Florida Shifts Medicaid Mental Health Strategy Issues: Seeking to improve care and lower costs, Florida became the first state to offer a Medicaid health plan designed exclusively for people with serious mental illnesses, such as schizophrenia, major depression, or bipolar conditions. The plan offered by Connecticut-based Magellan Complete Care - is part of a state experimentation to co-ordinate physical and mental healthcare for those enrolled in Medicaid. Mental illness is a big driver of Medicaid costs because it is twice as prevalent among beneficiaries of the public insurance program for the poor as it is among the general population. Studies show that enrollees with mental illness, who also have chronic physical conditions, account …show more content…
in 2009, according to a 2012 report by HHS' Substance Abuse and Mental Health Services Administration. About 35% of the country's more than 50 million Medicaid beneficiaries have some form of mental illness, according to a 2012 report by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. Of those beneficiaries, 61% also have a chronic physical …show more content…
The Florida state government is directly involved in this public health policy, since it is has the authority to make changes to the federal-state run Medicaid program. The Sunshine state has opted out from the Medicaid expansion program under the ACA. The Governor of Florida Rick Scott (Republican) endorsed Medicaid expansion, however the state’s GOP-led legislature rejected it. The Republicans have a majority in Florida state-legislature, whereas the ACA act was passed by the Democrats-led federal government under President Obama. The federal government could not require states to adopt the Medicaid expansion. The states must proactively enact legislation to expand their Medicaid program. Since it is non-binding on the states, the state legislatures have the final word whether or not to participate in the expanded Medicaid
Looking at the different readings which analyzed and discussed the different ways that states are handling the Medicaid expansion under the Affordable Care Act, it seems that each state has their own unique prospective on the expansion, dependent on the political leanings and wealth of the state. For example, one of the article describes Kentucky opting to traditional Medicaid, while Arkansas opted to buy coverage for the poor through the federal marketplace. The states that have limited the expansion of Medicaid seems to be typically Republican states, which obviously has an issue with not only the costs associated with the expansion but also the ideological issues that seems to be in conflict with
When it validated the constitutionality of The Patient Protection and Affordable Care Act in 2012, the United States Supreme Court also ruled that states could decide for themselves whether or not to expand their Medicaid programs (Sonfield, 2012). Predictably, South Carolina said no. The Palmetto State’s decision not to expand Medicaid in concert with the Affordable Care Act was wrong, and it is time to correct that mistake.
In the article, This Is What Happens When Your State Blocks The Medicaid Expansion Jonathan Cohn discusses the impact that the Affordable Care Act has had on the percentage of people that have health insurance in the United States. Cohn goes in depth about what the Affordable Care Act is and why it has been so beneficial to the states that have adopted it, most specifically the expansion of Medicaid. Cohn also addresses the loophole that allows states to opt out of the federal program due to a Supreme Court ruling in 2012 that allows states to block the Medicaid expansion. The new Medicaid expansion has helped lots of Americans get access to health insurance that they would not have had access to otherwise, but some states are not taking
The Affordable Care Act (ACA), also referred to as ObamaCare, is a complex U.S healthcare reform that attempts to expand and improve access to healthcare and decrease spending through taxes and regulations. The main goal of the ACA is to provide more Americans with affordable health insurance. States vary in when and how they implemented the ACA in order to meet the needs of their state in hope to decrease the uninsured population. Every state had the option decide whether to offer healthcare through a state-based or a federal marketplace. Some states sued the federal government questioning whether they even had to right to impose this act. New Mexico and Pennsylvania are just two of the states that have had to figure out a way implement the Affordable Care Act. Each one had to take into consideration several factors including their state population, the demographics of that population, how many uninsured people there were, and the economy of their state. They both had the public plans such as Medicaid, Medicare and Children’s Health Insurance Program (CHIP) options as well as new federal subsidies that would now be offered depending upon income. Since there is no “one size fits all” health plan each state was challenged to make the best decisions using the tools available to them. This information was then used to formulate a plan that would give the most people access to affordable healthcare in each of these
An Urban Institute analysis found that if all states expanded Medicaid to individuals at or below 138% FPL, more than 15 million adults will be eligible to enroll (Kenney, Dubay, Zuckerman and Huntress, 2012). If a state failed to implement the expansion, it faced the possible loss of all federal Medicaid funding, making it an offer the states could not refuse. However, the U.S. Supreme Court ruled that Congress could not intimidate states into expanding Medicaid. As a result, the ACA Medicaid eligibility expansion is now optional for each state. States still await official guidance from CMS, including revised ACA regulations to match the court’s ruling. It is also likely that states may opt into or may subsequently opt out of Medicaid eligibility expansion at any time in the future. Although the Supreme Court upheld the ACA as constitutional, it determined that the Medicaid expansion would be a state option rather than mandatory (Kaiser Family Foundation, 2012). At the same time, 4.3 million adults in the United States are currently eligible for Medicaid but not enrolled (Kenney et al., 2012). Because of state expansion discrepancies and past experiences with enrollment among eligible populations, the Congressional Budget Office has projected that only eight million will enroll in the first year (2014) and only 11 million two years after implementation (Congressional Budget Office, 2013).
