Medicaid Benefits

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.

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 public health insurance that is federally funded for those who do not have private health insurance (Families USA, 2014). In the U.S. one out of every five adults and one out of every three children use Medicaid (Families USA, 2014).

Before the PPACA in 2010, Medicaid programs reimbursed 65 cents for every dollar charged. With the PPACA in place, Medicaid covers individuals up to 133% of the federal poverty level. The mandatory Medicaid income eligibility for children will increase from 100% to 133% of the federal poverty level. At the state level, benefits can be expanded to persons with higher incomes. Those that receive benefits through Medicaid cannot accept benefits through the exchange programs. The hospital will have the option to increase

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 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 huge program that touches many lives but is nonetheless poorly understood by both the public and policymakers. Each state has the right to not participate in the Medicaid program, but Medicaid is one of the largest government insurance programs for individuals of all ages whose income and resources are insufficient to pay for health care.

The benefits and drawbacks of having state health programs verses one that is uniform across the country can vary on a broad basis. Medicare and Medicaid are state and federally funded health programs; programs that must be fair and allow access to everyone across the country that are enrolled and eligible to receive such benefits. In addition, these programs have unlimited caps so that there is flexibility to continue financing care without delay. The Medicare program was designed to provide access to health care for those who are not able to afford appropriate health care and meet the needs of vulnerable communities. If it were not for the assistance of the federal government in providing states the necessary funds to continue providing health

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).

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 amount of money the state is leaving on the table over the next decade due to the lack of expansion is $5.3 billion. Medicaid is available for pregnant women with incomes 139% of FPL, children with incomes up to 200% of FPL, and parents with incomes up to 51% of

In order to qualify for Medicaid individuals must meet certain regulations. Eligibility depends on each state, age and whether the individual is a U.S. Citizen, blind, pregnant, single parent, or suffers from any disabilities; all of this plays a huge role in the Medicaid eligibility criteria. Although, some immigrants may be able to benefit from this program, if the immigrant is a woman whose labor and delivery of child is taken care of inside the U.S. that is enough to make them eligible for Medicaid (Medicaid, 2012). Even though the states are allowed to provide their own regulation guidelines along with other decisions for this health program, there are certain mandatory federal requirements that must be met by each state in order to receive funding. Some of those requirements include; inpatient hospital service, prenatal care, vaccines for children, rural health clinic services, transportation services and many others that according to the federal government are extremely essential for the management of this program ("What is medicare/medicaid?," 2012).

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

Medicaid provides a comprehensive benefit package for those who enroll. The federal government requires coverage of thirteen services, including inpatient and outpatient hospital services, nursing home and home health care, and for children under the age of twenty-one. The benefits do not end there, Medicaid offers a

Medicaid is a “state-federal program” that works to make certain medical services are available to the poverty-stricken population. It creates a guideline for the state to organizes services and make them