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This is a critical analysis assignment on national government health policy and its effect on nursing, written for a healthcare module. It examines two United States policies, the Affordable Care Act and Medicare, then separates the enablers that let registered nurses influence policy from the barriers that stop them. The literature it cites runs to 2023; coverage figures are dated where they appear.

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Critical Analysis of National Government Policy and Its Impact on Contemporary Healthcare

The full assignment title was "Critical analysis of national government policy and how it impacts contemporary healthcare, and examination of the enablers and barriers that impact registered nurses in influencing health policies". The sample runs in six numbered sections: an introduction, an account of two United States policies, the enablers, the barriers, a critical weighing of the two against each other, and a conclusion.

How Do You Write a Critical Analysis Assignment?

Describe briefly, then judge at length. State what the policy or text claims, test that claim against evidence, weigh the strongest counter-argument, and reach a position you can defend. A critical analysis that only summarizes will pass low however well it is written, because the marks sit in the judgment rather than the description.

In practice that means four moves per section, and this assignment repeats them. Name the policy and what it was meant to do. Give the evidence on whether it did. Name what it left out or whom it disadvantaged. Then state your position and carry it into the next section. The table at the head of section II sets those moves out for both policies, and the Affordable Care Act section is the clearest example: it reports the fall in the uninsured rate, then shows that the fall stopped, that fewer than half of adults eligible for Medicaid enrolled, and that the Act survived in court without its central provision being tested.

Check that any two figures you compare were measured the same way. The Census Bureau counts a person as uninsured only if they had no coverage at any point in the calendar year, and it changed the processing behind that count in 2017, when the same year came out at 8.8 percent on the old system and 7.9 percent on the new one. Set 8.8 percent for 2016 against 8.0 percent for 2024 and the rate appears to have fallen; on one basis it was no lower in 2024 than in 2017. A marker who knows the series looks for exactly this, which is why section II compares years on one basis only.

Two habits raise the mark. Attribute every claim, because an unattributed judgment reads as an opinion. And keep description under a third of the words: if you cannot cut your summary paragraphs in half, they are doing work the analysis should be doing. For a worked example in the same subject area, see our assignment on communication in healthcare.

I. Introduction

National government policy reaches healthcare practice through three channels. Money decides what exists: which hospitals and clinics are funded, at what staffing level, with what equipment, and which research gets done. Workforce rules decide who may do what, through scope-of-practice regulation and licensing. Service design decides how care is organized, through quality and safety standards, privacy requirements, and rules that push providers to coordinate primary, specialist and mental health care rather than deliver them separately.

This analysis takes two United States policies in turn, the Affordable Care Act and Medicare, and asks what each achieved and what it left undone. It then examines the enablers and barriers that decide whether registered nurses have any say in policies of this kind, and reaches a position on whether the enablers are strong enough to matter. The answer it arrives at is qualified, and the reasoning for that qualification is set out in section V.

II. National Government Policy and Contemporary Healthcare

Two federal programs carry most of the national government's reach into US healthcare: the Affordable Care Act, which reorganized how working-age people obtain insurance, and Medicare, which pays for the care of most people over 65. Each is tested here against what it set out to do. Both adjust a mixed public and private system rather than replace it, and that choice is itself contested: Stewart, Goodwin and Karagiannis (2022) set the "market-based" view of the US system against a "socially sensitive" one and examine the merits and demerits of different approaches to a comprehensive national health and insurance scheme.

