County Profile on Shasta, California Essay

The health care system must change to improve our nation’s health and takes strong steps to address the unsustainable growth of health care costs in America. We still have a long way to go before our health system become effective. We still have population that do not have insurance, have difficulties accessing their health care, or their needs are not met within the healthcare system. It is an investment in prevention and wellness and increasing access to primary care physician.

“According to the report, titled Income, Poverty and Health Insurance Coverage in the United States: 2010, 49.9 million Americans or 16.3 percent of the total US population had no health insurance in 2010. That percentage represents a slight increase on 2009’s figures, when 49 million citizens or 16.1 percent of the population was uninsured” (Gamser, 2011).

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

As a health policy analyst for the state of Texas which has not elected to expand Medicaid as part of the Affordable Care Act (ACA) and now has been notified that the state leaders have taking into reconsideration their recent decision during an upcoming session in order that we begin gathering data on the benefits of adapting the Medicaid expansion. As a health policy analyst our goal is to assure data quality, interpret data, and discover new information in the data. Medicaid is a federal and state partnership with shared authority that is a health insurance program for low-income individuals, children, their parents, the people with disabilities and the elderly. Nationally Medicaid covers health care for over 72 million people. Even though participation is optional, all 50 states participate in the Medicaid program. However, Medicaid benefits eligibility varies widely among the states all states must meet federal minimum requirements, but they have options for expanding Medicaid beyond the minimum federal guideline (http://www.ncsl.org/research/health/affordable-care-act-expansion.aspx). In this research we will identify the state of interest which is Texas, compare the state’s decision, determine the alternate approaches to expanding access and provide a recommendation on whether or not the state should opt in to the Medicaid expansion.

Challenges were evaluated and although the ACA has provisions for healthcare, numerous individuals still remain uninsured and blame the high cost of healthcare insurance as the primary reason they do not have healthcare coverage. In a survey by the Kaiser Foundation in 2014 showed that 48% of uninsured people stated the cost for healthcare was too expensive as the primary reason they were uninsured. Many workers do not have accessibility to healthcare coverage through an employer, and others, predominantly poor working adults from states with no Medicaid expansion, stay ineligible for public healthcare insurance coverage. Furthermore, undocumented immigrants are not eligible for Medicaid or other healthcare from the Marketplace.

In 2014, only 11.4% of the U.S. population was uninsured. In result of the Employer Mandate, employer-based insurance covered the largest population of people covering roughly 55% of the U.S. population. Due to the Medicaid Expansion, more elderly people were covered with 19.5 percent and Medicare with 16%. Since 2010, over 30 states across the country plus the District of Columbia have seen improvements in the access of healthcare for the poor, elderly, children, and low-income adults. In the states of Kentucky and Arkansas, people going in for check-up appointments rose by 8%. An 8% rise of people going in to see a doctor for a routine checkup.

There are providers, of public hospitals community and rural health centers, and local health department considered to be safety net providers that service the uninsured. But the result of increased demand has caused limited capacity and decreased treatment options due to eroding finances (KFF, 2013). In order to improve the well beings of Americans, it is imperative to establish a health care policy that will deliver comprehensive coverage for all.

One of the major social problems in the United States is the increasing number of uninsured people who are among the vulnerable populations in the America. In 2008, there were approximately 46 million of non-elderly Americans without health insurance including adults and children. While this population includes people from all age ranges, young adults account for a significant portion of these people since they are likely to be uninsured. Moreover, many uninsured individuals are in families with at least a single full-time worker as Hispanics excessively have the highest rates of the uninsured. However, the huge share of this population is white Americans as compared to people from other races.

The South Carolina Title XIX State Plan, also known as Medicaid, was designed to maintain the provision of “quality health care to low income, disabled, and elderly individuals” (South Carolina Department of Health and Human Services, 2016). The South Carolina Department of Health and Human Services (SCDHHS) acts as the designee for this administration, managing the state and federal reimbursement of funds for approved medical providers. Services are designed to provide services for diagnosis, treatment, and management of illnesses. The Management Care Organization program provides insurance coverage through a network comprised of contracted, providers who are paid a “per member per month capitated rate” (SCDHHS, 2016). These

As health care reform in the United States makes drastic changes in insurance policies under the Affordable Care Act, San Francisco developed Healthy San Francisco in 2007, a safety net program aimed to help transition the low income and uninsured Americans as they qualify for various health insurance programs (Katz & Brigham, 2011). Healthy San Francisco is a program only for the uninsured adult citizens within the county limits. Under the program, individuals and families can choose primary care homes and defined specialty care networks, with transparent pricing based on income level (Katz & Brigham, 2011). Children under the age of 18 do not qualify for Healthy San Francisco as they would otherwise qualify for another county run program for children who do not qualify for state or federal health insurance (Katz & Brigham, 2011). As part of the program, a health information program would analyze applicants

Medicaid is one of the most widely acknowledged sources of health insurance coverage in the United States, benefiting over 48 million low-income children and parents (Hansen, 2012). It also supports those over the age of 65 who may also receive Medicaid. By providing essential health insurance protection, Medicaid supports the growing un- and under- insured population. This federal program for the financially needy is administered at the state level. Coverage varies and each state creates its own rules, typically offering support through county social services, welfare, or other department of human services offices (Goodman, 1991).

The RHC’s main form of increasing coverage is the continuation of the St. Louis Healthcare Safety Net. After the last free, public hospital in St. Louis closed in 2001, the St. Louis RHC stepped in to redirect around $30 million dollars from the federal government back into the St. Louis City and County healthcare net. Their program Gateway to Better Health is a bridge for healthcare access for low-income, uninsured residents of St. Louis, covering 40% of the uninsured residents in poverty in the St. Louis region. Their access to care is provided by 5 Federally Qualified Health Centers (FQHCs) that are distributed across the city and county region. These FQHCs are state-of-the-art facilities with amazing doctors who provide a wide variety of services under one roof. The comprehensive model of FQHCs includes but is not limited to dental, WIC (women with infants and children), mental health, psychiatry, and primary care services. This comprehensive coverage all under one roof helps to reduce the transportation barrier, since patients are able to keep and meet their appointments. Additionally, FQHCs are open to all patients regardless of ability to pay or immigration status, though there are still challenges

As demonstrated above, lack of health insurance is a legitimate problem for any individual American, as well as society as a whole. This problem is greatly compounded by the large numbers of people who are not covered. Although much progress has been made in getting people insurance, the uninsured rate is still a problem and there is work to be done.

Lower income populations have been categorized with high rates of being uninsured and as mentioned in this brief earlier, mental health and substance use disorders are more prevalent among lower income populations. The changes to the Affordable Care Act (ACA) regarding mental and behavioral services increased the ability for people with these health concerns to gain insurance coverage and acquire the appropriate services needed (Beronio, K., Frank, R., Glied, S., 2014). Along with these changes to coverage, the ACA emphasizes the integration of services among healthcare agencies. With the passing of the Mental Health Services Act (MHSA) in 2004, funding was provided to counties in California. San Francisco’s Department of Public Health (SFDPH)

There are many issues that are causing changings in the healthcare system. Population aging, rapidly increasing costs of healthcare and the growing burden of chronic disease are challenges to health systems worldwide. To meet these challenges will require new approaches to healthcare delivery and comprehensive population health management. Many states are not prepared to tackle this issue yet. The US has the most expensive healthcare system in the world with health status indicators that are only average in comparison