The Expansion Of The United States

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

The Westward expansion began for the United States with the Louisiana Purchase in 1803. For $15 million dollars, President Thomas Jefferson purchased from France 828,000 square miles, including most of 14 current states, thus doubling the size of America. Jefferson now had the land, but how to populate it was another story. On a three year expedition, Lewis and Clark were sent by Jefferson to explore the lands to get a better understanding of the geography and resources of the West. During the 1830s to 1840s, to promote further territory expansion, the “manifest destiny” came into play – which was the idea that America was destined to expand across the entire country westward. Quickly, the nation expanded.

During the 1890’s, the United States began building and advancing their economy, as well as focusing more independently on becoming an even more powerful nation. Not only did the Americans begin to create a stronger national military and navy, they also began to look overseas towards the Pacific Ocean for resources and territories; this is when America began to look less like a national power and more like an imperial power. There were many reasons as to why the United States began to expand between 1880-1929, two of which include the military opportunities countries abroad had to offer, such as Pearl Harbor, as well as the domestic and political objectives the U.S. felt obligated to fulfill. Although, there were many important reasons for the United States to began to expand, the most significant reason for the expansionist foreign policy was the economic resources and opportunities other foreign countries had to offer the U.S.

These programs in state level would cater health service on basic levels to rural areas and also the urban areas. However, There must be the same rules and regulations for health care services across the state as well as the country and the access to minority groups to health care services must be fast and continuous in rate. The positives of state flexibility in health care certainly outweigh the negative in that some states have more growth than other states, therefore in these situations, the levels of health care may differ. As population and development grows in a state, the health care industry must grow, thus increasing the need for new technology. "Due to the needs of vulnerable populations and the requirements necessary to make health insurance coverage for them viable, these programs are quite different from standard private health insurance plans (Teitelbaum & Wilensky, 2013)." Private state insurance health care plans have the flexibility of choosing what groups they want to cover and what type coverage they will pay for. Medicaids concern for the needy is ethical and moral, illness or injury doesn't

Westward expansions of the united states molded and affected the nations advancement socially, politically and economically holding quick to its connections to agriculture, its relations with and through slavery with the westward expansion therefore there would not be an abolishment movement and the women would not have been there to find against it. Although the Indian removal has helped shape the westward expansion politically and economically because it has given America more land and cotton. The Mexican war shaped the western expansion culturally and politically because the Mexican were racially religiously superior.

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

Some may argue that the expansion of Medicaid is a bad idea because of the potential shortage of healthcare professionals. A new study has predicted that the expansion of Medicaid could lead to a shortage of 52,000 primary care physicians by 2025, it also states that visits to the doctors will increase from 462 million a year to 565 million a year, which will strain the system. Its also

From 1830 to 1860 the United States, as a country, experienced change unlike any other before. This change was the territorial expansion of the United States, otherwise known as Manifest Destiny or “The Way West.” This expansion exponentially grew the size of this young country. When there is change, controversy is not far behind, uniting and dividing people. In the case of territorial expansion, this change was able to unite the United States. It was because of territorial expansion that the economy of the United States thrived. It was because of territorial expansion that the United States was viewed as a supper power, helping the countries National Security. It was also because of territorial expansion that more people were able to life the American dream of freedom and prosperity.

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

Since the implementation of the Affordable Care Act, the population of people with access to health care insurance has increased by millions. Medicaid expansion has increased access to health care services for millions but the amount of physicians that accept Medicaid as payment has not increased to cover the increase in patients.

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 and sectionalism throughout American history, the colonial resistance to the "proclamation line" had been one of unifying factors that had committed many English colonists to revolution and helped spread an emerging nationalism.  The exciting textbook American Nation, states that, "American independence and control of a wide and rich domain were the most obvious results of the Revolution."  The revolution provided access to vast western lands and for many years western expansion would serve as an element that bound the various sections together. Yet, as the decades rolled on and the United States added even more land in its march to the Pacific, expansionism led to sectionalism which resulted in the Union being torn apart.

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,

Ever since the first English colonists arrived in Jamestown and Plymouth, the colonists and eventually Americans have always considered expanding west, whether the land was previously inhabited or not: And like most things, many people had different opinions if and how it should be done. Before the 1800s, this issue already had opinions on the best solution. One example of this can be observed by King George III in The Royal Proclamation of 1763, in which he forbade all English settlement past a line in the Appalachian Mountains. Contrarily, Daniel Boone carved out the Wilderness Road and built the settlement of Boonesborough in the late 1700s. These sharp contrasts in ideas led to future debates. From 1800-1855, territorial expansion ignited nationwide debates: The supporters of territorial expansion rallied behind the term “manifest destiny,” while the opposition argued the unconstitutionality of the acquisition of territory, and the future negative consequences expansion may cause.

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)