The Affordable Care Act and Medicare: Aim Against Evidence

Point of comparison	What It Set Out to Do	What the Evidence Shows
Coverage (ACA)	What It Set Out to Do Cut the number of people with no health insurance	What the Evidence Shows Uninsured all year fell from 13.3% in 2013 to 8.8% in 2016; on the updated series it was 7.9% in 2017 and 8.0% in 2024
Medicaid expansion (ACA)	What It Set Out to Do Open Medicaid to adults with incomes up to 138% of the federal poverty level	What the Evidence Shows Only 44% to 46% of eligible adults enrolled, 2014 to 2017, in expansion and nonexpansion states alike (Decker, Abdus and Lipton, 2022)
Coverage requirement (ACA)	What It Set Out to Do Require most people to hold coverage, backed by a penalty	What the Evidence Shows Congress set the penalty at zero in 2017; the 2021 challenge failed on standing, and the provision's constitutionality was not decided
Nursing homes (Medicare and Medicaid)	What It Set Out to Do Finance safe long-term care	What the Evidence Shows A system that "often fails to ensure the well-being and safety" of residents (National Academies, 2022)

Affordable Care Act (ACA)

The Affordable Care Act, passed in 2010, set out to reduce the number of people without health insurance. Its instruments were a requirement that most people hold minimum essential coverage, backed by a monetary penalty; regulated exchanges on which individuals compare and buy private plans; and an extension of Medicaid to adults with incomes up to 138 percent of the federal poverty level. It also removed pre-existing condition exclusions and defined a set of essential health benefits. Because employment is a main source of health insurance for working-age Americans, its effects reached the labor market and the wider economy as well (Fang and Krueger, 2022).

On coverage, the first three years bear the aim out. The Census Bureau's measure of people uninsured for the entire calendar year fell from 13.3 percent in 2013 to 8.8 percent in 2016, from 41.8 million people to 28.1 million, and the steepest fall came between 2013 and 2014, when many of the Act's provisions took effect (US Census Bureau, 2017). After that the record is flat. The survey's processing system changed in 2017, which puts a break in the series: the 2017 rate was 8.8 percent on the old system and 7.9 percent on the new one. On the new basis the rate was 7.9 percent in 2017, 8.6 percent in 2020 and 8.0 percent in 2024 (US Census Bureau, 2025). The Act's coverage gain was made between 2014 and 2016; on a consistent measure, the share of people uninsured for a whole year was no lower in 2024 than in 2017.

Eligibility is not enrollment, and a policy is judged on the second. Decker, Abdus and Lipton (2022) estimate that between 2014 and 2017 more than one in five adults were eligible for Medicaid in states that expanded it, against about one in 30 in states that did not, yet only 44 to 46 percent of eligible adults were enrolled in either group. Differences in eligibility, not in participation, explained the gap in enrollment between the two groups of states. The expansion widened who could join; it did not bring most of those people in.

The Act's central instrument has also lost its force. In 2017 Congress set the penalty for going without coverage at zero, and when Texas and other states argued that the coverage requirement was unconstitutional without it, the Supreme Court disposed of California v. Texas on standing, holding that the plaintiffs had "not shown a past or future injury fairly traceable to defendants' conduct enforcing the specific statutory provision they attack as unconstitutional" (Supreme Court of the United States, 2021). The Act survived on a procedural ground, and the constitutional question was left undecided. That leaves the exchanges, which Handel and Kolstad (2022) assess against the goals they were set: whether they succeeded in expanding coverage, creating robust marketplaces, providing product variety and generating innovation in health care delivery. On the first of those four goals, the Census series above is the answer, and it is a qualified one.

Medicare Program

Medicare is the federal health insurance program for people aged 65 and over, younger people with certain disabilities, and people with end-stage renal disease. It is funded through payroll taxes, premiums and general revenue, and it pays for hospital stays, physician visits and prescription drugs. Its purpose is to pay for that care on terms the federal government sets, and three developments test how far it still does.

The first is who manages the care. Medicare Advantage, the private-plan option, covered an estimated 29 million people in April 2022, 46 percent of beneficiaries, and Jacobson and Blumenthal (2022) expected it to become the dominant source of Medicare coverage. By 2026 it was: 35.2 million people, 55 percent of the 64.2 million beneficiaries with both Parts A and B, were enrolled in Medicare Advantage plans (Freed et al., 2026). The two percentages are measured against different totals, so they show the direction of travel rather than an exact rate of growth. Payment stays public, but a growing share of decisions about what care is delivered sits with private insurers.

