The Question of Health Care Access for Children

There are major challenges faced by policy makers such as trying to control the cost of Medicaid spending because Medicaid is the biggest payer of these services. Policy makers must ensure that they are also keeping the individual served front and foremost in their decisions. Ensuring that quality services are met is one piece of the puzzle. As stated, unfortunately it seems that those who have lesser insurance or who cannot afford these services are provided with less than

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

Mr. Little’s May 13, 2014 email (Exhibit 2) specifically required vendors to submit a list of requested non-Medicaid rates for the services each vendor would provide. In follow-up conversations with Mr. Williams our team explained that it would impossible to submit these rates in advance, unless we submitted the rate for every possible procedure a vendor could potentially provide. The process outlined in Exhibit 2 would be fine if we made appoints for youth for a specific service, and that was the only service provided. However, anyone who has ever had a doctor’s appointment understands that during an examination a doctor has the discretion to order additional services or tests based upon their initial

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.

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

The enactment of the ACA in 2014 would make it possible for more working and nonworking parents to qualify for Medicaid. Based on the income levels, 51% of working and 37% of nonworking parents qualified for Medicaid prior to the ACA. Afterwards, the percentage increased to 138% for working and nonworking parents, and childless individuals. The projections showed a 38% increase in the number of children 6-18 eligible for Medicaid coverage and fewer on the North Carolina’s Health Choice insurance plan. This increase would have been huge based on the case study (Short, 2013). State officials chose not to go with the Medicaid expansion program, and instead offered marketplace exchanges. This could mean North Carolina would potentially have a large number of uninsured

In 2008, during President Obama’s campaign, President Obama announced that he would fight for a national health care system that helped millions of uninsured Americans obtain health insurance. The Affordable Care Act, also termed Obamacare, passed on Christmas Eve of 2009. While some people believe the Affordable Care Act is great, others are not too fond of the of it. From passing the bill, the government hoped to expand Medicaid eligibility to help more people whose income was meager or near poverty level. Although the idea was good, studies show that people of color, families in rural areas, and those with cultural and language barriers struggle to receive health care and pay for it. Furthermore, since Obamacare passed into law, the

Although the Affordable Care Act (ACA) has increased the number of insured, the problem of access to primary care still remains an issue due to the large pool of individuals who are now receiving coverage. Nonetheless, even if the current health care reform debate increases insurance coverage, residents in areas with inadequate physician supply will still have greater difficulty receiving timely and appropriate clinical care (Walker et al. 2010). Over the last decade the healthcare system has continues with relatively the same level of access to care for most Americans, and although there is an upwards of 84% of Americans have some form of insurance, the rising cost of care, the large group of uninsured and underinsured, and the lack of focus on

Medicaid financing has become an increasing issue for most states throughout the years. The Government Accountability Office (2010) reported that forty-seven of the states as well as the District of Columbia had concerns regarding the sustainability of their program. Around 16% of the state budgets go towards Medicaid each year, totaling around $183 billion (Center on Budget and Policy Priorities, 2015). A significant share of vulnerable populations relies on Medicaid for medical coverage. Rocco, Gellad, & Donohue (2015) estimated that of the

Medicaid has grown exponentially after healthcare was expanded under the Affordable Care Act. However, this did not guarantee an increase in access to health care services, as many providers do not accept Medicaid beneficiaries, one of many reasons being low reimbursement rates. This discrepancy in rate reimbursement is further underscored when compared to those

Social problems exist all around us, one that seems to be quite prevalent right now is the Affordable Care Act is also known as ACA or more commonly known as Obama Care, which is a derogatory term meant to lessen or negate the President who founded it. There are many issues with this particular act that it’s difficult to pinpoint just one. However, I feel as though the utmost obvious is the negative shadow that is cast upon the Affordable Care Act, this is the real problem. The greatest common insurance that is utilized through this plan is Medicaid, which is insurance that is issued by the state that you live in, and is determined by income (CMS.gov, 2013). The main objective of this policy is to provide medical care for the

One of the reasons for this is that having a chance of seeing a specialist in D.C is more problematic than any part of America as findings have shown (8% nationally vs. 12% in D.C). The access to dental and developmental assessment is a challenge to both parents and children. In the years 2004 through 2008, ambulatory care has worsened in this part of the country since there have been increased cases of the hospitalization of patients related to the care. For the last two decades, it has increasingly become difficult for a number of people in D.C to pay for premiums that health insurance require them to. The situation has even been made more desperate because of the soaring amounts premiums each year, not forgetting that health care cost has also heightened thus most of the burden has been shifted to the consumers themselves. The citizens have had to deal with increased deductions whereas the covered services have been cut accordingly. The middle and low-income families deserve a relief from this ever-increasing cost of health care. The Affordable Care Act (otherwise better known as the Obama Care) has come at a time when it is needed more than ever. If fully implemented, it will bring a big relief to Many Marylanders.

In addition to the immediate health and financial benefits that Medicaid provides, children covered by Medicaid experience long-term health and economic gains as adults such as better health status, higher educational attainment, and greater earnings. Medicaid and the Children’s Health Insurance Program (CHIP) play an important role in providing health coverage for millions of children across the country. While the programs differ in terms of size and scope, financing and program design, together, they provide coverage to more than one in three children. In June 2013, over 28 million children were enrolled in Medicaid and another 5.7 million were enrolled in CHIP (Rudowitz R., Artiga S., and Arguello R., 2014).

Changes in access to health care across different populations are the chief reason for current disparities in health care provision. These changes occur for several reasons, and some of the main factors that contribute to the problem in the United States are: Lack of health insurance – Several racial, ethnic, socioeconomic and other minority groups lack adequate health insurance coverage in comparison with people who can afford healthcare insurance. The majority of these individuals are likely to put off health care or go without the necessary healthcare and medication that is needed. Lack of financial resources – Lack of accessibility to funding is a barrier to health care for a lot of people living in the United States