Obama Care: Affordable Health Care Insurance for All

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.

As a health policy analyst for the state of Texas which has not elected to expand Medicaid as part of the Affordable Care Act (ACA) and now has been notified that the state leaders have taking into reconsideration their recent decision during an upcoming session in order that we begin gathering data on the benefits of adapting the Medicaid expansion. As a health policy analyst our goal is to assure data quality, interpret data, and discover new information in the data. Medicaid is a federal and state partnership with shared authority that is a health insurance program for low-income individuals, children, their parents, the people with disabilities and the elderly. Nationally Medicaid covers health care for over 72 million people. Even though participation is optional, all 50 states participate in the Medicaid program. However, Medicaid benefits eligibility varies widely among the states all states must meet federal minimum requirements, but they have options for expanding Medicaid beyond the minimum federal guideline (http://www.ncsl.org/research/health/affordable-care-act-expansion.aspx). In this research we will identify the state of interest which is Texas, compare the state’s decision, determine the alternate approaches to expanding access and provide a recommendation on whether or not the state should opt in to the Medicaid expansion.

With the upcoming election for president, we have a chance at having Obama Care repealed. The presumptive Republican party nominee, Donald Trump, has a plan in place that will be ready to take action if he is elected president. If he is elected president, Congress will be asked to immediately repeal Obama Care. Together Donald Trump and Congress will then work together to implement a series of reforms that follow free market principles. The reforms will restore economic freedom to everyone in this country. Donald Trump’s plan will broaden health care access, make health care more affordable, and improve the quality of the care available. As part of a comprehensive reform effort, the Trump Administration will work to restore faith in government and economic liberty.

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.

Medicaid initially established that each state is responsible for designing their medical costs to pay medical care for the poor. Also, Medicaid created as a voluntary program for each state; they have to have the choice to participate. For one thing, because of the rising costs of healthcare, it has been difficult to bring Medicaid recipients into the “mainstream” of United States (U.S.) medical care. Donald R. Barr notes, “between 1975 and 1989, the cost of the Medicaid program increased by an average of 11.9 percent per year before adjusting for inflation” (172). The rising costs of healthcare are necessary for each state to determine if it is beneficial for them to participate in the Medicaid program. As the government level of payment is determined by each state economic condition. For instance, a state with lower per capita income will receive more government funding. A state with higher per capita income receives less reimbursement for program costs. Therefore, on December 31, 2010, many states continued to experience budget cuts. As a result on August 2010, Congress increased reimbursement rates through June 2011.

For those states that decided to take part in the Medicaid expansion it would help adults that were living under the poverty line. Many of these adults did not have jobs that offered them health insurance or they struggle to even pay the bills to just barely get by, and therefore health insurance is one of the last things on their mind when it comes to having that or being able to have electricity or even putting food on the table, they are not able to just go and be able to pick out health insurance for themselves and their family because they live below the poverty line. Officials promised that individuals who liked their currents plans would be able to keep them but it turned out that was not the case because many current plans of insurance did not meet the standards that the Affordable Care Act made. Again employers had to change their plans to fit the standards, premiums shot up and many of the plans had more coverage then what most people needed- meaning they had to pay higher copays and deductibles. They would use the marketplace to find the details of the types of plans that were being offered. States that choose not to participate in the expansion of Medicaid still would not have the people who lived in between the 100%-138% level of income on the federal poverty would be able to be granted subsidies but these subsidies might not cover their entire monthly cost for their health insurance, or their premium. Because of this though there is less on an incentive for people to go out and buy insurance on their own. “With fourteen states opting out, we estimate that 3.6 million fewer people would be insured, federal transfer payments to those states could fall by $8.4 billion, and state spending on uncompensated care could increase by $1 billion in 2016, compared to what would be expected if all states participated in the expansion.”(Polycin, 2009). For the

The Medicaid revisions and expansion under the ACA, exhibited the federal government overstepping their power as they tried to penalize any state governments in opposition of the expansion, consequently, taking away states’ power. The Medicaid Expansion Mandate would’ve compelled states to join due to the loss of federal funding towards Medicaid if they did not adhere to (Phi Le, par.40). The Supreme Court hearing allowed states to have a choice whether or not to participate in the expansion without a total loss of their Medicaid funding. In return, states who didn't participate wouldn’t receive additional funding that coupled with this mandate that required inclusion, extending coverage of those who were at “Income below or ar 133% federal

On March 23, 2010, President Obama signed the Affordable Care Act into law. The Obama health care has received mixed reviews over the last couple years. It has put in place comprehensive reforms that improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices. Many people dislike the idea of Obamacare because of misinformation from the press, opposing political candidates and by those who refuse to seek the information themselves. Additional reforms aimed to reduce costs and improve healthcare outcomes by shifting the system towards quality over quantity. President Obama has stated on several occasions that the new health legislation would start out slow but pick up over time to compensate for the initial loss.