The second is what it pays for. Drugs given accelerated approval reach the market on surrogate end points judged "reasonably likely" to predict clinical benefit, before a confirmatory trial is complete. In 2019 fee-for-service Medicare spent $1.2 billion on 36 such drugs that still lacked full approval, and Ballreich et al. (2022) conclude that Medicare should adjust its incentives so that sponsors complete those trials as soon as possible.

The third is the quality of what it finances. The National Academies' 2022 report concluded that "ineffective responses to the complex challenges of nursing home care have resulted in a system that often fails to ensure the well-being and safety of nursing home residents" (National Academies of Sciences, Engineering, and Medicine, 2022), a judgment on a sector Medicare and Medicaid largely finance.

Medicare therefore still pays, but control over what it pays for has moved away from it: to private plans, to drug sponsors whose evidence is incomplete, and to a nursing-home sector that on the National Academies' reading often fails its residents. None of this was decided by the nurses who deliver the care, and sections III to V ask why.

III. Enablers for Registered Nurses in Influencing Health Policies

Five enablers recur across the literature on nursing and health policy: education and training in policy and advocacy, professional organizations, transparent and inclusive policy development processes, partnership with other stakeholders, and legislative and regulatory frameworks that require nursing input. Hajizadeh et al. (2021), a systematic review of eleven studies published between 2000 and 2019, sorts the same material into three themes, nursing-related factors, management and organizational factors, and the work environment, which is a reminder that most of what helps an individual nurse is decided above them.

Education and Training

Registered nurses who receive education and training in health policy and advocacy strategies are better equipped to take part in policy discussions and to argue for change. The evidence for the gap is direct: Hajizadeh et al. (2021) record "lack of knowledge and education about the policy-making process" in four of their eleven studies and "lack of understanding of a complex political process" in four, and three of the eleven recommend integrating political education into the design of the nursing curriculum. Training supplies two distinct things: knowledge of how policy development actually works, and the practical skill of making a case to a policymaker in the form and the timescale that policymaker uses.

Professional Organizations

Professional organizations provide advocacy training, support, and a route to policymakers that an individual nurse does not have. They also act as a collective voice, which changes the weight of the same argument: a position taken by a national nursing body is heard differently from the same position taken by one practitioner. Shariff (2014) ran a three-round Delphi survey with national nurse leaders in Kenya, Uganda and Tanzania and found the facilitators to be involvement in health policy development itself, knowledge and skills, an improved image of nursing, and enabling structures and processes, with the barriers as their mirror images, including structures and processes that exclude nurses. Bodies such as the American Nurses Association supply the infrastructure that turns those facilitators into practice: policy analysis, briefing material, and a standing relationship with the committees that matter.

Process of Policy Development

Registered nurses engage more effectively where the development process is transparent and open to stakeholders. Two conditions have to hold together. The process must admit nurses, and nurses must understand the language and the concepts it runs on, because a consultation that is technically open but written in an unfamiliar register is closed in practice. Hajizadeh et al. (2021) find the absence of the first condition in five of their eleven studies, recorded as a lack of enabling structures, the most frequent finding under organizational structure in the review.

Partnership and Collaboration

Nurses who work with patients, families, other providers and community organizations build broader support for a policy change than they could alone. Partnership also improves the content of the proposal rather than only its reception, because a coalition forces a policy solution to account for several perspectives at once. Sulosaari, Kosklin and De Munter (2023) reach the same conclusion from cancer nursing leadership, calling for collaboration among multidisciplinary leadership, health care organizations, academic institutions, professional organizations and policy-making structures.

Legislative and Regulatory Frameworks

Where legislative and regulatory frameworks require nursing input, engagement stops depending on individual initiative. Frameworks of this kind do two things: they mandate stakeholder engagement at defined points in the process, and they fund the research and data collection that give advocacy something to stand on. Scope-of-practice regulation is the clearest example of the stakes, since the rules that define what a nurse may do are themselves the product of a policy process that nurses may or may not have been inside. In Australia, for example, Wiggins et al. (2022) found legislation and regulatory policies among eight factors that influence scope of practice across nursing and midwifery, pharmacy and physiotherapy, alongside education, competency and organizational structures.

