Health Care Post ACA: A Case Study

The Medicare, Medicaid, and other types of public funded health insurance programs are the other major sources of insurance in the United States. These types of insurance programs target some particular populations of people and most Americans don’t fall into such populations. This mode of healthcare coverage left over 50 million American (17.6 of the population) including about 7.5 million children, without any form of health coverage in 2009. (Lapierre,2012)

President Obama signed the Affordable Care Act on March 23, 2010. This law puts in place widespread health insurance reforms that expanded out over the last 4 years and continues to change the lives of many Americans today. Health care reform has been an extensively debated topic for multiple years, and the ACA is the first effective attempt at passing a law aiming to make health care not only affordable, but accessible for all individuals. The law impacts many Americans including, children, employers, government programs which includes federal and state, health plans and private insurers, health care coverage, health care cost, and the quality of care received. The main goal of the law is to expand health care coverage, broaden Medicaid eligibility, minimize and regulate health care cost, and improve the health care delivery system. In order to improve the health care delivery there have been new consumer protections established and an increase access to affordable care.

Those who utilize the Medicaid system range from low income families to the over 65 age group. Within this population is also those who are disabled due to physical or mental problems. This is among the sickliest of our American population. A paper based on a study in Oregon stated that “Medicaid significantly increased the probability of being diagnosed with diabetes, and being on diabetes medication as well as high blood pressure and high cholesterol.”(Baicker et al., 2013, p. 1715). Much of this is due to the struggle that the Medicaid beneficiary has

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

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.

Medicaid has help many qualified Americans who were historically unable to access health care. At the same time, it has raised questions and controversies as how efficient is the plan overall. Various research studies were conducted and contradicting results were presented. According to Paradise and Garfield (2013), some said that having no coverage at all is better that having a Medicaid coverage. On the other hand, some expressed that Medicaid paved a way to improved health due to increased access to services that provides prevention of diseases, health maintenance, and effective treatment (Paradise & Garfield, 2013). As for me I am in favor of the later, health care access for all. It comes down to equitable distribution of resources

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.

The Affordable Care Act (ACA) was enacted in March, 2010. The purpose of this law is to reform public and private health insurance systems resulting in expanded coverage for millions of Americans by the year 2023. Full implementation of the Act, will result in a reduction of the number of uninsured U.S. citizens by more than one-half (Rosenbaum, 2011). The ACA “expands Medicaid eligibility to include all individuals and families with incomes up to 133 percent of the poverty level” (Riggin, 2013).

The Affordable Care Act (ACA) was created by President Barack Obama on March 23rd, 2010. This act created several policies that covered many individuals in the United States who were previously uninsured. The ACA mostly focus on improving health by creating initiatives that improve access to healthcare, lowering healthcare cost, improving quality of healthcare, and updating new consumer protections. According to authors Gruber and Sommers, “Since the passage of the Affordable Care Act(ACA), an estimated 20 million Americans have gained health insurance, and the country’s uninsured rate has dropped from 16% to 9% since 2010 (Gruber & Sommers, 2016). The issue with health insurance in the United States is that it is primarily expensive, while

The Affordable Care Act, also called the ACA or Obamacare, is a health care reform law in America. The Affordable Care Act is a long, complex piece of legislation that attempts to reform the healthcare system by providing more Americans with affordable quality health insurance and by curbing the growth in healthcare spending. The law includes new benefits, rights, and protections, rules for Insurance Companies, taxes, tax breaks, funding, spending, and the creation of committees, education, new job creation, and more. The ACA includes 10 titles that address reform the U.S. healthcare system. Some of the provisions include eliminating lifetime and unreasonable annual limits on benefits. It mandates that EHB (or essential health benefits) must be included on all new plans. These benefits include ambulatory services, emergency care, hospitalization, maternity and newborn care, prescription drugs, mental health and substance abuse services, rehabilitative services and devices, labs, chronic disease management and oral and vision care for children. The new law prevents individuals from being dropped from their coverage for any reason other than fraud. The ACA requires coverage of preventative services and immunizations and of dependents up to the age of 26 years old. The law also provides assistance for individuals with preexisting conditions. The ACA also caps insurances companies’ non-medical and

There are those who believe that Medicaid should not be allowed at all, much less expanded for easier access to those who use it. Few have noted that “opponents of the ACA’s Medicaid expansion have often cried foul, claiming that it provides taxpayer-funded health coverage for able-bodied adults who choose not to work, and rely instead on the government for everything from food to shelter – and now health insurance.” (Norris L., 2016.). For some of those who are against the expansion of Medicaid, they believe that many of the Texans who are using Medicaid are able to work, and therefore can afford to provide insurance for their self. Likewise, a valid point is made when Benjamin Sommers states “there is also evidence that in 2014 some Texans who were eligible for Medicaid before the ACA, but had yet to sign up, gained coverage as a result of the “woodwork effect.” This led to a 5 percent increase in the state’s Medicaid enrollment through 2015 even without expanded eligibility.” (2016.). Arguments stating that Medicaid has already experienced an increase without expanding, due to the number of people who are gaining coverage through the Affordable Care Act would lead one to believe that expansion is no longer

Medicare is a federal program that makes an authorized privilege to health benefits for the elderly and disabled. It also undermines the right of workers to control their retirement savings and the freedom of elders to control their own health care. On the other hand, Medicaid creates an entitlement to health benefits for the poor. While I realized that Medicaid and Medicare were federal programs offered by the U.S. government, I did not know whether some states expanded or restricted Medicaid/Medicare. For this issue analysis, I set out to discover more data about how some states react towards the extension/restriction of Medicaid/Medicare. Questions I hope to answer through my research incorporate the following: How does Medicaid/Medicare benefit or harm the government/society? What are the actions of certain states that chose to neglect or bolster Medicaid/Medicare? What laws/acts have been proposed to support Medicaid/Medicare?

In this paper we will discuss John Q. and Medicaid. John recently moved into a rural community and works a full time job. John is eligible for Medicaid due to his low income and needs to see a doctor since he has high blood pressure and recently his father had a heart attack. He has local doctors but none of them except Medicaid and the closest one he can find is a 40 minute drive away and needs the appointment to be made two weeks in advance. John doesn’t have a vehicle of his own and catches rides to work and relies on public transportation. We will be discussing what factors may affect John’s health care utilization, if the

The article presents information regarding how Medicaid has expanded to States that it was not in existence such as New York through the provision of the statistics of the beneficiaries. The author focuses on the measurement of the quality of the Medicaid which has deteriorated at an alarming rate leading to a greater future concern on the medical coverage of the patients in the Medicaid program. The article also emphasizes on the reports by Centers for Medicare and Medicaid services which reported of poor quality of the services offered by Medicaid. For instance, the existence of low- birth weight babies, patient’s satisfaction and body mass indexes. The authors further states that, for the future success of the Medicaid on the poor and the sick, there should be a balance on the quality and financial