Healthcare CO-OPs

I had to write a paper for my course Professional Aspects of Advanced Nursing and "take a position" on a current healthcare issue. I had to limit it to two pages using APA format. This is what I came up with. Let me know what you think:

  The Patient Protection and Affordable Care Act (PPACA) passed in 2010 is an ambitious attempt to make healthcare a reality for every citizen, mandating that employers provide health insurance to its employees and that every individual has health insurance. This might become problematic for small businesses and the self-employed or unemployed individuals. As it currently stands, small businesses and the individual have more expensive plans than large employers and coverage is often minimal within these plans. Small businesses and individuals are relatively too insignificant to create favorable change within the current market. Healthcare providers, including nurse practitioners, often feel the strain of their patient’s financial burdens when they are compelled to stray from the standards of practice due to the patient’s lack of coverage or inability to meet high deductibles and co-pays.

  To offset the burden of the mandate and avoid forcing people onto government-run healthcare, section 1322 of the ACA created the Consumer Operated and Oriented Plan (CO-OP) and provided each prospective CO-OP the potential to borrow up to $56.4 million in federal funds to cover the expenses of start-up. CO-OPs that take out a loan have several contingencies they must follow: the health insurance issuer must offer plans on a statewide basis, it must be governed by its own members, and it must be recognized as a nonprofit organization as defined by the state while reinvesting its profits to improve benefits or lower the premiums.

  There is some opposition to the implementation of CO-OPs. Since the CO-OPs are using federal dollars and there isn’t a guarantee that they will be viable, some think that it’s too much of a risk for taxpayers to invest in. Initially, the goal was for all states to implement CO-OPs but because of pressure to decrease federal spending, only 24 states received these funds before budget cuts were made.

  Oregon is one of the 24 states that received federal loans and is the only state to attempt two co-ops—Freelancers CO-OPs of Oregon and Oregon’s Health CO-OP. A major appeal of a healthcare CO-OP is that with each member being a part-owner, the individual will have more autonomy within the healthcare system. Focus groups within Oregon found that consumers are interested in established flat rates for their appointments, being able to contact providers through email, having alternative medicine as part of the plans, and affordable premiums. Enrollment for these two CO-OPs begins in October 2013 and coverage will start in January 2014.

  Oregon nurse practitioners should consider supporting healthcare CO-OPs for several reasons. First, the nature of a CO-OP not only respects the patient’s autonomy but it promotes it. As part-owners of their healthcare policy, patients will be able to vote on the type of care they want covered and the rates that are willing to pay. Second, it is also a form of social justice. As the healthcare system stands today, access to care is limited by the ability to pay. By providing healthcare insurance with predictable costs, patients will be more likely to seek early treatment for both acute and chronic diseases and injuries from their primary provider and reduce emergency room visits. Patients will also be more able to afford medications and procedures that they previously could not.

  Since healthcare CO-OPs that received federal loans are unable to advertise and solicit membership, nurse practitioners should draw attention to these healthcare plans by working within their communities and informing small businesses and self-employed individuals about this option. Having a large enough membership is crucial as it will determine the CO-OP’s viability.