Taken together, these five enablers describe a chain rather than a list. Education produces competence, professional organizations convert competence into access, open processes make that access usable, partnership gives it weight, and a statutory framework makes the whole thing routine instead of exceptional. Break any link and the chain stops carrying load, which is the reason the barriers in the next section matter individually and not only in combination.

IV. Barriers for Registered Nurses in Influencing Health Policies

Five barriers are analyzed here: limited education and training in policy and advocacy, organizational cultures that treat advocacy as outside nursing practice, opaque policy development processes, power imbalances against administrators and officials, and competing priorities, since patient care comes first and advocacy takes unpaid time. The first and third are the mirror images of enablers above, which is the point: the same factor helps when present and blocks when absent.

Limited Education and Training

The first barrier is limited education and training. Many registered nurses do not have the knowledge or the skills that policy engagement needs, because the policy element of a nursing program is often a single short unit rather than a strand running through the degree. Continuing education opportunities after qualification are limited in the same way, which makes it difficult to stay current on policy issues or to learn advocacy technique on the job. The result is a workforce that has the clinical evidence and not the means to present it, which is the pattern Hajizadeh et al. (2021) record across their sample.

Organizational Culture and Structure

The second barrier is organizational culture and structure. Healthcare organizations may not treat advocacy as part of nursing work at all, and a nurse who raises a policy position can meet resistance from leadership or from colleagues who see it as outside the scope of practice. Structure compounds culture: where nurses are not represented on the committees where decisions are made, exclusion needs no one to intend it. Shared governance exists to close that gap: McKnight and Moore (2022) define its core as shared decision-making between bedside nurses and nurse leaders on resources, research and evidence-based practice projects, equipment purchases and staffing. An organization without such a structure has the barrier in place by default.

Policy Development Processes

The third barrier is the policy development process itself. Policy is often made in ways that are complex and opaque, in committees whose timetables and vocabulary are not public knowledge, and sometimes in closed meetings that exclude external stakeholders by design. Hajizadeh et al. (2021) record a top-down approach to health policy as an explicit finding in two of their studies, and where policies are developed in silos with little input from nurses or other frontline staff, the resulting rules can be internally coherent and still unworkable at the bedside.

Imbalances of Power

The fourth barrier is imbalance of power. Nurses advocating for change are usually arguing against better-resourced stakeholders: hospital administrators, government officials and industry bodies with dedicated policy staff. Access is unequal before the argument starts, and the effect registers on the individual as well: Hajizadeh et al. (2021) record nurses feeling powerless in two of their eleven studies and fearing confrontation with administration in one. Fear of this kind is better documented elsewhere in nursing. In the review of barriers to incident reporting by Hamed and Konstantinidis (2022), fear of negative consequences was the most cited barrier, alongside a pervasive blame culture. The step from incident reporting to policy advocacy is an inference, but the mechanism is the same: a nurse who will not report an error for fear of blame is unlikely to argue against a policy in front of the managers who hold that power.

Competing Priorities

The fifth barrier is competing priorities. Registered nurses carry patient care, administrative work and professional development at the same time, and advocacy is the activity with no protected time attached to it. This is a structural point rather than a motivational one, and it is the most consistent finding in the review evidence: Hajizadeh et al. (2021) record lack of money and other resources in eight of eleven studies, lack of time in five, and heavy workload in two. Advocacy is largely unpaid, often out of hours, and frequently requires attendance at meetings held in the working day, so the nurses best placed to speak are the ones least able to be absent.

