Medicaid Essay

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.

This paper will discuss the early years and failed efforts that transformed the Medicaid program into what is seen today. A comparison between Medicaid and Medicare will be brief but is necessary because there are significant and critical differences between these government-funded insurance options. The substantial growth of Medicaid expenditures and beneficiaries are important and these trends will be looked at in detail. There have been provisions related to the unanticipated expansion of this program which will be reviewed. Attempts to expand Medicaid eligibility further need to be addressed (example: Patient Protection and Affordable Care Act). Stigmas that are associated with receiving Medicaid will be reviewed. I will share my

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.

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.

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

The South Carolina Title XIX State Plan, also known as Medicaid, was designed to maintain the provision of “quality health care to low income, disabled, and elderly individuals” (South Carolina Department of Health and Human Services, 2016). The South Carolina Department of Health and Human Services (SCDHHS) acts as the designee for this administration, managing the state and federal reimbursement of funds for approved medical providers. Services are designed to provide services for diagnosis, treatment, and management of illnesses. The Management Care Organization program provides insurance coverage through a network comprised of contracted, providers who are paid a “per member per month capitated rate” (SCDHHS, 2016). These

For close to 50 years, the Mississippi Medicaid program has provided health coverage for its low-income residents. “While Medicaid originally only insured Americans receiving cash welfare assistance, Congress expanded it over the years to help insure those left behind by the private insurance system”.7 Medicaid in the state of Mississippi is a health care program that help pays for medical services for its low income residents. In Fiscal Year (FY) 2009, Medicaid provided $3.9 billion in benefits which attributed to 20.4% of all health care spending in the state7 and insured 754,333 – 1 out 4 (25.6%) state residents.6

The Medicaid expansion will cost the federal government between 15-20 billion dollars in the first six years, but the federal government is paying for 93% of the direct expansion costs. But with the expansion, the greater majority of people will be able to pay their own medical bills, which means the state and local governments will save millions of dollars.

Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).

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.

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.

The U.S. health care system is a scrutinized issue that affects everyone: young, old, rich, and poor. The health care system is comprised of three major components. Since 1973, most Americans have turned to managed-care programs, known as HMOs. The second type of health care offered to Americans is Medicare, health care for the elderly. The third type of health care is Medicaid, a health care program for the poor.

Medicaid and Medicare are two different government programs. Both programs were created in 1965 to help older and low-income families be able to buy their own private health insurance. These programs were part of President Lyndon Johnson’s “Great Society” plan, a commitment to helping meet the needs of individual health care. They are social insurance programs, which allow the financial load of patient’s illnesses to be shared by other healthy, sick, wealthy, and lower income individuals and families.

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