The Medicaid Expansion: Article Analysis

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

Texas, which currently has a large uninsured population and limited Medicaid eligibility, forfeits billions of dollars from the federal government every year by not expanding its Medicaid program as implemented in the Affordable Care Act. In contrast, Medicaid expansion could benefit the state exponentially and give its citizens the fullest potential of what this country offers. A substantial amount of federal funding that could increase uninsured coverage, improve healthcare costs, and provide economic stimulus is left on the table. Additionally, the nation benefits when each state participates, contributing to the success of the healthcare reform.

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

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

Despite these gains, the Affordable Care Act is still experiencing a multitude of challenges. For instance, some states like Texas refused to expand Medicaid eligibility for low-income individuals below the poverty rate, undocumented immigrants not covered under the open marketplace and Medicaid options and the increasing cost of health insurance premiums.

For those states that decided to take part in the Medicaid expansion it would help adults that were living under the poverty line. Many of these adults did not have jobs that offered them health insurance or they struggle to even pay the bills to just barely get by, and therefore health insurance is one of the last things on their mind when it comes to having that or being able to have electricity or even putting food on the table, they are not able to just go and be able to pick out health insurance for themselves and their family because they live below the poverty line. Officials promised that individuals who liked their currents plans would be able to keep them but it turned out that was not the case because many current plans of insurance did not meet the standards that the Affordable Care Act made. Again employers had to change their plans to fit the standards, premiums shot up and many of the plans had more coverage then what most people needed- meaning they had to pay higher copays and deductibles. They would use the marketplace to find the details of the types of plans that were being offered. States that choose not to participate in the expansion of Medicaid still would not have the people who lived in between the 100%-138% level of income on the federal poverty would be able to be granted subsidies but these subsidies might not cover their entire monthly cost for their health insurance, or their premium. Because of this though there is less on an incentive for people to go out and buy insurance on their own. “With fourteen states opting out, we estimate that 3.6 million fewer people would be insured, federal transfer payments to those states could fall by $8.4 billion, and state spending on uncompensated care could increase by $1 billion in 2016, compared to what would be expected if all states participated in the expansion.”(Polycin, 2009). For the

With the implementation of the ACA, many states have expanded their Medicaid programs to include a larger population of low income individuals and families that were not able to obtain health insurance prior to the law. Some of the issues that state legislators struggle with are the overall cost of providing services for the additional recipients, staying within budget, determining an adequate approach of offering quality care, and providing adequate coverage for each recipient. Even though the cost of Medicaid expansion within each state has increased the budget for the program, new appraisals has shown that Medicaid programs spend less per enrollee than commercial health insurance and much of the increase in Medicaid expenses originate from the increase in enrollment in the programs (Coughlin, Long, Clemens-Cope, & Resnick, 2013).

The following analysis will explore the current health insurance problem under the ACA. It will discuss the proposed policy of Medicaid Expansion and the impact of States not cooperating with the implementation of such provision. Moreover, a recommendation on strategies to alleviate the health

The United States (US) is distinguished for its medical advances, leading technology and astonishing discoveries in various science fields. These advancements in the health care ground have impacted and improved the health care delivery of several in the nation. The US is found among the wealthiest, most developed countries around the world; however, it is the only developed country that fails to provide universal health care to its people. Health care in the US is described as fragmented, inaccessible, and expensive. Diebel (2015) compared the health system in the US to other nations and supported that it is extremely overpriced, yet the end result does not always support its cost. Lack of coverage, high copayments plus deductibles force Americans to postpone seeking medical attention resulting in undiagnosed health conditions and complications of current diseases. In 2010, under President Obama’s mandate, Americans witnessed the birth of a controversial legislation, The Patient Protection and Affordable Care Act (PPACA). The goal of the PPACA is to improve just about every aspect of the system such the health of Americans, health care access and quality, while reversing the health care expenditure (Hahn and Sheingold, 2014). The aim of this paper is to discuss the PPACA and the Medicaid Expansion under the PPACA including its risks and benefits; as well as, the impact of the expansion in the healthcare delivery