Policy analysis of mental health care under the ACA as well as description of how mental health care/service are organized under the ACA from federal to local levels.
With the Affordable Care Act back in the news, the debate over government-sponsored health insurance programs continues. Supporters of the A.C.A. have argued in favor of expanding the insurance program Medicaid to cover adults who earn up to 138 percent of the poverty level—but so far twenty-one states have decided against such an expansion. For the most part, governors of those states have given the same explanation: they simply cannot afford to pay for their share of the program.
The price of the prescriptions for mental illness The amount of money the people that had a mental illness have to pay is a large amount money that they have to pay for treatments and prescriptions. Medicare covered 29 cents of every dollar spent on prescription drugs in 2014, up from less than 2 cents in 2004. Medicaid covered 10 cents of every dollar spent on prescription drugs in 2014, up from less than 19 cents in 2004. The customers in 2004 had to pay 25 cents of every dollar spent on prescription, in 2014 the prices when down to 15 cents of every dollar spent on prescription. The share of spreading covered by private insurers shrank from 49 cents to 43 cents. At least 3.7 million Americans who are currently
Since the federal government pays for the vast majority of the cost for states to expand Medicaid, Florida’s choice to opt out of expansion results in the loss of 66 billion dollars of federal reimbursements over ten years (Florida and the ACA’s Medicaid expansion, 2017).
The Affordable Care Act promotes Medicaid expansion. Medicaid expansion is needed in North Carolina to insure the disabled and those that live below the poverty level receive adequate healthcare coverage. The resistance of North Carolina legislature in the promotion of Medicaid reform has retarded Medicaid expansion to its uninsured residents. The cooperation of the North Carolina legislature and its support of the Affordable Care Act is necessary for successful Medicaid reform. This paper reviews the impact of the Affordable Care Act 's lack of implementation in North Carolina.
The Florida Senate partnered with the Obama Administration to force the expansion of Medicaid. The Senate suggests that the Low-Income Pool (LIP) should be exited due to safety-net funding. LIP is a federal program that has ties to hospitals and other providers and provides 1.3 billion dollars while also matching additional local dollars. In 2006, LIP was approved to replace a previous program that had been set in stone for decades. The federal government believes that Florida LIP needs to stop, but has no sense of idea on what a new program should look like. Several months later, the state was told that LIP funding is heavily linked to the expansion of Medicaid. Since Florida chose not to expand, it doesn’t get LIP
The United States has never had an official federal-centered approach for mental health care facilities, entrusting its responsibility to the states throughout the history. The earliest initiatives in this field took place in the 18th century, when Virginia built its first asylum and Pennsylvania Hospital reserved its basement to house individuals with mental disorders (Sundararaman, 2009). During the 19th century, other services were built, but their overall lack of quality was alarming. Even then, researchers and professionals in the mental health field attempted to implement the principles of the so-called public health, focusing on prevention and early intervention, but the funds were in the hands of the local governments, which prevented significant advances in this direction.
Problem Statement: The World Health Association defines ‘good’ health as: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” However, in the United States, access to care and funding for mental health care are grossly neglected and underfunded in comparison to other aspects of health care.
According to stateline.org, “In 2014, 43.6 million adults had a mental illness... Fewer than half of these people received treatment” (Ollove). Mental health disorders are a growing epidemic in the United States. Tens of thousands are diagnosed each year, however few decide to seek treatment. Costly medications and treatment options are often to blame, as they are difficult for patients to afford. Mental health care coverage should be included in all health insurance plans because mental health disorders should be treated the same as any physical illness, it benefits society as a whole, and many mentally ill patients cannot afford necessary medication or care.
Lack of access to mental health care and treatment is one of the top ten reasons that many mental health conditions go untreated. Many private and group health insurance plans only include minimal mental health care coverage or do not incorporate mental health care coverage at all. Over half of adult citizens of the United States of America, who possess a mental illness, do not obtain mental health care treatment. According to the U.S. Department of Health and Human Services, one out of every five adults in America have endured their own mental health difficulty, and one out of every twenty-five American adults suffer from a severe mental illness, such as major depression, schizophrenia, or bipolar disorder. (Top 5 Barriers to Mental Healthcare Access, Social Solutions.com, 2017)