Children's Health Insurance Program: A Case Study

In the U.S. “Decreasing the number of uninsured is the number one goal of the Affordable Care Act (ACA), which provides Medicaid coverage to many low-income individuals” (The Kaiser Family Foundation, 2015, Introduction section). Despite the success of the ACA enrollment of millions of people with health insurance, the most at risk and pressing group of our population is the children. This is a group that needs our attention and their health should be the country’s number one priority. This is a vast difference from Canada, where every child has health care coverage for life because of its Universal Health Care. Bodenheimer and Grumbach (2013) noted that over the years, “reformers in the United States argued for the passage of a national health insurance program, government’s guarantee that every person is insured for basic health care”(p.187). But this effort was not only defeated time and time again, but it was constantly shoved under the rug. It was not until a great effort was pushed by President Obama that we started to see some changes in our health care system. Still a lot of work needs to be done, especially for our children. Stronger measures must be implemented to make sure that every child has an opportunity to live a long and healthy life. This is especially geared towards children living in rural areas, “where access to

Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).

For those adults with children that are not eligible for Medicaid but their income is not enough for private insurance, KidsCare was an option until it froze in January 2010 due to a cost-cutting effort. KidsCare is a state sponsored insurance program for low-income families that is part of the federal Children’s Health Insurance Program (CHIP). Arizona is currently the only state that does not have a CHIP program which forces families that were on the program to partake in the health care exchange and pay for private insurance or forgo health coverage and be uninsured (Whiteman, M., 2014). The number of children covered at the time of the program freeze went from 45,000 to about 2,000, which was a ninety-five percent drop (Whiteman, M., 2014). Governor Jan Brewer proposed to restore coverage to thousand of children through KidsCare II, where Phoenix Children’s Hospital, Maricopa Integrated Health System, and the University of Arizona Health Network would pull money together and receive extra federal funds. The federal funds that the

The Affordable Care Act (ACA), also referred to as ObamaCare, is a complex U.S healthcare reform that attempts to expand and improve access to healthcare and decrease spending through taxes and regulations. The main goal of the ACA is to provide more Americans with affordable health insurance. States vary in when and how they implemented the ACA in order to meet the needs of their state in hope to decrease the uninsured population. Every state had the option decide whether to offer healthcare through a state-based or a federal marketplace. Some states sued the federal government questioning whether they even had to right to impose this act. New Mexico and Pennsylvania are just two of the states that have had to figure out a way implement the Affordable Care Act. Each one had to take into consideration several factors including their state population, the demographics of that population, how many uninsured people there were, and the economy of their state. They both had the public plans such as Medicaid, Medicare and Children’s Health Insurance Program (CHIP) options as well as new federal subsidies that would now be offered depending upon income. Since there is no “one size fits all” health plan each state was challenged to make the best decisions using the tools available to them. This information was then used to formulate a plan that would give the most people access to affordable healthcare in each of these

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

The United States health care system is considered broken because we do not have one universal system. Within the American system there are different types of health insurance such as private, group or self-insurance. The United States works on a fee-for-service system so the providers receive money for every service they provide therefore the medical bills for Americans are significantly high. Before the Affordable Care Act was implemented a few forms of government programs were Medicaid, the Children’s Health insurance Program and Medicare. Medicaid and Children’s Health Insurance Program were to help insure the low income citizens and their children. CHIP and Medicaid are both funded by the government and state but administered by the individual states. CHIP covers children whose family income is up to 200% of the poverty level. Medicaid insures low income citizens but can also

Signed into law in 1997, Children’s Health Insurance Program (CHIP) provides health coverage to approximately eight million children. This law encompasses families whose incomes are too high to qualify for Medicaid, but cannot afford the expense of private health insurance. CHIP is like Medicaid, it’s managed by the states, but different because it’s jointly funded by the federal government and by the states. The Affordable Care Act of 2010 retains the CHIP eligibility standards and extended CHIP funding until October 1, 2015. The Affordable Care Act also provides an additional $40 million in federal funding to continue efforts to encourage enrollment in Medicaid and CHIP.

