The Pros And Cons Of Mediciciana Plan

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

Mental Health coverage prior to the Affordable Care Act was far to none. With about nearly one-third of currently covered individuals having no coverage for substance abuse disorder services and approximately 20% having no coverage for mental health services. Services such as outpatient therapy visits, impatient crisis intervention and stabilization were among many that were not offered. Since the Affordable Health Care Act has been passed more individuals are able to afford health insurance that were once uninsured. It has helped many individuals in being able to obtain medical services that were once inaccessible.

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).

Those who utilize the Medicaid system range from low income families to the over 65 age group. Within this population is also those who are disabled due to physical or mental problems. This is among the sickliest of our American population. A paper based on a study in Oregon stated that “Medicaid significantly increased the probability of being diagnosed with diabetes, and being on diabetes medication as well as high blood pressure and high cholesterol.”(Baicker et al., 2013, p. 1715). Much of this is due to the struggle that the Medicaid beneficiary has

The federal Affordable Care Act (ACA) together with Illinois Public Act 98-104 will increase access to health coverage as a critical step toward improving the health of the people of Illinois (HFS, 2014). Illinois residents can use the health insurance marketplace, but easily compare health plans and see what costs are better for them before buying a plan. Every plan is covered essential benefits such as preventive care, doctor visit prescription drugs, maternity care, emergency services, hospital stays and more. Residents can succeed for financial help through the Marketplace to lower monthly premiums and out-of-pocket costs. Insurances companies’ cannot reject residents that apply for coverage for they are sick or have a preexisting health condition. People can receive Medicaid for the first time low-income adults who are legal residents, regardless of parental or health status may be eligible for health coverage through Medicaid. Adults that have incomes at or below 138% of the federal poverty level on the family may be eligible. Application for benefits Eligibility is an easier to apply for Medicaid, SNAP, and the Medicare Savings. Indiana purpose of healthcare reform for residents is enrolling adults in its new Healthy Indiana Plan. The plan was offered in the state of Indiana. With the plan,

For close to 50 years, the Mississippi Medicaid program has provided health coverage for its low-income residents. “While Medicaid originally only insured Americans receiving cash welfare assistance, Congress expanded it over the years to help insure those left behind by the private insurance system”.7 Medicaid in the state of Mississippi is a health care program that help pays for medical services for its low income residents. In Fiscal Year (FY) 2009, Medicaid provided $3.9 billion in benefits which attributed to 20.4% of all health care spending in the state7 and insured 754,333 – 1 out 4 (25.6%) state residents.6

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

Many forms of 1915 and 1115 waivers have been proposed and implemented in Florida and other states in the past. According to Holahan, Coughlin, Lipson, & Rajan (1995), the section 1115 research and demonstration waivers are designed to allow states to develop new solutions to health and welfare problems. The federal government may waive some standard Medicaid rules if the change is deemed to be budgetary, no higher than it would have been expected without the waiver (Holahan et al., 1995). States using these waivers have proposed to save money by using managed care plans for current Medicaid patients, and limiting the cost of new Medicaid enrollees (Holahan et al., 1995).

As previously illustrated, there are both advantages and disadvantages of Medicaid. However, being a beneficiary of Medicaid increases access to health care. As a result of the program, adults were 70% more likely to have a regular place of care, “55% more likely to have a regular doctor than the adults who did not gain coverage;” and the utilization of preventative services have increased (Garfield & Paradise, 2013). Furthermore, access to speciality care such as physical therapy; podiatry and hospice remain unattainable. In a multiple city audit, researchers found that only 34% of Medicaid beneficiaries were able to “secure an appointment for urgent” specialist care, compared to 64% of those privately

The original purpose of the Affordable Care Act (ACA) was to address the rising amount of healthcare cost in the United States, and substantially increase the amount of Americans insured with access to affordable healthcare. The ACA allows for the expansion of Medicaid; the government health insurance program, which is designed to increase enrollees for low income families in Medicaid. With this new legislation people who are under the age of 65 who are at or below 133 percent of the poverty line will have access to Medicaid. Anyone who earns below 400 percent of the poverty line will qualify for subsidies for health insurance. (Cockburn, 7) Americans who earn above this level must either buy insurance, or use their employer’s coverage. This is a huge implication because the estimated of new enrollees in 2014 estimated by the Congressional Budget Office is between 16 and 17 million. The federal government has agreed to finance this expansion of Medicaid for the first three years of implementation, for states that agree to the program. After these three years the states will have to start to pay a small portion of Medicaid. Many people with substance abuse problems, and mental disorders without insurance, are low income earning childless adults. (Bainbridge, 5)Under the ACA these Americans now have access to behavioral health treatment, in the 26

Policy plays a key part in mental health care services available to the public. They can determine what options and treatments are available and how much an individual will pay for them. Recent policies including the Mental Health Parity and Addiction Equity Act of 2008, the Affordable Care Act, and the Children’s Health Insurance Program Reauthorization Act work to expand access to coverage. It is important to know how policies play a role in the health care that individuals receive.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted on October 3, 2008 as sections 511 and 512 of the Tax Extenders and Alternative Minimum Tax Relief Act of 2008. MHPAEA amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHS Act), and the Internal Revenue Code of 1986 (Federal Register, 2013). The MHPAEA is an extension of the Mental Health Parity Act of 1996, which prohibited annual or aggregate lifetime financial limits on mental health coverage by addressing other restrictions, such as limits on outpatient visits or inpatient days (DOL, 2010). MHPAEA expands parity requirements to treatment limitations, financial requirements, and in- and out-of-network covered benefits (Smaldone, 2010). It also expands the opportunity of mental health parity requirements at the federal level and includes substance use disorders within its scope. Prior to 1996, health insurance coverage for mental illness had historically been less generous than that of other physical illness (Sarata, 2011). Mental health parity is a response to this disparity in insurance coverage, and generally refers to the concept that health insurance coverage for mental health services should be offered equally with covered medical and surgical benefits (Smaldone, 2010).

In 2010, the Affordable Care Act invoked a $75 millon dollar demonstration project known as the Medicad Emergency Psychiatric Demonstration that was amended in section 2707 of the Affordable Care Act (ACA). The change seemed to be just what the nation needed, however, there was fine print added to the amendment that changed the interpretation. The fine print stated, patients who are on Medicaid from the ages of 21-65 seeking inpatient mental health care can receive treatment under the law. However, the inpatient facility will receive no

Preceding the enactment of the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, approximately forty-nine million individuals in the United States were uninsured. The Mental Health Parity and Addictions Equity Act (MHPAEA) does not command or require coverage for mental

Research conducted indicates that this method of fund raising will increase the state resources by approximately 11% and as a result more low income individuals and families will have access to appropriate health services to manage their conditions (CPBB, 2015). It is proposed that the federal and state government allocate the funds obtained towards the Medicare and Medicaid programs. This will expand the services offered by these programs and with additional funds; they can provide individuals with access to specialized care and services needed to manage their condition. However, it is imperative that the federally established poverty guideline be periodically re-evaluated, to increase the percentage of individuals that are eligible for subsidized health care. The idea is to have individuals with chronic illness sign up for the packages that offer the services and care needed. With the aforementioned, proposal for increasing both the federal and states health care budget, the goal of providing all Americans with access to health care, will become realistic. The goal of the ACA is to ensure that everyone has access to healthcare, so by providing government assistance to individuals in need to manager their illness will ultimately reduce the long term health care cost. Chronically