POLI 330 Week 6 Change Agent Assignment, Assignments of Nursing

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Week 6: Change Agent Assignment Chamberlain College of Nursing Political Science August 15, 2025

Why is this Policy Necessary?

Expanding free and reduced-cost clinics is vital for millions of Americans,

especially in rural and underserved areas, who face barriers like high costs, limited

transportation, and lack of insurance. These clinics provide essential access to

preventive, primary, and confidential care for vulnerable populations, such as adolescents

hesitant to seek care due to cost or privacy concerns. My initiative to implement this

change is driven by evidence of rising healthcare avoidance, despite broader coverage

under the Affordable Care Act, as increasing the availability of affordable and

confidential services can enhance health outcomes and reduce long-term healthcare costs.

Statistics In 2022, 8.4% of Americans, or 27.6 million people of all ages, were without health insurance, a decrease from 10.3% or 33.2 million in 2019 (Centers for Disease Control and Prevention, 2023). Rural adults are twice as likely as urban residents to delay or avoid medical care due to costs (Burch, 2022). Research shows that free or reduced-cost clinics offering confidential reproductive health services can improve health outcomes for adolescents and decrease rates of unintended pregnancies (Brandt et al., 2022). The impact of the Affordable Care Act on free clinics differs by state; those in states with stronger funding tend to provide better continuity of care, while those in states with weaker funding often face closures (Darnell & O’Brien, 2022). Furthermore, the lack of affordable healthcare access leads to an increased

References Brandt, C. M. A., Shire, M. A., Wilson, G., & Ito, K. (2022). Addressing Organizational Barriers to Adolescent Access to High-Quality, Low-Cost, Confidential Sexual and Reproductive Health Services in a Community Health Center. Health Promotion Practice ,

1. https://doi.org/10.1177/ Burch, A. E. (2022). Factors responsible for healthcare avoidance among rural adults in the Eastern Region of North Carolina. Journal of Community Health , 47 (5). https://doi.org/10.1007/s10900-022-01106- Centers for Disease Control and Prevention. (2023, May 16). U.S. Uninsured Rate Dropped 18% During Pandemic. Www.cdc.gov. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2023/202305.htm Darnell, J. S., & O’Brien, L. (2022). Location, Location, Location: The Affordable Care Act’s Impact on Free Clinics Depends on What State They’re In. Journal of Health Care for the Poor and Underserved , 33 (2), 887–901. https://doi.org/10.1353/hpu.2022.