V. Critical Analysis of the Impact of Government Policy on Registered Nurses

The enablers and the barriers are not symmetrical. Enablers mostly need individual effort: a nurse studies policy, joins an organization, builds a coalition. Barriers are mostly structural: funding, time, hierarchy and the design of the process. Individual effort cannot dissolve a structural constraint, which is why advocacy capacity in nursing remains concentrated in a small group of leaders.

Limited Resources and Funding

Two further constraints sit underneath all five barriers, and the first is money. Advocacy has direct costs: attending meetings and conferences, releasing staff time, and commissioning the research and data analysis that give a position evidential weight. Nurses without institutional backing pay those costs personally or do not incur them, and the effect is selective rather than general, since it filters out exactly the practitioners whose caseload gives them the most to say. It is also the constraint the review evidence finds most often, in eight studies of eleven (Hajizadeh et al., 2021).

Political Nature of Policy Development

The second underlying constraint is that health policy development is political, not merely technical. Partisan positions, organized interest groups and lobbying shape which options reach a decision point, and evidence enters that process as one input among several rather than as a settled answer. Hajizadeh et al. (2021) record lack of support from the political sector as a finding in its own right, and Shariff (2014) reaches the same place from the other direction, with structures and processes that exclude nurses named as a barrier by national nurse leaders. A nurse who expects a well-evidenced case to win on merit will read the outcome as a failure of communication when it is usually a difference in resources. Recognizing this changes the tactics: it moves advocacy towards coalition-building and timing, and away from the assumption that better data alone will carry the argument.

Effective Strategies

Four strategies follow from that analysis, and each targets a structural barrier rather than a personal shortfall.

The first is collaboration with patients, families, other providers and community organizations. A coalition raises both the visibility of a position and its quality, and it spreads the cost of advocacy across more people, which addresses the competing-priorities barrier directly rather than asking individuals to find more time.

The second is to work through professional organizations and advocacy groups. These bodies hold the resources, the training and the standing relationships that an individual nurse lacks, and they offer a platform where a practitioner's experience reaches policymakers without that practitioner having to build the route themselves.

The third is to prioritize education and training in policy and advocacy, and to do it inside the nursing curriculum rather than as optional continuing education. Treating it as optional reproduces the first barrier in every graduating cohort, and it is the recommendation the review evidence makes explicitly (Hajizadeh et al., 2021).

The fourth is direct, ground-level advocacy: contacting elected officials, responding to public consultations, and taking part in public campaigns. These raise the visibility of an issue and build the support a policy change needs, and they are the activities most open to nurses who are not in leadership positions.

This section's conclusion is qualified. The strategies work, and the evidence for each is reasonable, but they redistribute effort rather than remove the constraint. Until advocacy carries protected time and a statutory seat at the table, nursing influence on health policy will continue to depend on the small number of practitioners willing to absorb the cost of it personally.

VI. Conclusion

National government policy reaches nursing practice through money, workforce rules and service design, and it does so whether or not nurses had any part in writing it. The two policies examined here show both halves of that. The Affordable Care Act cut the full-year uninsured rate from 13.3 percent in 2013 to 8.8 percent in 2016, but on a consistent measure the rate was no lower in 2024 than in 2017, and fewer than half of adults eligible for Medicaid between 2014 and 2017 enrolled. Medicare still pays for the care of older adults while control over that care moves to private plans, and the quality of the long-term care it finances remains unresolved. Neither outcome was decided at the bedside.

The examination of enablers and barriers gives the answer to the second half of the assignment title, and it is not an encouraging one. The enablers are real, and the chain that runs from education through professional organizations to open processes, partnership and statutory frameworks does work where it is intact. The barriers, however, are structural where the enablers are individual. Limited policy education, organizational cultures that place advocacy outside nursing, opaque processes, unequal power and unprotected time are not problems a motivated practitioner can solve alone.

The position this analysis reaches is therefore conditional. Registered nurses can influence health policy, and the strategies in section V describe how, but the influence available is proportional to the institutional support behind it rather than to the strength of the clinical case. Making that support routine, through protected time, curriculum change and a statutory place in policy development, is what would change the pattern. Until then, nursing influence on health policy will remain the achievement of individuals rather than a property of the profession.

