Long Term Care Policy Essay

In present times, people with high incomes that’s above the 100 percent poverty level is eligible for premium subsidies to purchase private plans in the health care market. Individuals that are below the 100 percent of poverty in states that don’t wish to expand Medicaid; do not have access either to subsidized private coverage or Medicaid (Garber & Collins, 2014). Originally, the law require that all states expand Medicaid eligibility, to enable those people living with income that is increasing to 138 percent of the poverty level. These factors are equivalent to $15,856 for each individual and $32,499 for a family living in a single dwelling (Garber & Collins, 2014). In 2012, the Supreme Court made these regulations optional for ruling.

Long-term care can be defined as a broad set of paid and unpaid services for people who are mentally or physically disabled, or whose chronic illness places them in need of medical or personal assistance for long periods of time. “It is estimated that there are more than twelve million Americans of all ages whose mix of serious disability and chronic illness places them at the high risk for functional decline, hospitalization, or nursing home placement.” (Benjamin) Several different populations require long-term care services, and the needs of these populations vary. In addition to the elderly, many of the long-term care users are younger persons with physical disabilities; persons with developmental disabilities; and persons with chronic

The Medicare and Medicaid federal programs were put in place as a way to help the less fortunate. Individuals with severe disabilities or over the age of 65 qualify for Medicare. This program helps them with health coverage, so the disabled and elderly who have Medicare do not have to worry about their medical bills and not going to the hospital when they are sick. Medicaid is a similar program, however, it only applies to low income families who cannot provide for their children. Similar to Medicare, this program covers any health related problems and takes away the worry and troubles that come with hospital bills.

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).

ACA expanded Medicaid to all Americans below 133% of the federal poverty level from the previous cut-off at 138 percent. The enrollment for Medicaid and CHIP has been simplified. ACA prohibits insurance companies from denying coverage based on pre-existing conditions. This is known as guaranteed issue. ACA also extends dependent coverage for young adults unto the age of 26; so they can stay insured on their parent’s insurance. Individuals upto 400% of the federal poverty level are entitled to tax subsidies in order to assist them in having a health insurance. The subsidy is meant to achieve 2 goals: (1) provide sufficient funds to ensure that people can afford their health insurance premiums and (2) provide a financial incentive for people to choose lower-cost plans. These two goals are opposing, but both are essential. Families who earn more than 400% of the FPL can also purchase health insurance from the exchange, but they receive no subsidy.

Affordable care act is a law that was passed in March of 2010 to help decrease health care cost and make it more affordable for all Americans. The affordable care act is set to decrease the number of uninsured Americans, qualify more for Medicare and Medicaid, increase the quality of care, promote prevention, extending funding for the children, and help with funding in the communities. The goal for affordable care act is to have everyone insured, no matter what income class you are in. The affordable care act is there to insure everyone so that prevention will increase. It will increase by being able to get check ups and children being able to receive vaccination. If you are not able to qualify for Medicare or Medicaid there

While the Affordable Care Act was implemented in 2010, the most significant changes in the healthcare system began in 2013 with the expansion of Medicaid. According to the ACA’s official website, the law’s main goals are to create cost efficient health insurance and medical services, as well as expand Medicaid so that the stated programs will be available to more Americans. (“Affordable Care Act (ACA)”). To do so, the ACA imposed many requirements on both sides of the health care system. The ACA has expanded federal regulations on private insurance providers by requiring that these companies cannot deny coverage based on the health of the beneficiary. The ACA has also established a marketplace for health insurance to be purchased by small businesses and individuals. Finally, the most noteworthy reform is the requirement for all Americans to purchase minimum coverage, or pay a penalty. However, those who cannot afford coverage and have “an income below 138% of the Federal Poverty Level eligible for Medicaid” will be paid for by the government (“The Affordable Care Act in the US”).

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

Medicaid and Medicare was created and called the Social Security Act of 1965 to provide coverage for medical treatment for qualified individuals and their families. Medicaid is a program that is jointly funded and managed by the federal and state governments that reimburse hospital and physician for providing care to qualified patients who cannot afford medical expense. To qualify for Medicaid he or she must be a United States or resident citizen which, includes low income adults and their children, people with certain disabilities and senior citizens. “Medicaid and Medicare is overlooked by the Center for Medicare and Medicaid,

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).

The ACA addresses eight themes: Access; cost control; quality improvement; prevention; workforce; revenue; administrative items; and the CLASS Act (which was eventually repealed) (Emanuel, 205). The “access” section primarily focuses on efforts to cover the 15 percent of uninsured Americans at the time of the ACA’s conception. Part of this included raising the age young adults could be covered by parents’ insurance until the age of 26, which affected three million young adults who otherwise would have been uninsured. The largest chunk of the section, though, was dedicated to transforming Medicaid and establishing web-based marketplaces that would allow people to buy health insurance with government subsidies. By 2014, the ACA established nationwide eligibility standards dictating that American adults under the age of 65 with incomes below 138 percent of the federal poverty level would qualify for Medicaid (Emanuel, 205). Prior to the decision, some states were only providing Medicaid to residents making as little as an abysmal 18 percent of the federal poverty level ($20,090 for a family of three) (Medicaid,

The federal government has created rules to expand Medicaid that include offering Medicaid medical insurance to all non-Medicare eligible individuals whom are under the age of 65 with incomes up to 133% of the federal poverty level which is based on the modified adjusted gross income (MAGI) (KFF, 2013).

States determine what the requirements are for eligibility, and the benefits that the people will be subject to. They are required to provide some “mandatory benefits”, and can chose to

As states make the decision to move forward with the expansion of Medicaid they will see benefits from this decision. First, those individuals who were previously over the income level will now qualify for Medicaid coverage. The Patient Protection and Affordable Care Act has the primary goal to provide health insurance to as many American citizens as possible.

The Affordable Care Act (ACA) has expanded the choices for different populations, across the nation, to apply for health insurance. Under the ACA, it is a requirement that everyone have health insurance that meets the minimum requirements or they will be charged a fee. For unemployed individuals, often times the price of healthcare is concerning. Without an income people may struggle to come up with the necessary funds to pay for a healthcare plan for either themselves or their family. The ACA offers a healthcare marketplace that allows individuals to check their eligibility for affordable healthcare insurance, Medicaid, or the Children’s Health Insurance Program (CHIP).