Questions on Medicaid

Medicaid is a joi8nt federal and state program. It provides health coverage to nearly 60 million Americans including children, pregnant women, seniors, and individuals with disabilities. As well as those people who are eligible to receive federally assisted income. Eligibility does however vary state to state.

Medicaid is a huge program that touches many lives but is nonetheless poorly understood by both the public and policymakers. Each state has the right to not participate in the Medicaid program, but Medicaid is one of the largest government insurance programs for individuals of all ages whose income and resources are insufficient to pay for health care.

Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).

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

In order to qualify for Medicaid individuals must meet certain regulations. Eligibility depends on each state, age and whether the individual is a U.S. Citizen, blind, pregnant, single parent, or suffers from any disabilities; all of this plays a huge role in the Medicaid eligibility criteria. Although, some immigrants may be able to benefit from this program, if the immigrant is a woman whose labor and delivery of child is taken care of inside the U.S. that is enough to make them eligible for Medicaid (Medicaid, 2012). Even though the states are allowed to provide their own regulation guidelines along with other decisions for this health program, there are certain mandatory federal requirements that must be met by each state in order to receive funding. Some of those requirements include; inpatient hospital service, prenatal care, vaccines for children, rural health clinic services, transportation services and many others that according to the federal government are extremely essential for the management of this program ("What is medicare/medicaid?," 2012).

Medicaid and Medicare was created and called the Social Security Act of 1965 to provide coverage for medical treatment for qualified individuals and their families. Medicaid is a program that is jointly funded and managed by the federal and state governments that reimburse hospital and physician for providing care to qualified patients who cannot afford medical expense. To qualify for Medicaid he or she must be a United States or resident citizen which, includes low income adults and their children, people with certain disabilities and senior citizens. “Medicaid and Medicare is overlooked by the Center for Medicare and Medicaid,

Basically what Medicaid does is expand covering about 133 percent of the population close to the poverty line. This is significant because people above the poverty line that previously did not qualify, now they can be cover by Medicaid, including the lower middle class. The Federal Government is subsidizing this by giving the states the money to pay for everyone under the program, but they are afraid that the money is going to run out and they are going to be left out with the problem.

The Affordable Care Act (ACA) highlighted the importance Medicaid played in insuring every American receive healthcare coverage. (42 U.S.C., 2010) Medicaid provides health benefits to over 71 million across the country. While involvement is optional, all 50 states participate in the program and requirements differ across the nation. The flexibility given to each state has allowed them to make their own decisions to work towards improvements that they believe would best benefit their region (Feldstein, 2015, p. 125-126).

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.

The Medicaid program is a federal health insurance program for the under-privileged and incapacitated. The plan is managed by states within comprehensive limits instituted by the federal government. Together the federal and state governments finance the program, with the federal share ranging from 50 percent to 74 percent. Now Medicaid currently makes up 7 percent of the federal budget and 23.7 percent of all state expenses. Approximately sixty million people are enrolled in the Medicaid program and 400 million is spent annually.

Medicaid provides a comprehensive benefit package for those who enroll. The federal government requires coverage of thirteen services, including inpatient and outpatient hospital services, nursing home and home health care, and for children under the age of twenty-one. The benefits do not end there, Medicaid offers a

Medicaid is the largest source of health coverage available in the United States that provides health coverage to United States residents including seniors, children, pregnant women, and individuals with disabilities. To participate in Medicaid, federal law requires states to cover mandatory eligibility groups of individuals such as low-income families, qualified pregnant women and children, and individuals who receive Supplemental Security Income; each state may choose to cover residents who receive home and community based services and children who are in foster care (Medicaid, 2017).

Medicaid is a government insurance initiative that was started in 1965. The objective of the scheme is to provide health insurance to low-income citizens, as well as their families. Medicaid places more emphasis on covering people with disabilities, parents, children, pregnant women and the elderly from low-income families (CBPP, 2014). Both the state and federal governments are responsible for funding the program. Each state has its own independent Medicaid program that operates within the set federal guidelines. These guidelines are broad and give states some sort of flexibility in the design and administration of the programs.

The Medicaid program provide health insurance to low income individuals. Congress passed Medicaid intending to achieve a new benefit package for Medicaid recipients, including "standard pertaining to program eligibility, benefits, and payment to participating healthcare providers." However, there are thousands of administrative regulations and rules pertaining to Medicaid, which have become a controversial topic over the past 40 years. "In the true sense," the passing of the Medicaid regulations has brought "life" and "vitality" to the program. This "operationalizing" function of administrative law is seen a wide range of important health issues, including the "reporting of infectious diseases, the development of sanitation standards, and the