Medicaid Essay

Critically analyze the implications of the state’s decision to opt out of Medicaid expansion on the citizens of the state.

The concept of providing basic healthcare services to individuals in need has undergone an agonizing transition, from a luxury once only afforded by the affluent to a basic human right granted to citizens of every economic station, and the recently enacted Affordable Care Act (ACA) was designed to finalize this ethical evolution. Reflecting perhaps the bitter political enmity currently consuming the nation's once cherished democratic process, Republican legislatures in states throughout the union have bristled at the ACA's primary provisions, threatening all manner of procedural protestation as they attempt to delay and derail the bill's eventual implementation. One of the most intriguing aspects of the sprawling, thousand page law, however, has been the stipulation that individual states will be given a choice to either accept federal funding to expand their statewide Medicaid roster, or to forfeit all federal funding for that program in perpetuity. The role of government in monitoring and regulating the healthcare industry has been long debated, and the bitterly contested passage of President Obama's ACA, a law aimed at revising the country's health insurance system through the creating of a federal health insurance exchange to facilitate increased competition among insurers, has rekindled the debate over who holds the ultimate responsibility for regulating the care provided by hospitals, community clinics, and private practices.

This is an area where public opinion and public policy match in that they both heavily favor regressive taxation (Brown et al., 2014). Tausanovitch and Warshaw (2013) have developed a means of understanding political preference in comparison with public opinion and public policy to determine whether a government is best serving the desires of its people. This type of tool would be very useful for the state of Texas to use to determine whether the government is serving the desires of its constituents. But, just because public opinion and public policy line up doesn’t mean that the interests of citizens are best served because some groups may still be left out and those groups may have more needs than others. Texas’ current operational stance of “pay-as-you-go” makes for a very tight budget where the government cannot always afford to spend money on things the citizens of Texas may need. For instance, Texas operates its roads with the same “pay-as-you-go” mentality by opting for toll roads (Brown et al., 2014). Toll roads receive some government funding through state issued bonds and the collection of tolls after completion. This system is hardly fair for the citizens who do not use the toll roads but still must subsidize them through taxpayer dollars when the toll revenue does not meet the projected earnings. There are also many more citizens in Texas who live below the poverty line, 18.4% for Texas in comparison to 15.1% for the entire United States (Brown et al., 2014). With a larger proportion of citizens in poverty the burden to the state becomes greater, especially when funding remains low (Insert citation). Texas is just hurting its citizens by not being able to provide as much support and assistance to them as possible. Texas was given the opportunity, along with every other state in the union, to expand its offering of Medicaid under the Affordable Care Act. A sample of public opinion was obtained

That mostly depends on our Presidential election in November. If a Republican wins office they could option not to enforce the act or overturn it during Legislative session. As long as Governor Perry is in office, there will be no expansion of Medicaid until at least 2014. Since, Governor Perry is not expanding the Medicaid system, as a state will need to prepare for higher insurance premiums to cover the costs that Medicaid does not. The state will need to revamp the state Medicaid system because our population is rising higher than the cost of healthcare. As of December of 2011 total enrollment in Medicaid was 3,652,591. This cost the state of Texas 12.8 billion dollars, paid for by our taxpayers. As our state population increases it is estimated 1.2 million newly eligible Texans for Medicaid, and by 2019 it will cost the state and additional 5.3 billion in taxes (Texas Health and Human Services Commission, 2012).

Any decision naturally means there must be at least two options from which to choose. The decisions made concerning the Affordable Care Act (ACA) are certainly no exception. Certainly politics enters into the mix, as does associated costs, availability of medical care, quality of care and numerous other factors. While the idea medical care for all seems quite simple on the surface, the devil is in the details. My father, Dudley Plaisance, worked in healthcare for many years, even co-founding a company whose role was to find sources of funding for patients without resources to pay medical

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

In every day life one must make decisions, and with decisions there comes options from which to choose from. One decision from Texas that has caused concerned has ties to one of the provisions in the Affordable Care Act. This provision wants to expand Medicaid coverage to low income Americans. However, the Supreme Court ruled a decision to make the Medicaid expansion optional for states. Therefore, Texas opted out on this idea but is still indecisive on weather or not this expansion is beneficial to the state. As we all know factors like politics enter into the mix, as does the costs of the expansion, availability, and quality of care for these new “enrollees”. The idea of medical care for all seems like a simple effective idea, but the effects overall is detrimental to Texas citizens like myself and my family, who doesn’t necessarily fit into this “mold” of the uninsured citizen the act is trying to attract. The decision Texas made to not expand, in my opinion is a reflection of all citizens who feel that they will not benefit from this implicated Medicaid program.