With the implementation of the ACA, many states have expanded their Medicaid programs to include a larger population of low income individuals and families that were not able to obtain health insurance prior to the law. Some of the issues that state legislators struggle with are the overall cost of providing services for the additional recipients, staying within budget, determining an adequate approach of offering quality care, and providing adequate coverage for each recipient. Even though the cost of Medicaid expansion within each state has increased the budget for the program, new appraisals has shown that Medicaid programs spend less per enrollee than commercial health insurance and much of the increase in Medicaid expenses originate from the increase in enrollment in the programs (Coughlin, Long, Clemens-Cope, & Resnick, 2013).

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

Medicaid provides medical assistance to citizens in the United States who fall within the eligibility requirements. Medicaid has been enacted since 1965 and has faced many changes. One change most recently was the Patient Protection and Affordable Care Act, and the attempt to require states to expand Medicaid coverage to include more citizens. However, Medicaid is a states’ right and therefore Congress decided to leave expansion up to each individual state. As some states decide to move forward with expansion and some do not, this paper will discuss the pros and cons to each option and the financial impact that Medicaid expansion has on healthcare entities.

There are close to twelve million people signed up for health insurance and many of those people are of low-income. A down side to these numbers is the fact that some states do not have exchanges for people to go to so, it is possible for the the numbers to be higher. But however in “June 2012, the Supreme Court ruled that the states expansion of medicated had to be voluntary. That left the poor in states such as Texas or Florida that did not expand Medicaid faced with having to pay more that those who are not poor” (Brill 20). The success of this bill relies on the citizens and we must find ways in which we all can benefit from this and not just throw it

On March 32rd, 2013, President Obama presented to Congress a Healthcare Reform Stimulus Act, in which he ensured will help all the American people save plenty of money on health coverage and medical expenses; such as, hospitalization and treatments. The Affordable Health Care Act, bill was put into law to cover recipients who was paying high premiums reduce their premiums and to insure uninsured recipients who could not afford to purchase coverage get it at a cheater cost. Without a doubt, universal healthcare is still considered one of the most challenging social problems that we have to deal with today. Even though, this issue is unsolved there is still a lot to discuss that need to be clarified concerning affordable healthcare. During presidential election in 2012 both parties the Republicans and the Democrats presented different viewpoints on this ideologies matter. Obama care new health care policy was put into action this to provide more coverage to a larger percentage of low–income working American, it is less cost effective and more within citizens spending budget. “AHRQ-funded researchers compared data on health maintenance organization (HMO) premiums in various markets. Premiums were lower in more competitive markets, where a high percentage of the population was enrolled in HMOs and many HMOs competed for their business” (AHRQ, 2002, Para. 13).

However, contrary to the expected success of these provisions involving healthcare coverage to rural areas, healthcare coverage to rural areas did not change as much as expected due to several other factors. The same judicial decision in June 2012 that deemed one of the act’s most controversial provisions constitutional also dealt a large setback to extending healthcare coverage in rural areas. The decision ruled that expansion of Medicaid, a state government, become optional for states because Congress had “exceeded its constitutional authority by coercing states into participating in the expansion by threatening them with the loss of existing federal payments” (Supreme Court). Two years later, twenty-four states were not implementing the Medicaid expansion. The states that are not expanding their Medicaid program are primarily the states with Republican-led state governments: Midwestern and Southern states (Weiner 9/15/15). In addition, many states are defining coverages areas differently. When a region chosen as a coverage area combines rural areas and nearby urban areas, the number of insurers and number of coverage plans available to the rural areas increases. As a result, the costs of insurance due to competition and other factors are lowered. Therefore, this is beneficial to both urban and rural residents. However, some states, due to the discretion that they have, are not defining coverage areas that way (Dickstein). One example is Texas, which has created regions