If I were the chief nursing executive for a small rural clinic that provides contraception services to low-income individuals, and an insurer, providing care under the Affordable Care Act (ACA), had rejected paying the claims, stating that they were a not-for-profit religious organization and were not obliged to cover these services, I would do the following to advocate for the patients of the clinic affected by the change:

1. I would first contact the insurer and try to understand their reasoning for rejecting the claims. I would explain that the clinic provides contraception services to low-income individuals who do not have access to any other health care services in the region. I would also explain that nonpayment for contraception would place a significant financial burden on the clinic.
2. If the insurer was not willing to reconsider their decision, I would then contact the state insurance commissioner. The state insurance commissioner is responsible for ensuring that insurers comply with the ACA. I would explain the situation to the state insurance commissioner and ask them to intervene.
3. I would also contact my state’s congressional delegation. I would explain the situation to my state’s congressional delegation and ask them to introduce legislation that would require insurers to cover contraception services.
4. I would also contact national organizations that advocate for women’s health. These organizations could provide me with support and resources. They could also help me to raise awareness of the issue and to pressure the insurer to change their decision.

How do you justify your actions based on legal and ethical guidelines?

My actions would be justified based on the following legal and ethical guidelines:

• The ACA requires insurers to cover contraception services.
• The right to access contraception is a fundamental human right.
• Denying contraception services to low-income individuals who do not have access to any other health care services is discriminatory.

I would also support my position with the following scholarly source:

• Religious Exemptions Under the Affordable Care Act: A Primer. This article by the Guttmacher Institute provides a comprehensive overview of religious exemptions under the ACA. The article discusses the legal and ethical implications of these exemptions, and it provides recommendations for how to ensure that women’s access to contraception is not compromised.

Conclusion

I believe that it is important to advocate for the patients of the clinic who are affected by the change. These individuals have a right to access contraception services, and they should not be denied these services because of the insurer’s religious beliefs. I would use the legal and ethical guidelines outlined above to justify my actions. I would also contact the state insurance commissioner, my state’s congressional delegation, and national organizations that advocate for women’s health. I believe that by taking these steps, I can help to ensure that the patients of the clinic have access to the contraception services they need.