
denying coverage or charging higher premiums to individuals with preexisting
conditions, such as diabetes. Paving the way for millions of Americans to acquire
coverage free from discrimination based on health status (ADA,2020,p.1). These
outcomes highlight the effectiveness of the ACA in addressing socioeconomic
disparities and improving healthcare access for vulnerable populations.
In essence, addressing social determinants, such as socioeconomic status, effectively
requires a comprehensive approach concerning policy change, community
engagement, and healthcare system improvements. The impact of the ACA on
expanding coverage, enhancing preventative care, and improving healthcare outcomes
strongly reflects evidence-based effectiveness. Lastly, ongoing support for Medicaid
expansion, targeted education campaigns, and initiatives aimed at reducing disparities
in healthcare access across diverse populations is imperative.
Response to Stacy
Stacy Pixley
Homelessness and Co-Occurring Disorders
Mental Illness and homelessness are two social determinants of health that are often intertwined.
In addition, drug and alcohol addiction compounds the situation, increasing the complexity of
addressing the needs of the person experiencing homelessness combined with the dual diagnosis of
substance abuse and mental health. Solving the problem of homelessness, particularly among those
with a mental illness or dual diagnosis, will take innovative approaches and assistance from the
federal government, as well as local and statewide resources.
As of 2016, there were almost 550,000 individuals experiencing homelessness in the United
States alone (Holzhauer et al., 2019). Out of these individuals, 17.2% had a substance abuse
disorder, and 19.6% had mental Illness (Holzhauer et al., 2019). Of those who had a diagnosed
mental illness, it was noted that up to 70% of those with mental Illness also had a co-occurring
substance abuse disorder (Holzhauer et al., 2019).Homelessness cannot be addressed or resolved
unless mental illness and substance abuse disorders or the presence of both are addressed
simultaneously.
Currently, there is a bill in the House of Representatives Committee on Financial Services to
address the epidemic of homelessness in those with mental illness and substance abuse disorders.
H.R.773 – Homelessness and Behavioral Health Care Coordination Act of 2023 wasintroduced by
Representative Madeline Dean (D-PA) with the support of Representative Sylvia Garcia (D-TX) and
Representative Suzanne Bonamici (D-OR) on 2/02/2023 (H.R 773-118th Congress, 2023-2024). In
this bill, it is proposed that grants be awarded on a competitive basis by the Department of Housing
and Urban Development to non-profits, agencies that provide public housing, and local government
agencies to assist homeless persons who also have a mental illness, a substance abuse disorder or
co-occurring disorder (H.R 773-118th Congress, 2023-2024). The monies would support these
agencies in improving care coordination for this population (H.R 773-118th Congress, 2023-2024).
The grants would not directly provide health care or housing but support established community
agencies already providing these services, enabling them to expand and coordinate with other
agencies in establishing these services for this population (H.R 773-118th Congress, 2023-2024).
This bill will also increase the availability of and training for Naloxone to help prevent opioid
overdose deaths (H.R 773-118th Congress, 2023-2024).
In conclusion, the social determinants of health homelessness, mental illness, and substance
abuse disorders have a great deal of influence over one another. To address the issues of
homelessness, issues like substance abuse, mental Illness, and co-occurring disorders must be
addressed as well. Legislation, like H.R. Bill 773, aims to address all those issues by increasing
funding to those community agencies already working with this population (H.R 773-118th Congress,
2023-2024). While this bill is still in committee status, it presents evidence to support the need for
this bill, and those like it, to become entered into law to address homelessness among the
population with mental illness and substance abuse disorders.
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