Essay On Medicaid Expansion

Money plays a huge role in access, therefore it is a vital issue to discuss. Within the current system, lack of money results in lack of health care, which leaves thousands of people without any health care coverage. Between 2001 and 2005, the number of people paying for health insurance increased 30%, however income only raised 3% (Health Care Problems). Adequate income is a necessity and unfortunately that is not present. According to the National Conference of State Legislatures, the average annual premium across the country is $16,000. Currently, the average annual income in the United States is $51,107. Mint Money Management suggests that about 4-6% of one’s total income should be spent on insurance, including life, disability, and health insurance. However, the averages in the United States show that the average person spends about 31% of their income on health insurance, which is not financially beneficial. When this rise in health insurance is not parallel to the inflation of income, innocent people are left without a method to achieve health care. There is a program for those who can’t afford health insurance out of pocket nor have access to it, and that is called Medicaid. Issues still exist with the program. There is only so much funding, which leaves many still uninsured. Additionally, people with Medicaid have difficulty

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).

The expansion of Medicaid in the United States has often been denounced due to fear of crowd-out. Crowd-out studies have been investigated since the 1990s. Data vary from study to study with some showing no significant evidence of crowd-out to some showing up to 50% (Muhlestein, 2013). Crowd-out occurs when people choose to drop their private insurance plan in favor of enrolling in the public plan. It can also occur if public program members refuse to use private plans available or if an employer reduces coverage based on public program availability.

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

In a traditionalist state, such as Texas, the financial toll that Medicaid would have on its taxpayers was on the frontlines. The Texas legislature was worried about whether or not its taxpayers would face a tax increase to cover the increased cost of those covered by Medicaid. These taxpayers would inadvertently pay for the hospital bills of those who are uninsured in Texas through an average $1,800 rise in the cost of their premiums (Rapoport, 2012). In support of expanding Medicaid, Texas would receive federal funds in order to ease the cost that accompany the expansion. Since Texas decided not to expand Medicaid, Texas “would be leaving billions and billions of federal dollars on the table” according to Anne Dunkelberg (Rapoport, 2012). Not only does this monetary incentive give Texas an extra push to participate towards expanding Medicaid but it would also help the residents of the state to get insured. Texas legislators understood that this monetary incentive would not fully cover the cost of the newly enrolled Medicaid recipients. In the end, they would have to rework the annual budget and increase taxes in order to cover these extra recipients.

Medicaid initially established that each state is responsible for designing their medical costs to pay medical care for the poor. Also, Medicaid created as a voluntary program for each state; they have to have the choice to participate. For one thing, because of the rising costs of healthcare, it has been difficult to bring Medicaid recipients into the “mainstream” of United States (U.S.) medical care. Donald R. Barr notes, “between 1975 and 1989, the cost of the Medicaid program increased by an average of 11.9 percent per year before adjusting for inflation” (172). The rising costs of healthcare are necessary for each state to determine if it is beneficial for them to participate in the Medicaid program. As the government level of payment is determined by each state economic condition. For instance, a state with lower per capita income will receive more government funding. A state with higher per capita income receives less reimbursement for program costs. Therefore, on December 31, 2010, many states continued to experience budget cuts. As a result on August 2010, Congress increased reimbursement rates through June 2011.

When it validated the constitutionality of The Patient Protection and Affordable Care Act in 2012, the United States Supreme Court also ruled that states could decide for themselves whether or not to expand their Medicaid programs (Sonfield, 2012). Predictably, South Carolina said no. The Palmetto State’s decision not to expand Medicaid in concert with the Affordable Care Act was wrong, and it is time to correct that mistake.

The Medicaid revisions and expansion under the ACA, exhibited the federal government overstepping their power as they tried to penalize any state governments in opposition of the expansion, consequently, taking away states’ power. The Medicaid Expansion Mandate would’ve compelled states to join due to the loss of federal funding towards Medicaid if they did not adhere to (Phi Le, par.40). The Supreme Court hearing allowed states to have a choice whether or not to participate in the expansion without a total loss of their Medicaid funding. In return, states who didn't participate wouldn’t receive additional funding that coupled with this mandate that required inclusion, extending coverage of those who were at “Income below or ar 133% federal

With the implementation of the ACA, many states have expanded their Medicaid programs to include a larger population of low income individuals and families that were not able to obtain health insurance prior to the law. Some of the issues that state legislators struggle with are the overall cost of providing services for the additional recipients, staying within budget, determining an adequate approach of offering quality care, and providing adequate coverage for each recipient. Even though the cost of Medicaid expansion within each state has increased the budget for the program, new appraisals has shown that Medicaid programs spend less per enrollee than commercial health insurance and much of the increase in Medicaid expenses originate from the increase in enrollment in the programs (Coughlin, Long, Clemens-Cope, & Resnick, 2013).

Holahan, J., Buettgens, M., Carroll, C., & Dorn, S. (2012). The cost and coverage implications of the ACA Medicaid expansion: National and state-by-state analysis (Publication # 8384). Retrieved from The Henry J. Kaiser Family Foundation: http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8384.pdf

The following analysis will explore the current health insurance problem under the ACA. It will discuss the proposed policy of Medicaid Expansion and the impact of States not cooperating with the implementation of such provision. Moreover, a recommendation on strategies to alleviate the health

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,

In 2010 the ACA was passed that expanded Medicare eligibility to include those with incomes up to 133% of the federal poverty level (“ObamaCare Medicaid Expansion,” n.d.). This helped the most impoverished people by providing them with health coverage. Because states cannot be forced to participate in the ACA's Medicaid expansion, not all states have expanded their Medicaid programs to cover individuals with household incomes below a certain level (“ObamaCare Medicaid Expansion,” n.d.). This created a Medicaid coverage gap in between those who can afford health insurance and those who qualify for Medicaid (“ObamaCare Medicaid Expansion,” n.d.). This means that not all U.S. citizens have any type of insurance coverage or access to health

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)

The affordable health care act provided expansion of Medicaid, which was federally mandated until 2012 when it was shot down by the supreme court and was made it be the states option. As of 2012 thirty-one states have elected to adopt this platform. The problem lies with the states who have designed the expansion, and this leads to the wage gap. According to (Norris, 2015) In Alabama Medicaid is only available to a family of three who make 2,611 dollars in annual income. This law virtually only affects the homeless and those who do not work. Families and individuals the state has also agreed to cover are citizens with