Delivering Health Care At Americ A Systems Approach

Critically analyze the implications of the state’s decision to opt out of Medicaid expansion on the citizens of the state.

Baicker, K., Taubman, S., Allen, H., Bernstein, M., Gruber, J., Newhouse, J., ... Zaslavsky, A. (2013, May 2, 2013). The Oregon Experiment — Effects of Medicaid on clinical outcomes. The New England Journal of Medicine, 368, 1713-1722.

In Texas, the uninsured rate dropped from 37 percent to 27 percent due to many adults meeting the low poverty criteria to become insured. The adults that were eligible for the Medicaid program were adults who were eligible for a tax credit to buy the coverage on the federal health insurance programs. Texas decision not to expand Medicaid also made it hard for low income families to receive health care and pay for health medications. According to the study and observations of other states who have expanded Medicaid, it is proven that many low-income adults have less trouble paying for and obtaining health care while on the Medicaid program. In states with the Medicaid program in full effect compared to Texas where there is no expansion on Medicaid, many Americans are struggling with household responsibilities and finances due to having to pay for the private insurance and receive the health care that is needed for their condition.

The potential opportunity for the state to opt into the Medicaid expansion is the fact that low-income citizens will be insured. The decision of the state to opt into the Medicaid expansion will also impact the state’s budget, and this is the main challenge (Frakt, 2013). The government will cover majority of all the cost even as Medicaid expansion provides coverage for the low-income uninsured citizens. Expansion of the Medicaid is also a broken system that has poor outcomes, not severe federal strings, high inflation and no incentive for the personal responsibility of the citizens who

In 2009 there were 50.7 million people, 16.7% of the population, without health insurance. Americans all over the country are working and yet they still can’t afford to pay the high cost of health insurance for themselves and their families. Under the Affordable Care Act of 2010, which was signed by Obama on March 23, 2010, thirty two million Americans who were previously not eligible for Medicaid may now have the opportunity to be covered. If this act is passed in North Carolina then it will be expanded to cover nearly all of the 1.5 million North Carolinians who are without health insurance. If more Americans are covered under the Medicaid that they need then

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.

Since the implementation of the Affordable Care Act (ACA) in 2010, there has been a continuous debate about the effects it will have on the United States economy. Many people argue that expanding insurance coverage for all people will create crippling cost burdens for the economy and taxpayers. While others believe that the ACA will in fact give the economy a much-needed boost. In 2006 as a measure to improve overall healthcare, the state of Massachusetts implemented the Health Care Insurance Reform Act. This paper looks at the positive and negative effects of the Massachusetts Health Care Insurance Reform Act (MHRA). Using a literature review of public health studies ranging from 2009-2012, I argue that there are both positive and negative effects of the Massachusetts Health Care Insurance Reform. While the Massachusetts Reform increased health insurance coverage for all citizens and decreased the number of uninsured citizens accessing emergency rooms, it also did very little to decrease already existing racial, ethnic, and socioeconomic disparities among minorities and whites in the state of Massachusetts. Understanding the Massachusetts Health Care Insurance Reform Act may help in the goal of trying to achieve near-universal healthcare. This paper provides an understanding of the missing pieces in the Massachusetts Health Care Insurance Reform Act and constitutes a starting place from which to understand the Affordable Care Act.

When President Barack Obama ran for office in 2008 he vowed to revolutionize the healthcare environment as it stood. With overwhelming election resuts Obama took the helm as the leader of our nation’s Medicaid program and immedialty begain lobbying for legislation to expand. Not since 1965 had our nation seen such a demeand from a president to change the landscape of healthcare for consumers and providers alike. One of the crucial elements of The Patient Protection and Afordable Care Act (Obamacare) was the need for states to expand eligibility to Medicaid in a bid aimed at improving the health of the welfare of the country Medicaid is a component of what the federal government enacted in the year 1965 that seeks to finance the delivery of better and affordable health care services to those designated “needy families” and to children. The program required states to expand the eligibility criteria to 138 percent of the federal government poverty levels to allow for the increased coverage of the children and an increase in the number of low-income earners. However, the Affordable care Act made the decision to expand the eligibility criteria the discretion of the States resulting in different state level governments opting for different approaches as some chose to expand while others decided not to expand. The subject is essential since it provides a clear insight into the effects policies pose to the healthcare sector and how people are affected. This study also allows one

There are some problems that must be addressed in the expansion of the Medicaid policy to include; social, economic, ethical, legal and political. First, the social impact of having health insurance removes the burden off of parents, people with chronic diseases, children and the disabled. If access to health insurance is unavailable our nation’s health care costs will continue to rise,

The Affordable Healthcare Act is expected to increase medical coverage to include an additional 30 million people. What has become clearer is that just because coverage was expanded does not mean an expansion of actual care. “When Congress enacted the national health law, it unleashed a potential tsunami of newly insured patients, flooding a delivery system that was already strained and fragile. The American health care infrastructure has had workforce shortages for decades and is not prepared to meet such a vast influx of patients effectively or

Also by rejecting the Medicaid expansion community-based providers, including hospitals are casualties. Hospitals will continue to provide care to the uninsured without sufficient compensation, increasing shift costs to the privately insured. This also has a chilling effect on enrollment in private insurance plans through the new federally facilitated marketplace. Opposing the Medicaid expansion also ignores the real needs of the uninsured and the massive financial burden shouldered not only by the hospitals but taxpayers and businesses. (Stultz, 27)

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 over

California rose to the challenge of implementing health care reform in a state with high needs and limited funds by expanding its Medicaid program (Medi-Cal) and establishing its own marketplace (Covered California). As a result, by June 2014 California 's uninsured rate had dropped from 22% to 11%. However, thoughtful examination of the rollout process reveals avoidable bumps in the road that, if corrected, could , have provided a better enrollment experience and thus better access to coverage for our most vulnerable populations. In order to assess California 's success in widening the doorway to Medicaid coverage this report reviews policy decisions that shaped efforts in reaching out to, enrolling, and retaining eligible low-income

In 2008, Baiker et al. seized the opportunity to look at the effects of Medicaid coverage through its expansion for low-income households in the metropolitan areas of Portland, Oregon. This was conducted by a random selection of approximately 30,000 names from a waiting list totalling 90,000 individuals. Such a lottery design allowed the authors to apply random assignment and study how the health outcome of this specific population of interest is affected by Medicaid. Similar to the RAND study, Baiker et al. (2008) find that insurance coverage (in this case, Medicaid) resulted in an increase in health care utilization along with improved health status (specifically limited to mental health). However, the authors limit their focus to the direction and causality of the effect and fail to provide an explanation on specifically how consumer behaviour is affected by the insurance coverage, which is an area of focus that Brot-Goldberg et al. (2015) bring to the literature at the time.