Medicaid Program: A Case Study

For those in states not willing to expand Medicaid, then low-income adults will be denied assistance, in which higher-income adults receive (Healthcare.gov, 2017). When the Affordable Health Care Act (ACA) was established, Medicaid expansion provision was mandatory for those participating in Medicaid, basically included all states participation. For those individuals in households

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

The new law added to a per-existing hospital provider tax, which lawmakers love because it leverages federal matching funds that help pay for the state's Medicaid program. Critics objected to the increase because it added a new tax on health insurance.

In the state of Texas Medicaid is funded by state and federal programs. Those eligible to receive Medicare benefit is the low income individuals, families, children, pregnant women, elderly and individuals who suffer with disabilities (Hegar). The Texas Health and Human Service commission (HHSC) distributes the Medicaid (Hegar). Those receiving Medicaid benefits in the fiscal year of 2010 were found to be 55 percent female and 77 percent under the age of 21 (Hegar). Children accounted for 66 percent of all Texas Medicaid recipients in that year; however, 32 percent of those children actually received health care (Hegar).

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:

States are being pressured to expand Medicaid to families earning up to $30,000 a year, just like the Affordable Care Act permits. While several respected governors have agreed to expand the program, many other governors and state legislators are cautious. These officials do not want to deny Americans their access to health care, however they do want to slow the expansion of a program that will provide them with limited access to quality care while destroying state budgets. One of the strongest arguments that can be made against the expansion of Medicaid is the fact that States simply can not afford it. The appeal to states to expand Medicaid is that the federal government will cover 100% of the cost through 2016 and eventually lowering to

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

As Congress considers potential options to reform Medicaid, it is important to keep in mind patient access to prescription drugs and other healthcare services. Retail community pharmacies believe that Medicaid prescription drug benefit reform efforts should be focused on maintaining a Medicaid prescription drug benefit, maintaining patient access to adequate provider networks, fair and appropriate cost-based provider payments, and facilitating patient access to pharmacist-provided health care services.

Without this expansion, Tennessee could have nearly 300,000 of its citizens uninsured and in an abysmal situation. Having the Medicaid expansion could help thousands of people in Tennessee be able to have the medical insurance they deserve. Considering the high ratings of poverty, the Medicaid expansion would be able to grant those who are near or below the poverty line with better care. Many Tennesseans are going against this notion based on the note that a person shouldn’t trust the federal government. Without the Medicaid expansion, the state could end up costing big time. With the citizens gaining medical insurance, the state would also attain something it

They could expand Medicaid in the future. Even if your state hasn’t expanded Medicaid and it looks like your income is below the level to qualify you should fill out a Marketplace application. States that refused to participate in the Medicaid expansion would risk losing federal funding for their current Medicaid programs. The Supreme Court ruled that the federal government could not withdraw existing Medicaid funding to punish states for not expanding their programs, this gives the states the choice to opt out of the expansion. Some states have expressed interest in doing so. Proponents of the health care law say that in long-term, the Medicaid expansion will save both state and federal government money while extending health care coverage to millions of lower income Americans. Medicaid expansion may not be good in certain situations such as the uninsured already having access to necessary health care, even for free. Expansion is also expensive in general, as is health reform. The money could be put to use in other ways which are beneficial. Medicaid expansion will exacerbate the effects of a shortage of primary care physicians. In some cases Medicaid expansion crowds out private coverage which is provided by private

(Owcharenko 2013) Yet, that couldn’t be further from the truth. This would actually make the state spend money that they would’ve spent on something else, or wouldn’t have spent at all. (Owcharenko, 2013) Another is that they claim that rejecting expansion would mean that other states would get more, when actually that Medicaid is a calculated formula based on actual expenditures. (Owcharenko, 2013) The fewer states that expand, the less the federal government spends. (Owcharenko 2013) Deciding and fully committing to expansion can be a real predicament for the states. (Owcharenko, 2013) To regulate spending, states normally fall on usual techniques to manage cost. (Owcharenko, 2013) As Medicaid spending continues to rise, other important state priorities such as education, emergency services, transportation, and criminal justice are squeezed. (Owcharenko, 2013). If states resist balancing among spending programs, the alternative is generating more revenues with tax increases. (Foster) But higher taxes come with a steep price: They reduce economic growth, which with most states still experiencing anemic growth, tax increases on top of already higher taxes at the federal level are not an appealing option.

By expanding Medicaid what will be the effect on the people is the question? For instance, where you live will affect the cost someone could pay for care, and affect how much someone might pay for their Medicaid benefits ("How Much Does Obama Care (Affordable Care Act or ACA) Cost in Texas?"). Under the Affordable Care Act on one can be turned down for coverage because of a pre-existing conditions or age and various other things. ("How Much Does Obama Care (Affordable Care Act or ACA) Cost in Texas?"). Having the insurance is good and well but if the patient care is below the standard of care these the insurance is no good to the people, but the state of Texas they have made legislation for that reason. For example, the Texas Medical Board and the Medical Practice Act. Texas Medical Board will “investigates complaints against physicians, physician assistants, acupuncturists, surgical assistants, respiratory care practitioners, medical radiologic technologists, medical physicists, and perfusionists.” ("Texas Medical

One of the topics we have discussed, and read about in this course is the role that the State Governments have in the expansion of their Medicaid program. It’s a tough decision, but it seems to have caught the eye of most Americans. Many states are not sure if they should expand their programs, with the help of the Federal Governments. It’s been said that 17 states have already outright rejected two major parts of this act (Branham 2013, 10). The real question now is will expanding Medicaid help give everyone insurance benefits, so they can stay healthy? That is the question that Governors, and Legislatures are asking themselves when it comes to saying thanks, or no thanks, to the

I am a firm believer in the fact that everyone deserves healthcare. Although the affordable healthcare act does promote health and does cover more screenings so that people can avoid delaying health problems, there are public policy implications that will affect the future of Medicare, Social Security and aging services. The Affordable Health Care Act requires every American to have health insurance and unless exempted, they must pay a penalty when they file their taxes. Businesses are cutting employees hours to avoid covering employees. Insurance companies cannot deny someone because of pre-existing health problems. Companies will have to pay up to cover health care costs and they cannot put a set dollar limit on coverage, which has caused

This is a follow-up email in reference to the email received for Medicaid validation with no award letter attached. The agent information was not provided, such as a writing number, party ID, national producer number or social security to properly research request. Please resend the email with the award letter for review of Medicaid to 866-802-6062 or icssupport@uhc.com by