The Benefits Of Medicaid In America

Oral health has a direct impact on the general health, hence, it is important that all Canadians have adequate access to dental care services. Over the years successive Governments have reduced financial support to programs delivering dental care to most vulnerable populations. As a result, many low income families and other vulnerable groups have been unable to access dental care. There is further escalation in the disparities in oral health care among Canadians, as the number of Canadians losing dental care benefits continues to increase. Also, higher oral health care costs can be expected in the near future due to shortage of health care professionals.

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

As the number of older Americans continue to rise, along with dental practitioners who are entering retirement, it would benefit this under-served population for the dental profession to develop new models of mid- level care. To expand training as well as additional licensing for dental hygienists, along with more training for other health care professionals would be a great beginning towards improved access to care (Overview of oral health,

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

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

While most of the patients I interacted with were seeking non-dental care, I met patients who were seeking care to health conditions that stem from their oral health such as oral abscesses, which our team was unable to treat except for prescribing antibiotics or painkillers. I encountered similar situations when I shadowed physicians in the emergency room of hospitals, observing a variety of craniofacial disorders originating from a preventable tooth decay. From these observations, I learned that patients often did not receive treatment that addressed the root of their problems: their oral health. As the result, I learned that many physicians saw the same patient repeatedly for problems that would otherwise be easily prevented through proper preventive dental care. Determining to address the unmet needs for accessible preventive dental care, I decided to pursue a career in dentistry so that I can provide a positive and meaningful impact to the underserved community on their oral health and ultimately their overall

ACA expanded Medicaid to all Americans below 133% of the federal poverty level from the previous cut-off at 138 percent. The enrollment for Medicaid and CHIP has been simplified. ACA prohibits insurance companies from denying coverage based on pre-existing conditions. This is known as guaranteed issue. ACA also extends dependent coverage for young adults unto the age of 26; so they can stay insured on their parent’s insurance. Individuals upto 400% of the federal poverty level are entitled to tax subsidies in order to assist them in having a health insurance. The subsidy is meant to achieve 2 goals: (1) provide sufficient funds to ensure that people can afford their health insurance premiums and (2) provide a financial incentive for people to choose lower-cost plans. These two goals are opposing, but both are essential. Families who earn more than 400% of the FPL can also purchase health insurance from the exchange, but they receive no subsidy.

Affordable care act is a law that was passed in March of 2010 to help decrease health care cost and make it more affordable for all Americans. The affordable care act is set to decrease the number of uninsured Americans, qualify more for Medicare and Medicaid, increase the quality of care, promote prevention, extending funding for the children, and help with funding in the communities. The goal for affordable care act is to have everyone insured, no matter what income class you are in. The affordable care act is there to insure everyone so that prevention will increase. It will increase by being able to get check ups and children being able to receive vaccination. If you are not able to qualify for Medicare or Medicaid there

Emergency room over utilization is one of the leading causes of today’s ever increasing healthcare costs. The majority of the patients seen in emergency rooms across the nation are Medicaid recipients, for non-emergent reasons. The federal government initiated Medicaid Managed Care programs to offer better healthcare delivery, adequately compensate providers and reduce healthcare costs. Has Medicaid Managed Care addressed the issues and solved the problem? The answer is ‘Yes’ and ‘No’.

Medicaid has grown exponentially after healthcare was expanded under the Affordable Care Act. However, this did not guarantee an increase in access to health care services, as many providers do not accept Medicaid beneficiaries, one of many reasons being low reimbursement rates. This discrepancy in rate reimbursement is further underscored when compared to those

Michigan expansion. The “Healthy Michigan Plan” is the Section 1115 waiver that was approved by CMS in December 2013 for Michigan to implement the ACA’s Medicaid expansion. This plan uses Medicaid funds to provide coverage for all newly eligible adults with income up to 138% of the FPL (Norris, 2017).

Medicaid is a medical assistance program for low-income Americans. It is funded partially by the federal government and partially by the state and local governments. The federal government requires that certain services be provided and sets specific eligibility requirements. Medicaid covers the following benefits required by the federal government; early and periodic screening, diagnosis, and treatment services, rural health clinic services, family planning services, SNF and home health services for persons over 21 years old, physicians’ services, laboratory and x-ray services, outpatient hospital care, and inpatient hospital care. Because Medicaid is also partially run by the state and local government individual states sometimes cover services

Many low income areas have dental therapists as part of their local dental team. Many people in these areas have never been to a dentist or do not go every six months as recommended this poses many other health problems. There has been case studies and data showing that in these areas dental health

Basic services, such as routine cleanings and exams, are important to maintain oral health; however, due to the costs involved, many people forgo these valuable preventative procedures. With a dental insurance plan, these costs can