The Affordable Care Act: Case Study

Critically analyze the implications of the state’s decision to opt out of Medicaid expansion on the citizens of the state.

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).

Medicaid is a huge program that touches many lives but is nonetheless poorly understood by both the public and policymakers. This is an argument for many people, mostly because the public has the idea that only people that refuse to work are on it, well for some yes that could be true but this program helps working families and the elderly. single individuals and childless couples are largely excluded from Medicaid coverage, but the program covers 65 percent of maternity stays for women under 25, and 40 percent of all maternity stays. Many of these women are uninsured individuals with incomes above the poverty line. ("PA DHS - Healthy Beginnings," n.d.) For many financially struggling families, whom otherwise are least likely to have insurance, Medicaid is the only available option for them to receive the coverage they need. The media portrays this façade of “Medicaid: Worst insurance in America?” It’s hard for citizens to not believe that line when it’s in the forefront of a political debate. With republicans like, Carly Fiorina making statements such as “Obamacare isn’t helping anyone” ("Medicaid: Worst insurance in America?," n.d.) what is the country supposed to

Those who utilize the Medicaid system range from low income families to the over 65 age group. Within this population is also those who are disabled due to physical or mental problems. This is among the sickliest of our American population. A paper based on a study in Oregon stated that “Medicaid significantly increased the probability of being diagnosed with diabetes, and being on diabetes medication as well as high blood pressure and high cholesterol.”(Baicker et al., 2013, p. 1715). Much of this is due to the struggle that the Medicaid beneficiary has

President Obama’s pledge to pay for the program by taxing the rich, who is anyone that makes more than $1 million a year (which would include President Obama) and will make for “a marketplace that provides choice and competition” (Conniff, 2009). He also proposes that reform is about every American who has ever feared losing their coverage if they become too sick, lose their jobs or even change their jobs. It’s realizing that the biggest force behind our deficit is the growing costs for Medicare and Medicaid programs.”

On June 28, 2012, The Supreme Court ruled the Federal Government does not have the constitutional right to sanction an individual to buy health insurance, but declared that the states do have the right to place a tax on citizens that do not carry insurance. This ruling is in response to President Obama’s Patient Protection and Healthcare Act of 2010. Passed on March 23, 2010, President Obama’s Reform Act mandates Texas, as well as the nation, to provide Medicaid funding to all individuals that are uninsured by 2014. As well as expanding Medicaid, it will provide exchanges, which are pools of insurance companies a previously uninsured person can pick

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.

In 2009 there were 50.7 million people, 16.7% of the population, without health insurance. Americans all over the country are working and yet they still can’t afford to pay the high cost of health insurance for themselves and their families. Under the Affordable Care Act of 2010, which was signed by Obama on March 23, 2010, thirty two million Americans who were previously not eligible for Medicaid may now have the opportunity to be covered. If this act is passed in North Carolina then it will be expanded to cover nearly all of the 1.5 million North Carolinians who are without health insurance. If more Americans are covered under the Medicaid that they need then

Medicaid has help many qualified Americans who were historically unable to access health care. At the same time, it has raised questions and controversies as how efficient is the plan overall. Various research studies were conducted and contradicting results were presented. According to Paradise and Garfield (2013), some said that having no coverage at all is better that having a Medicaid coverage. On the other hand, some expressed that Medicaid paved a way to improved health due to increased access to services that provides prevention of diseases, health maintenance, and effective treatment (Paradise & Garfield, 2013). As for me I am in favor of the later, health care access for all. It comes down to equitable distribution of resources

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

The state of Texas has pulled its Medicaid funding for Planned Parenthood, leaving poor residents with few options for affordable healthcare. Medicaid, a program focused on helping low-income families and individuals receive healthcare, has always been jointly operated by the state and the federal government. But to who this program would be eligible for is entirely up to the state. More conservative states, like Texas for example, strictly reserve Medicaid for only the most severe cases of poverty-stricken families, leaving a large portion of low-income residents uninsured. The Affordable Care Act, a federally mandated reform of Medicaid introduced by President Obama, would provide healthcare for many American citizens in need. Despite being

Texas has the largest uninsured population with an estimated 6.2 million uninsured citizens within its stateliness, approximately a quarter of the statewide population (Rapoport, 2012). In 2012, then governor, Rick Perry decided that Texas would not expand Medicaid under the Affordable Care Act (ACA). This decision led to much debate over whether or not Perry made the right decision to leave upwards of a million Texans, who did not receive insurance subsidies and did not qualify for Medicaid, uninsured. These Texans fell under what many politicians refer to as the “coverage gap.” Texas decided not to expand Medicaid under the Affordable Care Act because of the effects it would have on hospitals, financial reasons, and increased number of

Ironically, Texas has the highest number of uninsured citizens in the nation, 6.2 million to be exact. The majority of these citizens are children. According to Goodwyn (2013), “by Texas refusing to participate in the Medicaid expansion, which is part of the ACA, the state will leave on the table an estimated 100 billion dollars over the next decade. It is sad to know many citizens in this state will be denied health care by those who already have the best insurance and will never have to worry about being uninsured. In addition, the Texas politicians fail to recognize the need for health care for neither its most vulnerable citizens nor the burden on the Emergency room as well as the rise in healthcare premiums for citizens who maintain health insurance. Landers (2013) reports, “whether they have a good income or a lower one, Texas lag behind much of the nation in access to and quality health care.” States who fail to expand Medicaid will see their funds distributed to states on board with expanding Medicaid.

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)

     Most of the people who are uninsured are the working poor, which the overall costs of medical care can hurt them. By the means of doing their best, these people just can’t afford the insurance. Health care has become increasingly unaffordable for businesses and individuals. (Reese) Premiums grow several