Medicaid Expansion Research Paper

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.

As we become older, issues with our health begin to take affect and finding ways to fund for that care is becoming even more difficult. In the article “Some Elders Must Take Drastic Measures to Obtain Long-term Care”, national magazine journalist Mary A. Fischer (2011) states that many Americans must face demeaning and disempowering choices in order to qualify for Medicaid or Medicare—federal funded health insurance programs— such as refusing to pay for a spouses institutionalization, divorce, and spending down assets. The author argues that these choices leave the healthy spouse with decreased funds to plan for their own retirement expense (Fisher, 2011). Working in the health care field for 4 years, along with my family’s own personal experiences I can relate to this article, since I have seen a variety of ways that federal funded health insurances have been unable to meet the expectations and demands of its beneficiaries.

In a survey conducted in 2003, it highlighted that the recurrent problem is the reimbursement rate from Medicaid to the physician (O’Shea, 2007). The Center for Studying Health System Change (HSC) show that 21% of physicians that state they accept Medicaid have reported they will not accept a new Medicaid patient in 2004-2005(O’Shea, 2007). This number would only logically be assumed to have risen in 2013 A survey conducted by the U.S. National Health reported that researchers have found two standout trends among Medicaid beneficiaries: they have more difficulty getting primary care and specialty care and they visit hospital emergency departments more often than those with private insurance (Seaberg, 2012). The lack of primary and specialty care access is mostly contributed to the following barriers; unable to reach the MD by phone, not having a timely appointment with the MD and lastly unable to find a specialty MD that will accept Medicaid. In a recent report released by the Partnership to Fight Chronic Disease, it stated that about 30% of Medicaid patients experience “extreme uncoordinated care”, there is a strong correlation between this situation and higher Medicaid spending and less quality of care given (Bush, 2012). After January 1st 2013, healthcare providers have experienced a 2% reduction in payments for Medicaid beneficiary, this will only create more of a problem for these patients to seek the

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

Missourians must write their elected officials and demand answers for their failure to provide all working class Missourians with affordable healthcare. They must also hold politicians accountable for party line bantering that has been a catalyst to promote the growing uninsured population in Missouri. Missourians must educate themselves on the concept on Medicaid expansion. They must stay clear of misinformation and propaganda from opponents of Medicaid expansion. Continuing to promote the status quo of an uninsured populations is a tragedy in Missouri. Health care providers must truly focus on their mission of providing quality of care to all

In 2009 there were 50.7 million people, 16.7% of the population, without health insurance. Americans all over the country are working and yet they still can’t afford to pay the high cost of health insurance for themselves and their families. Under the Affordable Care Act of 2010, which was signed by Obama on March 23, 2010, thirty two million Americans who were previously not eligible for Medicaid may now have the opportunity to be covered. If this act is passed in North Carolina then it will be expanded to cover nearly all of the 1.5 million North Carolinians who are without health insurance. If more Americans are covered under the Medicaid that they need then

According to the American Hospital Association the cost of equipment, services, and information services has risen drastically. A huge problem for hospitals now is that there has been an enormous increase in patients who have Medicare or Medicaid. The Hospital Association states that “60% of all admissions. Neither program fully reimburses the cost of hospital care.” Not only is the hospital not getting paid the full amount through the health insurance, but they have also seen a jump in people who do not have insurance and cannot pay for their hospital expenses this averages out to about six percent of hospital expenses. Hospitals must assume these costs as a part of their charity pay. These costs are then calculated and increase the costs of health care for people who pay for it, in order to cover these costs.

Following the death of a Medicaid recipient, the program not only can but must attempt to recover costs from the estate of the deceased. Medicaid's official site says:

Most of the states in the US have the Vision of growing the health sector to help address issues in health. The Affordable Care Act has seen the development of the Medicaid along with the Accountable Care organizations as one of the strategies to help curb the problems in place. According to the report that was released by the White House IN 2014, it was suggested that most of the states are locked in the politics and have most of their personal constituents uninsured. Taking the instance of North Carolina, the numbers are extremely high and thus terminating the obstruction of Medicaid would benefit the residents economically. It is geared towards creating new opportunities for over 2000 citizens as well as improve the federal fund's

How Trumpcare Would Affect Medicaid and Why That’s Dividing Republicans. (2017). Daily Intelligencer . Retrieved 18 September 2017, from http://nymag.com/daily/intelligencer/2017/03/trumpcare-offers-states-short-term-money-for-long-term-cuts.html

Bill Haslam, the Tennessee state governor, announced that the state of Tennessee would accept the Medicaid expansion offer. The Medicaid expansion expands Medicaid eligibility to the region’s underserved populations living near or below the poverty line. The Medicaid expansion offer looked to be a major win for the state; however, others disagreed with this idea. Some of Tennessee’s lawmakers decided to deny the federal government’s Medicaid offer, even though many others wanted the offer to be accepted. The deal’s breakdown might be the result of “squabbling along party lines” which is a common theme at all levels of government. Although the deal was denied, it is still possible that the bill could still be passed with the help of the governor. The likelihood of Tennessee reviving its Medicaid expansion is a difficult one considering the state would have to fight. The Medicaid expansion could offer the state low-income citizens medical insurance, the state would come out of the deal with a net financial gain, and the state hospitals would come out on top.

"We don't believe it’s right and we know it's going to basically bankrupt the states."(Hensley 2012) quote given from Texas Governor Rick Perry about Medicaid expanding in Texas. The Medicaid expansion "would simply enlarge a broken system that is already financially unsustainable," he wrote. "Expanding it as the PPACA provides would only exacerbate the failure of the current system, and would threaten even Texas with financial ruin." (Hensley 2012). Texas is among the twenty-two states that did not expand Medicaid, and for good reason at that.

The decision to reject Medicaid expansion by the former and current governors of Texas has left at least one million low-income earning nonelderly adults Texans uninsured resulting in the loss of several millions of dollars in uncompensated health care services extended to this vulnerable demographic, coupled with high insurance premiums (Mangan, 2015) which begs for the expedient conception and implementation of a statewide solution to address this unsustainable economic burden and create a more healthy, and productive society in the great state of

Also by rejecting the Medicaid expansion community-based providers, including hospitals are casualties. Hospitals will continue to provide care to the uninsured without sufficient compensation, increasing shift costs to the privately insured. This also has a chilling effect on enrollment in private insurance plans through the new federally facilitated marketplace. Opposing the Medicaid expansion also ignores the real needs of the uninsured and the massive financial burden shouldered not only by the hospitals but taxpayers and businesses. (Stultz, 27)

In order to cover more seniors, states provide drug coverage in their expanded Medicaid programs. They take advantage of federal funds to uplift state resources. With the traditional Medicaid programs, states have to apply for medical waivers. If more seniors enroll in this Medicaid program, it increases significantly the states expenditure. The United States department of health and human services (HHS) announced plans to create a pharmacy waiver for seniors. The states under this special waiver can comfortably provide the seniors with a pharmacy waiver by taking advantage of the federal matching funds to provide service to the seniors who make a 200% of the federal poverty level.