The Occupational Hazard Of The Coal Mining Industry

In present times, people with high incomes that’s above the 100 percent poverty level is eligible for premium subsidies to purchase private plans in the health care market. Individuals that are below the 100 percent of poverty in states that don’t wish to expand Medicaid; do not have access either to subsidized private coverage or Medicaid (Garber & Collins, 2014). Originally, the law require that all states expand Medicaid eligibility, to enable those people living with income that is increasing to 138 percent of the poverty level. These factors are equivalent to $15,856 for each individual and $32,499 for a family living in a single dwelling (Garber & Collins, 2014). In 2012, the Supreme Court made these regulations optional for ruling.

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 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 Affordable Care Act (ACA), also referred to as ObamaCare, is a complex U.S healthcare reform that attempts to expand and improve access to healthcare and decrease spending through taxes and regulations. The main goal of the ACA is to provide more Americans with affordable health insurance. States vary in when and how they implemented the ACA in order to meet the needs of their state in hope to decrease the uninsured population. Every state had the option decide whether to offer healthcare through a state-based or a federal marketplace. Some states sued the federal government questioning whether they even had to right to impose this act. New Mexico and Pennsylvania are just two of the states that have had to figure out a way implement the Affordable Care Act. Each one had to take into consideration several factors including their state population, the demographics of that population, how many uninsured people there were, and the economy of their state. They both had the public plans such as Medicaid, Medicare and Children’s Health Insurance Program (CHIP) options as well as new federal subsidies that would now be offered depending upon income. Since there is no “one size fits all” health plan each state was challenged to make the best decisions using the tools available to them. This information was then used to formulate a plan that would give the most people access to affordable healthcare in each of these

Before the ACA was passed, all states decided to raise the eligibility for children under Medicaid and Children Health Insurance Program (CHIP). North Carolina raised the Medicaid FPL for families with children greater than 6 years old up to 216% (Milstead, 2013, p. 203). However, now that North Carolina has not chosen to expand the Medicaid program non-disabled adults are limited to 43% FPL and childless adults are ineligible (Kaiser Family Foundation, 2014). Those not eligible for Medicaid and CHIP that have incomes between 100% and 400% FPL may be entitled to tax credits if they purchase insurance in the marketplace (Kaiser Family Foundation, 2014). This raises another problem in North Carolina’s uninsured population. The ACA is written by the principal of low income people receiving coverage through the Medicaid expansion, therefore people below FPL are not eligible for Marketplace subsidies (Healthcare, 2015). North Carolina’s uninsured adult population is around 319,000 which is 20% of the uninsured in the state (Kaiser Family Foundation, 2014). This population qualified for the Medicaid expansion under the ACA and all fall below the FPL and now will remain uninsured.

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.

However, in states that have not expanded Medicaid, eligibility for adults remains limited, with median eligibility level for parents just 44% of poverty and adults without dependent children ineligible in most cases. Over 3 million poor uninsured adults are in the “coverage gap” because they earn too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits

Medicaid initially established that each state is responsible for designing their medical costs to pay medical care for the poor. Also, Medicaid created as a voluntary program for each state; they have to have the choice to participate. For one thing, because of the rising costs of healthcare, it has been difficult to bring Medicaid recipients into the “mainstream” of United States (U.S.) medical care. Donald R. Barr notes, “between 1975 and 1989, the cost of the Medicaid program increased by an average of 11.9 percent per year before adjusting for inflation” (172). The rising costs of healthcare are necessary for each state to determine if it is beneficial for them to participate in the Medicaid program. As the government level of payment is determined by each state economic condition. For instance, a state with lower per capita income will receive more government funding. A state with higher per capita income receives less reimbursement for program costs. Therefore, on December 31, 2010, many states continued to experience budget cuts. As a result on August 2010, Congress increased reimbursement rates through June 2011.

Holahan, J., Buettgens, M., Carroll, C., & Dorn, S. (2012). The cost and coverage implications of the ACA Medicaid expansion: National and state-by-state analysis (Publication # 8384). Retrieved from The Henry J. Kaiser Family Foundation: http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8384.pdf

Currently, Medicaid expansion has been implemented to cover individuals up to 138% of the federal poverty level. It fills in the coverage gap between individuals whose income is too high to qualify them for Medicaid but too low to purchase a healthcare plan on the exchange market. This policy has provided health insurance to millions more of Americans, created jobs

In the article, This Is What Happens When Your State Blocks The Medicaid Expansion Jonathan Cohn discusses the impact that the Affordable Care Act has had on the percentage of people that have health insurance in the United States. Cohn goes in depth about what the Affordable Care Act is and why it has been so beneficial to the states that have adopted it, most specifically the expansion of Medicaid. Cohn also addresses the loophole that allows states to opt out of the federal program due to a Supreme Court ruling in 2012 that allows states to block the Medicaid expansion. The new Medicaid expansion has helped lots of Americans get access to health insurance that they would not have had access to otherwise, but some states are not taking

enrolled in the new program. The $8 billion includes the state share of costs for both newly eligible adults and the additional Medicaid participation among currently eligible populations that would result from expansion. If all states implemented the Medicaid expansion, federal spending would increase by $800 billion, or 21 percent, compared to the ACA with no states implementing the expansion (Holahan, et al., 2013). Therefore, although the increase in spending per state is relatively small, the cost to our nation is exponential. With the national debt growing day by day, many believe that an exponential increase in national spending is a difficult thing to justify.

Healthcare is an industry that encounters numerous challenges such as cost and a myriad of uninsured individuals throughout the country. In 2010 the Affordable Care Act was executed as a means to provide the uninsured the opportunity to obtain health insurance. While a vast number of the states were on board with expanding their Medicaid coverage, there were some who opt to participate. The state of Georgia declines to broaden the program, although there are approximately 700,000 people without medical insurance. The state is facing a challenging decision since expanding Medicaid will consume an enormous portion of the state budget. Undeniable Georgia would prefer not to provide coverage to those who are not able to acquire coverage by

During the beginning of this era, reformers had the support of President Theodore Roosevelt who thoroughly believed “that no country could be strong whose people were sick and poor”. In 1915, a bill was proposed by the American Association of Labor Legislation (AALL) that limited coverage to working class individuals whose annual income was less than $1200 a year and included hospital services, sick pay, maternity benefits, and funeral expenses (Palmer, 1999). This system was believed to “relieve poverty caused by sickness” and would “yield a net savings for society” that would benefit not only citizens but businesses as well (Toland, 2014). Opinions on the AALL bill were mixed. The American Medical Association (AMA) was included in the formulation of the bill, leading them to create a committee whose entire aim was to assist the AALL but a disagreement over physician payment led the AMA to redact their support (Palmer, 1999). The American Federation of Labor continuously spoke against universal health care, fearing that it would result in complete state supervision over citizen’s health and would undermine current worker unions and the benefits they provided. Within all of this was also the strong opposition of the private insurance industry which, oddly enough, rested on the inclusion of death benefits in the AALL bill which had

A research study provided by Harvard concluded that individuals who did not have access to an adequate health insurance policy had a forty percent higher risk of death than there more financially inept counter parts. According to this study an average of one American dies every thirty minutes due to lack of adequate health care due to financial ineligibility. The work force also known as middle class americans are truly the ones who are directly affected by the intelligibility to afford decent health care. Consequently working class americans are the ones who traditionally are the unhealthiest due to the nature of many of the individuals careers. For example, black lung is known occupational hazard in the coal mining industry. Starting in 1968, there have been 75,000 death contributed to black lung. It was not until 1978 that the coal miners were compensated for sickness and death contributed to black lung disease.