Legal Factors Of An Urban Institute

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

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).

Texas, which currently has a large uninsured population and limited Medicaid eligibility, forfeits billions of dollars from the federal government every year by not expanding its Medicaid program as implemented in the Affordable Care Act. In contrast, Medicaid expansion could benefit the state exponentially and give its citizens the fullest potential of what this country offers. A substantial amount of federal funding that could increase uninsured coverage, improve healthcare costs, and provide economic stimulus is left on the table. Additionally, the nation benefits when each state participates, contributing to the success of the healthcare reform.

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

One of the main components that had given the Affordable Care Act issues with the uninsured rate in the United States is the growth of the Medicaid program. The Affordable Care Act granted all 50 states billions of dollars in federal financial aid to increase their Medicaid program to insure people who made up to 138 percent of the federal poverty level. Starting at the beginning of 2016, the federal government reduced its federal aid, covering less than 10 percent of what was promised, which ended up putting more of the responsibility of insuring Medicaid qualified Americans on the states. This caused a fallout of state governors being against ObamaCare, resulting with having 21 states declining any federal funding or expands their

The state of Texas has pulled its Medicaid funding for Planned Parenthood, leaving poor residents with few options for affordable healthcare. Medicaid, a program focused on helping low-income families and individuals receive healthcare, has always been jointly operated by the state and the federal government. But to who this program would be eligible for is entirely up to the state. More conservative states, like Texas for example, strictly reserve Medicaid for only the most severe cases of poverty-stricken families, leaving a large portion of low-income residents uninsured. The Affordable Care Act, a federally mandated reform of Medicaid introduced by President Obama, would provide healthcare for many American citizens in need. Despite being

Expansion of the Medicaid program is an important part of the PPACA (Vincent & Reed, 2014). To decrease the number of Americans without health insurance coverage, the Medicaid expansion is designed to provide coverage for individuals with incomes of up to 138% of the federal poverty level (FPL). Individuals with incomes of 100% to 400% of the FPL, who did not qualify for Medicaid, would be eligible for subsidies in the Insurance Marketplaces mandated by the passage of the PPACA (Sommers, 2015) . In the states that do not expand Medicaid, Sommers (2015) notes that individuals who do not qualify for Medicaid and have incomes below the criteria to receive insurance subsidies in the healthcare marketplace will remain uninsured. The Medicaid program is jointly funded by the federal

Across the United States, it was projected that over 11 million people would be accepted into Medicaid after the expansion of

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.

Medicaid financing has become an increasing issue for most states throughout the years. The Government Accountability Office (2010) reported that forty-seven of the states as well as the District of Columbia had concerns regarding the sustainability of their program. Around 16% of the state budgets go towards Medicaid each year, totaling around $183 billion (Center on Budget and Policy Priorities, 2015). A significant share of vulnerable populations relies on Medicaid for medical coverage. Rocco, Gellad, & Donohue (2015) estimated that of the

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 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).

States are being pressured to expand Medicaid to families earning up to $30,000 a year, just like the Affordable Care Act permits. While several respected governors have agreed to expand the program, many other governors and state legislators are cautious. These officials do not want to deny Americans their access to health care, however they do want to slow the expansion of a program that will provide them with limited access to quality care while destroying state budgets. One of the strongest arguments that can be made against the expansion of Medicaid is the fact that States simply can not afford it. The appeal to states to expand Medicaid is that the federal government will cover 100% of the cost through 2016 and eventually lowering to

Medicaid expansion is seen as a huge problem in this case it takes place among the 50 states. The environment includes the 50 states such as California, Texas, New York and New Jersey. Medicaid expansion offers financial protection. It also addresses the uncompensated care problem which involves paying and reimbursement for service rendered. Medicaid expansion also provides customers access to affordable coverage, as well as customers taking up that cover, which is a moral duty of the government. Medicaid also supports politically powerful interest groups who support expansion. The expansion of Medicaid helps rural hospitals stay afloat in states like Colorado, which added 400,000 people to the health insurance program under

This law was put into effect in order to give more Americans access to affordable, quality health insurance, and ensure that every citizen is covered. The arguments for and against the United States health care system are numerous and wide-ranging; virtually everyone could find certain aspects that they liked or did not like in the Affordable Care Act (ACA). Against expectations, health care reform has been showing signs that it is working. More than 500,000 Americans now say they have primary care physicians and fewer say they are struggling to afford care (Culp-Ressler). Based on the various statistical data found, the largest drop in the number of residents going without health care occurred in states who have embraced the bill. In some states, the uninsured rate has decreased rates by more than 10 percentage points; states including Arkansas, Kentucky, Oregon, California, West Virginia, and Alaska (Culp-Ressler). Furthermore, Arkansas is one of the poorest and most conservative states in the country. However, ever since the ACA was taken into effect, the percentage of those uninsured in the state had shown the greatest success for ObamaCare, which declined from 22.5% in 2013 to 9.1% by the first half of 2015; the rates plummeted drastically by more than half of the people that are now covered. (Culp-Ressler). In addition, costs of health care coverage can be quite pricey; however, based on multiple