If Medicaid is not expanded to the millions who have low incomes and aren’t insured, then starting in 2014 Americans who don’t pay for health insurance and aren’t eligible for Medicaid will then be issued a tax. In 2014 Americans will have to pay 95 dollars or one percent of their income, which ever is higher. The tax will only increase from there. In 2015 Americans will have to pay 325 dollars or two percent of their income, and in 2016 the tax will increase to 695 dollars or 2 and a half percent of their income. Americans who make $200,000 or more annually and couples with incomes above $250,000 will have a tax increase to help cover the costs of the program.

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

The state of Texas has pulled its Medicaid funding for Planned Parenthood, leaving poor residents with few options for affordable healthcare. Medicaid, a program focused on helping low-income families and individuals receive healthcare, has always been jointly operated by the state and the federal government. But to who this program would be eligible for is entirely up to the state. More conservative states, like Texas for example, strictly reserve Medicaid for only the most severe cases of poverty-stricken families, leaving a large portion of low-income residents uninsured. The Affordable Care Act, a federally mandated reform of Medicaid introduced by President Obama, would provide healthcare for many American citizens in need. Despite being

In March 2010, one of the most controversial bills in modern history was signed into law by President Barack Obama. The Patient Protection and Affordable Care Act expanded the 1965 bill passed under President Johnson that created Medicare and Medicaid (“LBJ Presidential Library,” 2015). While the Affordable Care Act, or “Obamacare” as it has been dubbed by the media, has many components, the focus here is the expansion of Medicaid. Obamacare sought to expand Medicaid to cover those who earn too much to qualify for traditional Medicaid, but not enough to afford employer-provided health care. These people are said to be in the “coverage gap” (“Obamacare Medicaid expansion,” 2015). While only 32 states have adopted Obamacare, we should advance a policy encouraging the remaining states to expand existing coverage by extending the period of federal government cost-sharing an additional five years. Doing so would give states previously refusing the cost sharing a second chance to opt-in. This expansion would save money for the states from some of the rising cost of healthcare, and fulfill our moral duty to care for uninsured Americans.

Under this new law, it is roughly estimated 18 million of the 34 million who would gain medical coverage over the next 10 years would be enrolled in Medicaid.

Ironically, Texas has the highest number of uninsured citizens in the nation, 6.2 million to be exact. The majority of these citizens are children. According to Goodwyn (2013), “by Texas refusing to participate in the Medicaid expansion, which is part of the ACA, the state will leave on the table an estimated 100 billion dollars over the next decade. It is sad to know many citizens in this state will be denied health care by those who already have the best insurance and will never have to worry about being uninsured. In addition, the Texas politicians fail to recognize the need for health care for neither its most vulnerable citizens nor the burden on the Emergency room as well as the rise in healthcare premiums for citizens who maintain health insurance. Landers (2013) reports, “whether they have a good income or a lower one, Texas lag behind much of the nation in access to and quality health care.” States who fail to expand Medicaid will see their funds distributed to states on board with expanding Medicaid.

Medicaid insurance covers approximately 60 million Americans, according to their income. Medicaid is larger than any other single private health insurance program. The criteria for participating

If Texas expands Medicaid coverage, the largest number of newly eligible Texas would be adults without children. Currently, these individuals are not covered under Medicaid. In addition, parents who have incomes at or below 133% of the federal poverty level (FPL), up from 12% previously. With a 90% federal reimbursement rate going forward, for every $10 of health care services obtained under the program, the State pays $1 and the federal funds pay the other $9. It is estimated that the State would contribute about 15.6 billion, while the federal