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Repeal of the ACA Could Lead to RN Job Cuts

Potera, Carol

AJN The American Journal of Nursing: December 2017 - Volume 117 - Issue 12 - p 15
doi: 10.1097/01.NAJ.0000527470.54212.a2
In the News

Women, who make up 90% of the profession, would bear the brunt.

Carol Potera

If Congress repeals the Affordable Care Act (ACA), not only might 22 million Americans lose their health insurance, but 156,000 nursing jobs could vanish in 2019 alone owing to reduced demand for health care services, according to an analysis by the Georgetown University Center on Education and the Workforce (see https://cew.georgetown.edu/wp-content/uploads/Nursing2-FR.pdf). Up to 60% of those lost nursing jobs are projected to be in southern and midwestern states, which have already been hit hard by losses in manufacturing jobs.

The potential consequences to nursing from an ACA repeal stem from the anticipated widespread loss of insurance coverage. “What we don't talk about are the providers who would also lose their jobs and, by extension, the families of those providers,” says Nicole Smith, PhD, chief economist at the Georgetown center and an author of the report.

Women would be especially hit hard, because they make up 90% of the nursing workforce. Their salaries would be difficult to replace, since RNs earn an average of $67,000 annually, which is about $7,000 more than average salaries for comparable workers. Nurses with a bachelor of science in nursing (BSN) earn $68,000 annually on average, and LPNs, $46,000. Advanced practice nurses have the highest salaries, ranging from an average of $83,000 for nurse midwives, NPs, and nurse administrators to $153,000 for nurse anesthetists.

Despite the uncertainty about the ACA's future, nursing remains an “oasis of opportunity” for women, with one of the most developed career ladders of any profession, according to the report. A person can start as a nurse's aide and eventually obtain a BSN through training programs geared toward helping working professionals attain higher degrees and salaries. In 1980, just 32% of nurses had a BSN, compared with 66% today. Nursing also has traditionally offered low-income and minority women opportunities for economic and social mobility. Some 44% of LPNs today are from racial and ethnic minority groups, although diversity among BSNs has progressed more slowly, according to the report.—Carol Potera

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