The Affordable Care Act (ACA) highlighted the importance Medicaid played in insuring every American receive healthcare coverage. (42 U.S.C., 2010) Medicaid provides health benefits to over 71 million across the country. While involvement is optional, all 50 states participate in the program and requirements differ across the nation. The flexibility given to each state has allowed them to make their own decisions to work towards improvements that they believe would best benefit their region (Feldstein, 2015, p. 125-126).

Implementation of the ACA would require an extensive expansion of the Medicaid program to low income adults in each state.³ The Congressional Budget Office projects that a previously 30 million uninsured Americans, approximately 92% of the legal, non-elderly population, will have coverage by 2022.³ The federal government will pay for 100% of the costs of expanding Medicaid programs until 2016, and then gradually fade their contribution to 90% by 2020.³ Currently, expansion of the Medicaid program is voluntary and several states have stated that they intend to turn down their share of the billions of dollars that has been made available to each state solely for the expansion of this program.³ States deciding to not expand their Medicaid program will not only exclude many poor, vulnerable families from access to an important health care program, but will also exclude themselves from an economic stimulus for their state and thereby decrease the strength of their health care delivery systems by not allowing them to be more financially stable for the long

The first piece of legislation (one legislation I discussion 2 pieces of that) discuss is section 101 part of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a bipartisan legislation signed into law on April 16, 2015. This law was created to replace the current law in that time Medicare reimbursement schedule with, the revolutionary idea of new program supposed directed focus on the quality, value and accountability of the national health care program. The CMS describe MACRA as a modern system new payment framework, supposed rewarded the national health care providers to obtain the better care instead of more service, looking for value over volume. The information’s observed in the interview provides consistent points

Basically, it’s built to replace the original Medicaid, due to the fact it only supports children based on their family income; The lower income family would be on Medicaid and the remainder making slightly above refer to Children’s Insurance Program (CHIP). To dive deeper on the matters, CHIP is slightly similar to Medicaid, but some differences set them apart. In Medicaid’s case “experts say the benefit is generally richer” than Chip. “Medicaid requires that children receive comprehensive services, including physical exams, immunization, laboratory tests and dental, vision, and hearing services. CHIP benefits are not as broad in some states”

The Children’s Health Insurance Program (CHIP) was created in 1997 to give health insurance to nearly 11 million uninsured children. Many of these children came from uninsured families that made too much money to be eligible for Medicaid. All 50 states have CHIP plans (Medicaid History).

Furthermore, the Disproportionate Share Hospital (DSH) payments are required by the federal government for the state’s Medicaid program to issue an extra financial aid to hospitals that are serving an excessive number of Medicaid beneficiaries and low-income people without insurance. To cover the costs, eligible states will obtain a yearly DSH allowance from the federal reserve. However, since the implementation of the ACA, the law demanded a cumulative cut on federal DSH’s fund allocations that began in the federal fiscal year (FFY) 2014 up to FFY 2018 due to the presumptive growth of people with health care coverage, which resulted in lower unpaid care expenses. The DSH’s allotment interruption is scheduled to continue until the FFY 2025 (Snyder & Rudowitz, 2015). Moreover, the main supply of financing for the non-federal share of Medicaid is derived from approximately 40% of the state funding and about 60% from the local government ("Financing," 2012).

The CHIP program provides low-income families, whom make too much to qualify for Medicaid, access to low-cost or free health insurance (CHIP,

Since the initiation of the Affordable Care Act in 2010, Americans have been put back in charge of their individual health care. Under this new law, a health insurance marketplace provides a haven for individuals without insurance to gain coverage. Just this year, citizens found out early whether they qualified for Medicare or the CHIP formally known as the Children’s Health Insurance Program. So much is to be learned about the Affordable Care act and this paper provides the roles of the different governmental branches, along with other important factors associated with this law.