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Sources

• Stewart, D., Goodwin, S. R., & Karagiannis, N. (2022). Towards a comprehensive national health system for the United States. In N. Karagiannis, S. R. Goodwin, & D. Stewart (Eds.), Assessing the Need for a Comprehensive National Health System in the United States (pp. 41-56). IGI Global. https://doi.org/10.4018/978-1-6684-4060-5.ch003
• Fang, H., & Krueger, D. (2022). The Affordable Care Act after a decade: Its impact on the labor market and the macro economy. Annual Review of Economics, 14, 453-494. https://doi.org/10.1146/annurev-economics-051420-115149
• Decker, S. L., Abdus, S., & Lipton, B. J. (2022). Eligibility for and enrollment in Medicaid among nonelderly adults after implementation of the Affordable Care Act. Medical Care Research and Review, 79(1), 125-132. https://doi.org/10.1177/1077558721996851
• US Census Bureau, 2017. Health Insurance Coverage in the United States: 2016 (P60-260). https://www.census.gov/library/publications/2017/demo/p60-260.html
• Supreme Court of the United States, 2021. California et al. v. Texas et al., No. 19-840, decided 17 June 2021. https://www.supremecourt.gov/opinions/20pdf/19-840_6jfm.pdf
• Handel, B., & Kolstad, J. (2022). The Affordable Care Act after a decade: Industrial organization of the insurance exchanges. Annual Review of Economics, 14, 287-312. https://doi.org/10.1146/annurev-economics-051420-114714
• Jacobson, G. A., & Blumenthal, D. (2022). Medicare Advantage enrollment growth: Implications for the US health care system. JAMA, 327(24), 2393-2394. https://doi.org/10.1001/jama.2022.8288
• Freed, M., Fuglesten Biniek, J., Damico, A., Ochieng, N., & Neuman, T. (2026, June 5). Medicare Advantage in 2026: Enrollment update and key trends. KFF. https://www.kff.org/medicare/medicare-advantage-in-2026-enrollment-update-and-key-trends/
• Ballreich, J., Socal, M., Bennett, C. L., Schoen, M. W., Trujillo, A., Xuan, A., & Anderson, G. (2022). Medicare spending on drugs with accelerated approval. Annals of Internal Medicine, 175(7), 938-944. https://doi.org/10.7326/M21-4442
• National Academies of Sciences, Engineering, and Medicine (2022). The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff. Washington, DC: The National Academies Press. https://www.nationalacademies.org/publications/26526
• Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses' participation in the health policy-making process: a systematic review. BMC Nursing, 20(1), 128. https://doi.org/10.1186/s12912-021-00648-6
• Shariff, N. (2014). Factors that act as facilitators and barriers to nurse leaders' participation in health policy development. BMC Nursing, 13(1), 20. https://doi.org/10.1186/1472-6955-13-20
• Sulosaari, V., Kosklin, R., & De Munter, J. (2023). Nursing leaders as visionaries and enablers of action. Seminars in Oncology Nursing, 39(1), 151365. https://doi.org/10.1016/j.soncn.2022.151365
• Wiggins, D., Downie, A., Engel, R. M., & Brown, B. T. (2022). Factors that influence scope of practice of the five largest health care professions in Australia: a scoping review. Human Resources for Health, 20(1), 87. https://doi.org/10.1186/s12960-022-00783-4
• Hamed, M. M. M., & Konstantinidis, S. (2022). Barriers to incident reporting among nurses: a qualitative systematic review. Western Journal of Nursing Research, 44(5), 506-523. https://doi.org/10.1177/0193945921999449
• McKnight, H., & Moore, S. M. (2022). Nursing shared governance. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549862
• US Census Bureau, 2025. Health Insurance Coverage in the United States: 2024 (P60-288). https://www.census.gov/library/publications/2025/demo/p60-288.html

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