Medicaid And Medicare : Health Care For Individuals And Families With Low Income

I chose to compare and contrast Ohio and Michigan State Medicaid. Medicaid is a state and federally funded entitlement program that pays for medical services to qualified low-income Michigan residents. It is one of the largest programs at the state level, providing services to over one million Michigan residents annually. All of the health care programs in Michigan have an income test and some of the programs also have an asset test. These income and asset tests may vary with each program. For some of the programs, the applicant may have income that is over the income limit and still be able to obtain health care benefits when their medical expenses equal or exceed their deductible (formerly known as spend-down) amount. Below are two examples of Michigan Medicaid plans that are available.

Medicaid is a joi8nt federal and state program. It provides health coverage to nearly 60 million Americans including children, pregnant women, seniors, and individuals with disabilities. As well as those people who are eligible to receive federally assisted income. Eligibility does however vary state to 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).

At which time States must offer health insurance to parents and childless adults who have an income up to 100% of the federal poverty line. As of January 1, 2019, States must offer health insurance to parents and childless adults who have an income that does not exceed 133% of the federal poverty line. The amount being paid by the Federal Government is 100% in 2014, which will be diminished over time by 5% and then 10%, with the States being required to pay the difference. If a State chooses not to follow the Expansion plan, it will lose all of its Medicaid funding.

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.

The federal part of Medicaid is known as the federal medical assistance percentage (FMAP) (Hegar). The FMAP annually reviews comparison of average state and U.S. per capita income. This means in Texas the federal government pays 60 percent of every dollar spent on Medicaid services (Hegar).

Medicaid is health insurance that covers low income or no income people and families. There are some people that qualify for both Medicare and Medicaid. Due to the Medicaid Expansion (Obamacare), 26 states and the District of Columbia have eased some of the income requirements for Medicaid. Anyone below 138% of the federal poverty level is eligible

The United States (US) is distinguished for its medical advances, leading technology and astonishing discoveries in various science fields. These advancements in the health care ground have impacted and improved the health care delivery of several in the nation. The US is found among the wealthiest, most developed countries around the world; however, it is the only developed country that fails to provide universal health care to its people. Health care in the US is described as fragmented, inaccessible, and expensive. Diebel (2015) compared the health system in the US to other nations and supported that it is extremely overpriced, yet the end result does not always support its cost. Lack of coverage, high copayments plus deductibles force Americans to postpone seeking medical attention resulting in undiagnosed health conditions and complications of current diseases. In 2010, under President Obama’s mandate, Americans witnessed the birth of a controversial legislation, The Patient Protection and Affordable Care Act (PPACA). The goal of the PPACA is to improve just about every aspect of the system such the health of Americans, health care access and quality, while reversing the health care expenditure (Hahn and Sheingold, 2014). The aim of this paper is to discuss the PPACA and the Medicaid Expansion under the PPACA including its risks and benefits; as well as, the impact of the expansion in the healthcare delivery

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

The Medicaid in first place was created as safety net. It was created by President Johnson to help with medical services and make wider services for people of all ages (LBJ, 2012). He promised people that it would improve healthcare for Americans. It was created as a program that helped people deal with their medical cost if their income and resources were limited. Unlike Medicare, this program was created to help with more long-term and personal care services (CMS, 2015). It was created to help people with more everyday kind of service, more detailed and more specific. Mainly was there in first place to help and support Americans with low-income, and later on lot more guidelines and changes began happening to Medicaid.

Why is Medicaid a huge topic in Texas and how does it relate to me? This is one important question to consider. Well, this paper will help shed light on the matter and illustrate the urgency for such an action. Just recently Texas had an option to extend Medicaid, but hastily decline to expand it. Medicaid expansion was part of the Health Care Reform or also known as the Obama Care; the federal government gave the 52 states an offer to expand the current Medicaid in ways that would include the coverage of more children and lower income adults as well. The latest on the issue is Texas had just agreed on a deal to reinstate Medicaid temporarily. The agreement on the reform has given Texas some time to see how the plan fairs across the other

Medicaid and Medicare are two programs that are very different but share the same instance of being federally run programs. Both Medicaid and Medicare were created in 1965 in response to the fact that older and lower income people could not buy private insurance. Medicaid is dispersed individually by each state in which is primary role is to cover low income people who do not have the financial means to purchase healthcare on their own. On the other hand Medicare is paid into by everyone that works a legal job where taxes are deducted. Medicare was created to address the issues of elderly; typically people 65 years or older; having extremely high healthcare bills but limited personal funding. These people will typically pay part of the cost

Medicaid, Medicare, and CHIP’s healthcare coverage is usually used in the typical American household. Though they serve different people they all have the same goal: To provide health coverage for lower costs and better care. They all have many ways they are funded. Medicare is funded through taxes, trust funds, premiums from members of Part A,B, and D, and funds from Congress. Medicaid and CHIP is funded by the government. The federal government pays states for a specific percentage of program expenditures or costs for a specific group. The percentage for Medicaid is 15% higher than CHIP’s. If you want to be a member of medicaid, you have to have a limited income, be 65 or older, a child under 19, be pregnant, be living with a disability,

The Medicaid program is jointly funded by the federal government and each individual state. To offset costs for struggling state budgets, the federal government will fully finance new enrollees in 2014, gradually reducing its contribution over time (Sederstrom, 2012). The federal government pays each state for a particular percentage of program expenditures. These expenditures are call the Federal Medical Assistance Percentage (FMAP). Per capita income, from each state, is one of the criteria that FMAP is based on. FMAP can range from 50%-75% based on the per capita incomes. Every 3 years, FMAPs are adjusted for each state to account for variations in the economy. Each state must ensure that they can fund their share of Medicaid expenses for the services and care available under their state plan. Generally, each state pays for services through managed care arrangements or fee-for-service arrangements. Each state can establish their own Medicaid provider payment rates, as long as they are within federal requirements. Under the managed care arrangements, each state has a contract with organizations to deliver care through networks and pay providers. Providers are paid on a monthly payment rate. Under a fee-for-service arrangement, each state pays providers directly for services. Payment rates may be based on the cost of providing the services, a percentage of what Medicare pays for services, and/or an assessment of what commercial