Healthcare Legislature Literature Review

HealthCare Legislature: American Rescue Plan Act 2021

Over the past decade, healthcare legislation has been used to enhance quality and reduce health care costs. Recently in March 2021, the president of the United States, Joe Biden, signed into law the American Rescue Plan Act (ARPA) aimed at providing financial incentives and expanding health coverage for millions of Americans. O’Mahen and Petersen (2021) found that APRA’s provisions ensure health coverage of uninsured populations. ARPA provides states with financial incentives to facilitate the Affordable Care Act (ACA)’s Medicaid expansion. The federal government covers 90% of costs incurred in Medicaid expansion of adults in households with incomes under 138% of the Federal Poverty Line (FPL) (O’Mahen and Petersen, 2021). ARPA offers attractive incentives whereby for the first two years of Medicaid expansion, effective 2022 financial year, the legislature will cover 79% of the total costs incurred by newly expanded states . these financial boosts will reduce the net state cost spending, and hence a saving scheme for newly expanding states. Despite the financial advantage to newly expanded states, Medicaid expansion still faces resistance, especially in Republican-controlled states.

Consistent with O’Mahen and Petersen’s (2021) findings, Straw et al. (2021) concluded that health provisions in ARPA enhance access to health coverage during the covid-19 pandemic. The Act serves as a relief for low-income people, eligible for ACA coverage but cannot afford to pay for premiums. The financial incentives offered to newly expanded states will ensure coverage of approximately 4 million uninsured low-income adults and over 2 million people within the coverage gap. Similar to arguments by O’Mahen and Petersen (2021), Straw et al. (2021) stipulates that the ARPA’s financial incentives facilitate premium tax credit improvements, a great financial help for families with income below the 150% FPL. Under ARPA, low-income families with household incomes of approximately $19,000 for a single person and $39,000 for a four-member family will be exempted from healthcare premiums (Straw et al., 2021). Such exemptions are likely to increase health coverage to about 4.5 million uninsured Americans. To this end, Cooper et al. (2021) postulate that ARPA will enhance health equity among minority groups and other disadvantaged populations. ARPA will reduce child poverty, enhance access to medical care, and promote community health offer significant support to address the social indicators of health. O’Mahen and Petersen (2021), Cooper et al. (2021), and Straw et al. (2021) agree that ARPA is a sustainable legislature that could enhance access to medical care, reduce healthcare costs and enhance healthcare equity. Increasing funding for and access to underfunded services such as public health monitoring has promising benefits to the American healthcare system.

ARPA legislature affects various populations, including children, low-income, and working families facing the adverse effects of the Covid-19 pandemic, the elderly, people living in high-cost areas, and disadvantaged communities. The Act provides $1.9 trillion in financial assistance to state and local governments, schools, and individuals to mitigate the adverse effects of the Covid-19 pandemic (Cooper et al., 2021). ARPA entails numerous priorities advocated for by the American Nursing Association (ANA), such as improving nurses’ mental health, improving national public health infrastructure, hiring additional frontline workers, and testing and vaccine efforts(ANA Summary on American Rescue Plan – March 10, 2021, 2021). Nurses applauded Biden’s ARPA because it will ensure mass production of nursing equipment, medical supplies, testing kits, and vaccines, vital to safeguarding frontline workers’ health. The covid-19 pandemic has had adverse effects on the healthcare system at large, jeopardizing the health of frontline workers. The ARPA will provide $ 40 million for healthcare providers to enhance their mental health amidst a pressurizing work environment. Six hundred and forty thousand frontline workers will also gain health coverage under the Act.


ANA. 2021. ANA Summary on American Rescue Plan – March 10, 2021. [online] Available at:—march-10-2021/  [Accessed 18 February 2022]

Cooper, L. A., Sharfstein, J. M., & Thornton, R. L. (2021, April). What the American Rescue Plan Means for Health Equity. In JAMA Health Forum (Vol. 2, No. 4, pp. e210658-e210658). American Medical Association. Retrieved from

O’Mahen, P. N., & Petersen, L. A. (2021). Will the American Rescue Plan Overcome Opposition to Medicaid Expansion?. Journal of General Internal Medicine36(11), 3550-3552. Retrieved from Straw, T., Lueck, S., Katch, H., Solomon, J., Broaddus, M., & Lukens, G. (2021). Health Provisions in American Rescue Plan Act Improve Access to Health Coverage During COVID Crisis.