The Cost Of The Medicaid Program

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).

The potential opportunity for the state to opt into the Medicaid expansion is the fact that low-income citizens will be insured. The decision of the state to opt into the Medicaid expansion will also impact the state’s budget, and this is the main challenge (Frakt, 2013). The government will cover majority of all the cost even as Medicaid expansion provides coverage for the low-income uninsured citizens. Expansion of the Medicaid is also a broken system that has poor outcomes, not severe federal strings, high inflation and no incentive for the personal responsibility of the citizens who

One of the main components that had given the Affordable Care Act issues with the uninsured rate in the United States is the growth of the Medicaid program. The Affordable Care Act granted all 50 states billions of dollars in federal financial aid to increase their Medicaid program to insure people who made up to 138 percent of the federal poverty level. Starting at the beginning of 2016, the federal government reduced its federal aid, covering less than 10 percent of what was promised, which ended up putting more of the responsibility of insuring Medicaid qualified Americans on the states. This caused a fallout of state governors being against ObamaCare, resulting with having 21 states declining any federal funding or expands their

states expanded Medicaid coverage to nonelderly adults who make $16,400 per year or less for a single adult. Michigan legislators could approve a unique model for the expansion of Medicaid coverage. Previously uninsured adults with incomes up to 138% of the Federal Poverty Level would now be able to revise healthcare benefits ((Dr. Ayanian, 2017). The “Healthy Michigan Plan enrollment has vastly exceeded expectations, surpassing the state’s first year projection in less than four months” (Udow-Phillips, et al, 2015). The federal funding for the Medicaid expansion has increased economic benefits to the Michigan budget. There was a reduced state spending of $235 million on services covered by the expanded Medicaid program and the macroeconomic benefit through increases in tax revenue and the expansion of economic activity from the new federal funding through the ACA (Dr. Ayanian, 2017). This increase in the economic activity benefits Michigan residents through increased employment and the increase has been shown to be positive for health care, construction, and retail services.

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

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.

The Affordable Care Act is supposed to be designed to make insurance costs affordable for Americans, rather than what the law offer for Americans to pay. The law states that everyone must have health insurance, or they will be subject to penalty. Sireesha Manne, a staff attorney at the New Mexico Center on Law and Poverty stated “For those with very low wages trying to raise kids after paying for housing, electricity, food, and transportation, and child care, asking people to pay another $50 to $100 a month that’s just out of reach.” A concern regarding the Affordable Care Act, is that even with the federal financial assistance available under the law, health insurance will remain unaffordable for a significant number of low-income families. Although the Affordable Care Act is to be cost effective, the prices and premiums are still exceedingly high for Americans with low and moderate income.

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.

The expansion of medicaid would be followed by negative repercussions for states budgets and low- income citizens. When dealing with budget decisions officials almost always have to take into consideration trade-offs such as: taxes versus debt and roads versus education. If federal funds need to be reallocated for better health care then the money would have to come from another area, such as education, or taxes would have to be raised. In 2013, James Madison Institute conducted a poll on Medicaid and one question read as follows: “To expand Medicaid coverage in Florida that would require either additional taxes of less state spending on things like education, roads, and law enforcement. Would you be more likely or less likely to support the governor and Legislature expanding Medicaid coverage, if it meant higher taxes and less spending on other priorities?” (“Florida statewide”, 2013). 60% of responses said they would be less likely to support expansion if it meant higher taxes, while 27% said they would still support the expansion.

Medicaid expansion is seen as a huge problem in this case it takes place among the 50 states. The environment includes the 50 states such as California, Texas, New York and New Jersey. Medicaid expansion offers financial protection. It also addresses the uncompensated care problem which involves paying and reimbursement for service rendered. Medicaid expansion also provides customers access to affordable coverage, as well as customers taking up that cover, which is a moral duty of the government. Medicaid also supports politically powerful interest groups who support expansion. The expansion of Medicaid helps rural hospitals stay afloat in states like Colorado, which added 400,000 people to the health insurance program under

The Affordable Care Act (ACA) caused some of the issues central to the expansion of Medicaid. Some of the major challenges in Affordable Care Act (ACA) the improved access to more individuals. According to Levitt, Claxton, and Damico (2013), the Affordable Care Act expansion increase limitation to families under 65 whose income is at or below 133% of federal poverty guidelines. This leads into significant growth in eligibility of newly coverage populations. Medicaid provide an opportunity to identify successful enrollment and renewal practices, strategies to ensure access to care, effective models of person-centered and coordinated care, and payment systems that align financial incentives with goals for quality and cost. (Paradise, 2015). Especially

The state also has a limited medical assistance program which is funded with General Revenue and Blind Pension funds. In Washington, said that two thirds of the states are cutting Medical benefits, increasing co payments, restricting eligibility or removing poor people from the rolls because of soaring costs and plunging revenues. A new survey of all fifty states, finds that 16 are cutting Medicaid benefits, fifteen are restricting or reducing eligibility and four are increasing the co payments charged to beneficiaries. Medicaid provides health care for more than 40 million people, at an annual cost of more that $250 billion. The federal government and the states share cost, which rose 13 percent in the last fiscal year, the biggest increase. Washington State and Oregon took pride in expanding Medicaid and other health programs a decade ago, but now are wrestling with

Under the ObamaCare, the federal government now imposes Medicaid on the states as a federal mandate to meet the federal requirements of the individual mandate for the entire below- age- 65 population with incomes under 138 percent of the poverty level (Forbes.com). That includes mandatory coverage for the first time of all non-elderly, childless adults within the income limits. The states, consequently, no longer retain substantial discretion to determine eligibility or scope and duration of coverage for the program within their respective jurisdictions, which makes the program unacceptably coercive.

The affordable health care act provided expansion of Medicaid, which was federally mandated until 2012 when it was shot down by the supreme court and was made it be the states option. As of 2012 thirty-one states have elected to adopt this platform. The problem lies with the states who have designed the expansion, and this leads to the wage gap. According to (Norris, 2015) In Alabama Medicaid is only available to a family of three who make 2,611 dollars in annual income. This law virtually only affects the homeless and those who do not work. Families and individuals the state has also agreed to cover are citizens with