Evidence Base in Design

 Evidence Base in Design

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy. Evidence Base in Design



To Prepare:

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

description of the health policy and background of its development

On February 5, 2021, the H.R.892 – Pre-existing Conditions Protection Act of 2021 was introduced but has not been decided upon (H.R.892 – pre-existing conditions protection act of 2021, 2021).  The purpose of the act is to prevent private insurance companies from “(1) limiting or excluding benefits covering pre-existing conditions; (2) denying enrollment to employers or individual applicants, subject to specified limits; (3) establishing rules for eligibility based on an individual’s health status; or (4) requiring an individual to pay a higher premium than similarly situated individuals enrolled in the plan based on the individual’s health status” (H.R.892 – pre-existing conditions protection act of 2021, 2021).  One may say these four items are already the provisions of the Affordable Care Act (ACA).  According to Representative Cathy McMorris Rodgers, a Republican from Washington State and the individual introducing the bill, this is a second layer of “safeguards that would protect the ACA even if future legislation or court decisions alter provisions under the Affordable Care Act” (Congressman Jack Bergman, n.d.). This act reflects the previous president’s attempts to repeal the ACA without having a proper healthcare replacement plan. Evidence Base in Design

brief background for the problem

In the enactment of the Affordable Care Act, pre-existing conditions were one of the major deciding factors.  Before the ACA, the history of health coverage capped at one million dollars; individuals were unable to obtain insurance, insurance companies terminated coverage without prior notice.  In referring to pre-existing, many think of high blood pressure or cancer.  Did you know a pregnant woman was denied health coverage?   Pre-existing affected those that were pregnant, pending surgery or hospitalization, paraplegia, and those with mental health disorders.  Babies born with health issues were denied the coverage they needed (The affordable care act’s new patient’s bill of rights, 2021).  Many psych patients now have Medicare or Medicaid, or some may have both (known as dual).

Imagine going to surgery and then finding out after the surgery that you no longer have insurance coverage.  Or after a surgical procedure, your insurance terminated, and follow-up care is now your financial responsibility. You can no longer go to rehab due to a lack of insurance.  For some people, before the Affordable Care Act was enacted, this was the reality.  Many stayed at a job they were unhappy with because they weren’t sure they would receive health benefits due to pre-existing conditions.  Insurance companies had no one to answer to and had the final say.

evidence base to support the proposed policy and explain why

The bill was introduced by Representative Cathy McMorris Rodgers, a Republican from Washington. It was supported by 47 co-sponsors, all of who happen to be republicans (H.R.892 – pre-existing conditions protection act of 2021, 2021).  Yet, not one republican voted for the Affordable Care Act (ACA) in 2010.  Ten years later, amid a pandemic, with people losing their jobs and health coverage, this portion of the ACA is once again a discussion. Evidence Base in Design

When patients are admitted to the hospital, it is very important to know the payor source.  You cannot plan for discharge appropriately with this missing information. A trend I came across is an increase in uninsured patients.  Due to the pandemic, many people lost their health insurance benefits due to unemployment or decreased work hours making them no longer eligible for employer coverage.   If this act passes both houses, the country would not have to experience the distress of the ACA being repealed.




(n.d.). Retrieved from Congressman Jack Bergman: https://bergman.house.gov/news/documentsingle.aspx?DocumentID=812

H.R.892 – pre-existing conditions protection act of 2021. (2021, April 12). Retrieved from Congress.gov: https://www.congress.gov/bill/117th-congress/house-bill/892?

The affordable care act’s new patient’s bill of rights. (2021, April 11). Retrieved from CMS.gov: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca-new-patients-bill-of-rights


By Day 6 of Week 7

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.

 You provided great insight about pre-existing issues are major factors regarding the issuance of insurance policies. COVID-19 has brought attention to healthcare in ways that demonstrate the importance of how healthcare can impact the economy, workforce, education, mental health and how neglecting it can result in a multifaceted problem in the long term. In addition to the multiple hardships, this pandemic has shed light on the need for long-term and affordable medical services (Melillo, 2021). Unlike other health issues, COVID-19 has affected all socio-economic classes of people, races, and cultures alike. For proposed policies to pass through legislation, the policy must reflect public opinion and evidence-based data. Evidence Base in Design

The pandemic has affected the world on a social, economic, and public health level. Because of the heavy impact, this particular policy took less than a month to enact into law. Hopefully, with budgets being distributed to different departments of government based on U.S Treasure findings, many Americans and the nation will improve outcomes as many Americans continue to rebuild their lives.



Milstead, J.A., & Short, N. M. (2019). Informing public policy: An important role for

registered nurses. In Health Policy and politics. A nurse’s guide (6th ed., p.90).

Burlington, MA: Jones & Bartlett Learning

U.S. Department of the Treasury. (2021, March 18). Retrieved April 12, 2021, from https://home.treasury.gov/news/featured-stories/fact-sheet-the-american-rescue-plan-will-deliver-immediate-economic-relief-to-families  Evidence Base in Design