Medicaid Cost Benefit Analysis

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.

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.

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

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

In 2010, the President of the United States signed the Patient Protection and Affordable Care Act (PPACA) into law (Luther & Hart, 2014). As written, the PPACA will be the most extensive change in the financing and provision of healthcare in 50 years (Luther & Hart, 2014). The stated purposes of the legislation are to decrease the number of medically uninsured people as well as decrease the cost of insurance and healthcare for those already insured (Shi & Singh, 2015). Medicaid expansion is significant element of the PPACA and is designed to provide health insurance to the lower income population (Vincent & Reed, 2014). The purpose of this paper

In a traditionalist state, such as Texas, the financial toll that Medicaid would have on its taxpayers was on the frontlines. The Texas legislature was worried about whether or not its taxpayers would face a tax increase to cover the increased cost of those covered by Medicaid. These taxpayers would inadvertently pay for the hospital bills of those who are uninsured in Texas through an average $1,800 rise in the cost of their premiums (Rapoport, 2012). In support of expanding Medicaid, Texas would receive federal funds in order to ease the cost that accompany the expansion. Since Texas decided not to expand Medicaid, Texas “would be leaving billions and billions of federal dollars on the table” according to Anne Dunkelberg (Rapoport, 2012). Not only does this monetary incentive give Texas an extra push to participate towards expanding Medicaid but it would also help the residents of the state to get insured. Texas legislators understood that this monetary incentive would not fully cover the cost of the newly enrolled Medicaid recipients. In the end, they would have to rework the annual budget and increase taxes in order to cover these extra recipients.

The following analysis will explore the current health insurance problem under the ACA. It will discuss the proposed policy of Medicaid Expansion and the impact of States not cooperating with the implementation of such provision. Moreover, a recommendation on strategies to alleviate the health

The ACA states that the federal government will pay 100% of the cost of a newly enrolled Medicaid participants until 2016 for all states that expand their Medicaid program up to 138% of the federal poverty level and will pay90% by 2020 (Kincaid, 2013). Other concerns include whether the federal government will give state enough flexibility to manage Medicaid program, whether hospitals will receive adequate compensation to care for more patients and whether the physician workforce can accommodate the increased demand for care (Kincaid, 2013).

The article examines the states (California, Connecticut, Minnesota and Washington, D.C.) who decided to expand coverage earlier. It closely examines enrollment period between 2010 – 2014. Administrative records showed that there was an increased Medicaid coverage. The data also shows that there is an increase coverage in the population who had multiple

California rose to the challenge of implementing health care reform in a state with high needs and limited funds by expanding its Medicaid program (Medi-Cal) and establishing its own marketplace (Covered California). As a result, by June 2014 California 's uninsured rate had dropped from 22% to 11%. However, thoughtful examination of the rollout process reveals avoidable bumps in the road that, if corrected, could , have provided a better enrollment experience and thus better access to coverage for our most vulnerable populations. In order to assess California 's success in widening the doorway to Medicaid coverage this report reviews policy decisions that shaped efforts in reaching out to, enrolling, and retaining eligible low-income

The Oregon Health Insurance Experiment is a groundbreaking study on the expansion of healthcare for low-income adults, which includes a look at health care outcomes, use, well-being, and financial burden. The study uses an innovated unsystematic strategy in which to gauge the overall impact of Medicaid in America; while random well-ordered studies are preferred within scientific observations, it is nearly impossible in social research. The state of Oregon, in 2008, decided to use a lottery in which to select low income, uninsured individuals, in an effort to produce such a study. As such, The Oregon Health Insurance Experiment is the combined effort of scientific researchers, and the state of Oregon in an attempt to better understand the costs/benefits of expanding public health care.

Every year the number of beneficiaries increases. The pressure to gain control of Medicaid program spending, which has consumed an ever-larger share of state budgets, increased during the recent economic downturn. Nearly a quarter of the U.S. population, or 77.5 million people, were enrolled in Medicaid or the Children’s Health Insurance Plan at some point in 2011, according to the March 2012 report of the Medicaid and CHIP Payment and Access Commission.(modern healthcare, 2005)

In 2008, Baiker et al. seized the opportunity to look at the effects of Medicaid coverage through its expansion for low-income households in the metropolitan areas of Portland, Oregon. This was conducted by a random selection of approximately 30,000 names from a waiting list totalling 90,000 individuals. Such a lottery design allowed the authors to apply random assignment and study how the health outcome of this specific population of interest is affected by Medicaid. Similar to the RAND study, Baiker et al. (2008) find that insurance coverage (in this case, Medicaid) resulted in an increase in health care utilization along with improved health status (specifically limited to mental health). However, the authors limit their focus to the direction and causality of the effect and fail to provide an explanation on specifically how consumer behaviour is affected by the insurance coverage, which is an area of focus that Brot-Goldberg et al. (2015) bring to the literature at the time.