"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 provisions of free medical services to those of low income has become a central component of the package of incentives for the poor in the U.S. for over the last twenty years. (Wolfe and Moffitt …show more content…
(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.
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
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
As stated in the article “Medicaid Spending: A Brief History”, the Omnibus Budget Reconciliation Act (OBRA-1981) decreased federal contributions in states where growth exceeded certain goals; this was a three-year reduction which cut matching rates by up to 4.5% in 1982, 1983, and 1984. Eligibility changed as well which made it increasingly difficult for families to receive Medicaid coverage. Reductions in federal contributions led to flexibility provisions that “broadened State options for providing and reimbursing Medicaid benefits, as well as State authority to limit coverage under medically needy programs” (Klemm, 2000). This led to experimentation with alternative options such as Health Maintenance Organizations to manage services and costs because most
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.
The reason I would expand Medicaid is that it has more upside than downside for Texas, I know that accepting the ACC would be the only to get Medicaid expansion and would get a majority of Republican representatives to be outrage with this decision, but if they don’t accept the ACC then they would lose according to an economist over $100 billion dollar over the next 10 years and that money would be used to pay health insurance to more than 1 million working Americans (Goodwyn, 2015). The reason I choose school-based health services is so that it doesn’t get their mom or dad to be rejected to not getting Medicaid because they have children, if their child already had health insurance provided to them at school and this is a way for children in kindergarten to high school can get health insurance to get Medicaid (Salazar et al, 75). This will also provide children from poverty parts of the state to get coverage for Medicaid, this will also provide students to get check on if their a facility next to the school to get medicine and finally school-based health services will also cover all medical need like immunizations, screenings, and other health needs for people’s children (Salazar et al,
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
This decreases the number of the uninsured, children and funds handed down to hospitals in aid. The bill states the government would cooperate by paying a hundred percent the first three years of coverage and afterwards the state would be responsible for ten percent the next year and so on. If states agree to such terms, the patients in the Medicaid Gap; amounting to 3.1 million of united state residences making more than required for Medicaid and eventually not enough for the private insurances. The plan was to offer “$29 billion pot of money to Texas health care providers over five years, about 40 percent of that money come from local funds- mostly property tax dollar…and 60 percentages from the federal government,” to facilitate the state’s needs. Eventually, the Texas decision to only expand temporarily will hinder in the push to return the resident taxpayers money
enrolled in the new program. The $8 billion includes the state share of costs for both newly eligible adults and the additional Medicaid participation among currently eligible populations that would result from expansion. If all states implemented the Medicaid expansion, federal spending would increase by $800 billion, or 21 percent, compared to the ACA with no states implementing the expansion (Holahan, et al., 2013). Therefore, although the increase in spending per state is relatively small, the cost to our nation is exponential. With the national debt growing day by day, many believe that an exponential increase in national spending is a difficult thing to justify.
More importantly, there are several suggestions that if applied can continue this projection toward the end goal which is access to affordable health care for all Americans. For example, state level executives should enforce a time frame for those remaining 19 states that have yet to implement the expansion of Medicaid (Kantarjian, 2017). By doing so, states such as Texas, Florida, and Georgia already would cover greater than one-half of such vulnerable individuals. States
Expanding Medicaid was supposed to to be a main element in the states wide acceptance of the Affordable Care Act, because Medicaid’s sole purpose is to provide coverage for all uninsured adults. Medicaid is mainly used by the working poor or those who don 't make enough money to pay for health insurance on their own. The expansion, however, is part of ObamaCare and Texans hate it, despite the numerous money problems that not accepting it causes. An example would be, the 100 billion dollars that the federal government has set aside for Medicaid over the course of ten years. Even though it seems that the insurance is doing good for many states, Texas Governor Rick Perry could not opt out fast enough. His reasoning behind the
The Medicaid expansion will cost the federal government between 15-20 billion dollars in the first six years, but the federal government is paying for 93% of the direct expansion costs. But with the expansion, the greater majority of people will be able to pay their own medical bills, which means the state and local governments will save millions of dollars.
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.
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)
Critically analyze the implications of the state’s decision to opt out of Medicaid expansion on the citizens of the state.
There are some problems that must be addressed in the expansion of the Medicaid policy to include; social, economic, ethical, legal and political. First, the social impact of having health insurance removes the burden off of parents, people with chronic diseases, children and the disabled. If access to health insurance is unavailable our nation’s health care costs will continue to rise,