By Debra Wood, RN, contributor
June 29, 2012 - Years of observing her emergency patients falling through the “safety net” convinced a Fort Myers, Fla., nurse that the country needed to change its health care policies, and on June 28, 2012, Laura Brennaman, MSN, RN, watched from the chambers as the U.S. Supreme Court upheld the Affordable Care Act (ACA), something she describes as a good first step.
Laura Brennaman, MSN, RN, traveled nearly 1,000 miles for a chance to watch as the Supreme Court announced its decision about the Accountable Care Act.
“It was a phenomenal experience,” said Brennaman, a nursing and health policy Ph.D. student at the University of New Mexico and an adjunct professor at Nova Southeastern University in Fort Lauderdale, Fla. She added, “I was ecstatic I was there and wouldn’t trade the experience for anything. It’s history.”
Upon hearing a definite date for the decision and checking the Washington, D.C., weather forecast, Brennaman cashed in her frequent flyer points and flew nearly 1,000 miles, folding chair in tow, to wait on the sidewalk for nearly 24 hours for a chance to watch as the justices read the decision and the descents. She was the second person to arrive and one of about 90 members of the public to observe.
This is not the first time Brennaman camped out at the court. During an internship at the American Nurses Association, in March, she watched the first day of oral arguments about the ACA, while lawyers argued whether the individual mandate was a tax or not.
“As it turned out, it was those arguments that were the foundation for the decision, the authority to tax being the basis for allowing the mandate to stand,” Brennaman said. “I heard in person the most critical arguments.”
Brennaman read all of the other arguments and delved into the law’s details.
“I thought, how cool to be in court for the verdict,” said Brennaman, adding later, “It was an opportunity, and since I had been there, I had to close the loop.”
She passed time talking with others who were waiting in line and educating reporters about care at the bedside and the difficulties uninsured people have obtaining needed services.
“I’ve always been passionate that everybody should have access to preventive care,” Brennaman said. “I watched people time after time come into the emergency room with chronic health problems getting exacerbated, causing disabilities. If they could have gotten into see somebody, they never would have gotten so sick.”
The woman in front of her had also been at the court in March; she had no health insurance but was opposed to the law. Behind her, Rep. Michelle Bachmann (R-Minn.) staff members and interns took turns holding a place for the Congresswoman who has been outspoken in her opposition to the ACA. Once Bachman arrived, Brennaman discussed the act with her, hoping to understand her perspective, and, when in the court, watched the Congresswoman react to the decision “and watched her hands sweat.” Then Bachmann left while Justice Ginsburg read the liberal descent.
The room remained quiet throughout the proceeding. Court decorum calls for no response, and the room itself creates a sense of the seriousness of the matter. The court’s artwork depicts justice through the centuries, from pictures of Moses with tablets to Greek and Roman Gods.
“It was awe-inspiring,” Brennaman said. When the court clerk calls the court in session, “a chill goes through your spine. Most of the important decisions that affect people’s lives come from them, and they usually get it right. They got it mostly right this time.”
Brennaman is glad about the decision and supports the bill, because it is a huge step; she describes it as the biggest thing since the creation of Medicare and Medicaid. However, she would prefer a single-payer system, Medicare for all, to remove fragmentation and the complexity associated with multiple payers.
“Let us all be covered by the same quality health care,” Brennaman said.
Brennaman anticipates growing opportunities for nurses, nurse practitioners, pharmacists and other professionals to care for the additional patients for which the act will enable coverage. Their real jobs, she believes, will be keeping people healthy and out of the hospital.
“We can take today to celebrate,” she concluded. “But now we have to roll up our sleeves and implement this thing.”
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