People don’t like being sick, however, some Missourians forego preventive care, required doctor visits and beneficial medicines because they cannot afford them. They may be working in part time jobs, seasonal jobs or other unskilled labor jobs and lack affordable health insurance. They are the poor people below the 138% federal poverty level (FDP). According to Chris Kelly, a former Representative of the Missouri House for district 24, the West Plains hospital Ozark Medical Center’s (OMC) service area includes more than 9,000 uninsured adults (p1). So, what do you do when you are poor and sick and can’t afford a doctor’s visit? You go to the emergency room of a local hospital and the hospital absorbs that

States are being pressured to expand Medicaid to families earning up to $30,000 a year, just like the Affordable Care Act permits. While several respected governors have agreed to expand the program, many other governors and state legislators are cautious. These officials do not want to deny Americans their access to health care, however they do want to slow the expansion of a program that will provide them with limited access to quality care while destroying state budgets. One of the strongest arguments that can be made against the expansion of Medicaid is the fact that States simply can not afford it. The appeal to states to expand Medicaid is that the federal government will cover 100% of the cost through 2016 and eventually lowering to

The Affordable Care Act has already created much history within the five years since it was passed into law. On March 23, 2010 The Affordable Care Act was passed into law (Clemmitt, “Health-Care Reform”, 505-28). With it came many new laws and regulations regarding health insurance. The law says that United States Citizens must buy health insurance unless one is enrolled on Medicaid or Medicare. If they choose not to buy insurance, they will face a fine that is adjusted to your income (Clemmitt, “Health-Care Reform”, 505-28). The Democrats, who mostly support the law, argue that the law will insure 32 of the 45 million people in the United States who are uninsured by expanding medicaid, providing subsidies to lower and middle class families to make insurance more affordable, and regulating insurance markets where people without employer sponsored insurance can buy subsidized coverage (Clemmitt, “Health-Care Reform”, 505-28). The Republicans, who mostly oppose the law,

The Florida state government is directly involved in this public health policy, since it is has the authority to make changes to the federal-state run Medicaid program. The Sunshine state has opted out from the Medicaid expansion program under the ACA. The Governor of Florida Rick Scott (Republican) endorsed Medicaid expansion, however the state’s GOP-led legislature rejected it. The Republicans have a majority in Florida state-legislature, whereas the ACA act was passed by the Democrats-led federal government under President Obama. The federal government could not require states to adopt the Medicaid expansion. The states must proactively enact legislation to expand their Medicaid program. Since it is non-binding on the states, the state legislatures have the final word whether or not to participate in the expanded Medicaid

In the United States, there is an inequitable distribution of power, money, and resources that create health disparities among the different socioeconomic classes (WHO, 2014). The PPACA was created to affect the social determinants of health through the Expansion of Medicaid via the PPACA. An example of health disparities can be seen with life expectancy across the difference levels of social economical levels. In the United States, the upper class individuals live on average 20 years longer than those in the poorer classes (Marmot, 2005).

This is forcing the doctors to no longer accept certain insurance companies such as medicaid because they aren’t being reimbursed for the services they’re providing to the consumers that are using medicaid. One doctor, Dr. Martha Boone in Atlanta, Georgia, said that she would have to see 20 patients an hour in order to make any reimbursement from medicaid. She said that medicaid paid none of their bills coming from her office for 18 months and when her office sent registered letters to Medicaid to see what the problem was they said it was a computer error and still didn’t reimburse her office (Heritage, 2010). Because most doctors don’t receive money from Medicaid, most of them don’t accept it. “Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital’s Web site.” (Connelly, 2009). This forces the Medicaid consumers to go to the emergency room when they need help since normal doctors rarely take their insurance. Dr. Lloyd Krieger says that the undoing of this healthcare bill is, “an urgent necessity.” because it is, “doing great damage even years before it’s individual mandates and other controls kick in.” (Krieger, 2011).