State Insurance Exchanges

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ANA has been a steadfast supporter of the 2010 Affordable care Act (ACA) health care reform law and its provisions to expand access to health care; protect consumers; improve the quality of care; and utilize nurses to their fullest capabilities. The ACA is transforming our nation's health care system from one that focuses on "sick" care to one focused on prevention, primary care and disease management. The law puts patients at the center and calls for a larger role for nurses.

Health Care Coverage is now Affordable for Millions of Americans. The share of adults without health insurance dropped to its lowest level in seven years in 2014 as the ACA took full effect. In 2015, nearly 80 percent of Marketplace shoppers using could purchase coverage for $100 or less after tax credits [pdf]. In summary, through March 31, 2015, of the about 10.2 million consumers who had purchased Marketplace coverage (Exchange) nearly 8.7 million nationwide and 6.4 million in the 34 states with Federally-facilitated Marketplaces received an average premium tax credit of $272 per month.

Registered Nurses (RNs) have been frontline witnesses of the harmful effects on individuals who are uninsured and defer needed care, bringing a unique perspective regarding the consequences of removing the ACA’s tax subsidies. The ANA applauds the June 2015 US Supreme Court decision (King versus Burwell) preserving tax credit subsidies for more than 10 million Americans to obtain health insurance coverage via the federal Marketplace. (

Now it’s time to focus on Medicaid expansion.